Hold Me Closer, Tiny Cancer

It all started in 2022 with a Christmas dinner I was cooking.

It was a family recipe, a hearty soup made with layers of toasted Italian bread, shredded chicken, mozzarella cheese, then the layers repeated. It's delicious comfort food. But my wife Marie came into the kitchen and asked (sternly), “What are you doing?”

I was bewildered. “I’m baking the soup.”

“You’re BURNING it! Can’t you smell that?”

Actually, I could not. I couldn’t smell a thing, not even the usual pleasant aromas of this dish, as the cheese and bread baked to a golden brown on top. But I had an explanation for this. Months earlier I attended my fiftieth high school reunion (oh, how it pains me to admit that), and as a memento, I took home a mild case of Covid. A little fatigue, no fever, and it was knocked out of me with a little Paxlovid. So I just figured I had long Covid, which affected my sense of smell. 

Oh, how I wish now that was all it was.

Heading into 2023, not only was my sense of smell not returning, but I started getting pains around my left eye. Then I got little bursts of pain on my face. Next were piercing headaches in the middle of the night. These pains were all along my sinuses, but the sinus medications I was taking did not work.

I went to an ear-nose-throat specialist for an examination. He said, “Whatever this is, it’s beyond my abilities to diagnose you in this office. I’m going to send you in for a CAT scan.” 

Then he paused. “No, I’m going to make that an MRI. That’s a better way to find out why you’re having nerve pain.”

I had the scan, and I waited for a call on the results. In a few days, he called from an airport terminal.

“Mr. Rocchi, I’m coming home from a medical convention. The tests show a mass in your sinuses. I’m going to refer you to my colleague who is a head & neck surgeon. He’s better qualified to discuss this with you.”

A surgeon is better qualified to discuss this? A medical person who invades you with sharp tools to fix your problem? Oh, this sounded threatening.

In a few days, I was in the head & neck surgeon’s office, and he showed me the scans of my skull. “See this area behind your right eye? It’s all dark. That means there’s nothing there.”

Then he switched views. “Behind your left eye is all white. That means there’s a mass there. We have to perform a biopsy to see what this is.”

He was right. The area was as white as the audience for a Barry Manilow concert. “Hm,” I murmured. “Is it cancer?” He said he couldn’t tell without a biopsy.

“Okay, what are the odds that it’s cancer?” Again, he couldn’t tell without the biopsy.

I tried again. “Okay. What are the odds that it’s malignant?” Again, he said he did not know without a biopsy. But this time he drew a long breath.

“I can tell you that growths generally don’t get this big if they’re not malignant.”

That hit me right between the eyes, both the one with the mass and the one without. That’s what I get for being nosey.

ENTER THE TUMOR BOARD
I got the biopsy in mid-October, and a few days later, Dr. Head & Neck told me and Marie that I had an aggressive squamous cell carcinoma in my skull. There was also evidence that it had breached the “floor” of my cranium, leaching into my brain. This location made surgery more difficult and less desirable as an option.

There was some good news. (I presume, reader, you may be looking for better news yourself as we progress here. I’m sure some of you are saying, “Pat, you’re a comedian. When does the funny part start?”) First, there was no evidence the cancer had metastasized; it was confined to my head. Also, the cancer had not entered my lymph nodes, so there was less danger of it spreading.

Next, I met my “Tumor Board,” which is a team of oncologists and surgeons dedicated to your case. Now that surgery was off the table, they had a new plan, which was explained to me by a younger physician, whom I would have preferred to be older and more experienced. They would start with a fairly aggressive chemotherapy regimen, (damn, there’s that word “aggressive” again!), which would comprise three infusions over nine weeks with the hope of beginning to shrink that tumor. After the infusions, I would start seven weeks of radiation.

I asked, “I presume this treatment is designed to shrink the tumor enough to make the surgery easier.”

Doogie Howser looked earnestly at me and said, “Oh, no, Mr. Rocchi. Our goal is to cure you.”

Now that seemed like a worthy goal. You see, the idea of surgery on my head and my brain was not appealing. My head is one of my two favorite body parts, and I don’t like the idea of surgeons messing with either of them. I got the first of my three chemo infusions the third week of November – just in time for Thanksgiving. Yea! Nothing whets the appetite like having lethal chemicals pumped into your body. (Actually, I was very lucky. Not only did I enjoy my Thanksgiving dinner, but I was never nauseous over those nine weeks.)

My one big side effect was that my thick hair started to fall out. (People have asked me, “Pat, did the chemo make you lose your hair?” My answer was, “No, I never lost my hair; I always knew EXACTLY where it was! It was on my pillow case, on the kitchen counter, in the shower drain….” I had to bite the bullet, and Marie and I put the electric razor to my scalp. It was a pity. A guy thinks of himself as Superman, and he ends up looking like Lex Luthor.)

EVERYONE HAS ADVICE, EVEN ME
When you start to tell people you have cancer, most have advice for you.  It’s usually in the form of fatuous spiritual or philosophical advice. Like, “Take one day at a time.” Or, “When God closes a door, He opens a window.” Yeah, and hopefully I can jump out of it to get away from tripe like this.

But the worst is when they say, “You know, something like this (diagnosis) really makes you think.” Dude! I’m in my seventies! If I hadn’t already been thinking about my mortality before this, what kind of a person would I be? No, these life crucibles do not make you think; they reveal your thinking.

My sister- and brother-in-law shared some particularly pertinent advice with me from the time their then-20-something year old son contracted a life-threatening cancer. He had pain at the tumor’s site as his treatment was shrinking it, so the oncologist suggested a visual: Imagine the tumor hanging on for dear life by a bunch of roots. As each root breaks away, one by one, pain occurs. This visualization could help me envision how my own healing process was progressing, just as my nephew was eventually cured.

Unfortunately, my own warped imagination envisioned Elton John crooning, “Hold me closer, tiny cancer…." Sometimes I'm too whimsical for my own good.

Here is my own advice to cancer patients: When you go to meetings with medical staff, have another person with you to take notes, because you never hear them clearly. Clinicians may say something as diplomatic as this:

“Mr. Rocchi, this treatment is designed to shrink your tumor without surgery, first with chemotherapy and then with radiation. The results have been very encouraging with other patients.”

However, this is what you will hear:

“AAGH! I HAVE CANCER! I HAVE CANCER! THERE’S NOTHING THEY CAN DO ABOUT IT!”

So have someone there with you, like I had Marie.

You see yourself as Superman, but end up looking like Lex Luthor!

I made it through the holidays, even managing to perform stand-up along the way. (Thank God for that Santa hat to cover my thinning hair.) But in the new year, after the chemo was complete, my oncologists said we didn’t achieve the results they expected. “But that’s okay,” one said gamely. “We are still confident the radiation will work.”

In February, we started seven weeks of radiation, five days a week, accompanied by what the docs called “baby chemo.” I presume this term was meant to describe a “small” dose that would boost the effects of the radiation, but you couldn’t prove that by me. I thought it described the feeling afterward of having a baby grand piano dropped on me. At any rate, I still had enough stamina to officiate three weddings and win a stand-up competition. 

Friends and family rallied behind me. I had more prayers said for me in Philadelphia churches and synagogues than are said for the Eagles during the playoffs. I’m an ecumenical person, so I gladly accepted prayers from all religions. You’re a Wiccan? Welcome aboard, Samantha!

Still, it was increasingly harder work to stay positive, if for no other reason than to see my hair still falling off my body. Everywhere. On most mornings, I stared into the shaving mirror, looked at how my hair was abandoning me like lemmings off a cliff and saying, “Well, boys. I don’t know how much longer we’ll be together.” But I took even that uncertainty in stride.

CRASH LANDING
My radiation and chemo lasted all of Lent, from Ash Wednesday to Good Friday. As a Catholic, I preferred to look at this coincidence positively, ultimately resulting in my resurgence. (I could have also looked at it ending in my martyrdom, but I didn’t go there.)  After bombarding my body with radiation and chemicals for seven weeks, my Tumor Board let my body sit for three months as this recipe cooked inside of me and worked its magic, sort of like starting a sourdough by creating a live culture. In the meantime, I stayed busy with my stand-up and weddings, including a fundraiser for autism and another for a nursing program at the University of Pittsburgh.

In the midst of my treatment, I could still do
a fundraiser for autism. My hair first came back as
white; later it would return to its original color.

Now my worst side effect was that I lost all my taste. No, I don’t mean I starting wearing leisure suits and watching reality TV shows. I mean my taste buds were shot. Marie is a great cook, but even her fine meals started tasting like I was chewing on The Wall Street Journal. That is too cruel to do to an Italian American! I had to force myself to eat to keep my weight up or risk getting a feeding tube, and I don’t think they could have force-fed me ravioli and meatballs through one of those.

Any positivity I had left was destroyed when I met with one oncologist at the end of June to discuss my latest scans. She uttered the most ominous phrase of my life.

“Well, we didn’t get the results we were expecting, (insert long pause here) and we’re running out of options.”

Wow, first the diagnosis, now the failure of the treatment. There is something to be said for bedside manner. 

I knew what this meant. To cure me of my cancer, they needed to perform surgery. Remember? The procedure that Dr. Head & Neck said he didn’t have the room for? The surgery that would include working on my brain? That part of my body that helps me think, make decisions, and remember my jokes?

To verify this, Dr. Head & Neck ordered another biopsy, and that showed there were indeed live cancer cells still squatting in my sinuses and taking up residence. That meant it was now urgent to perform surgery and get those little f***ers out of there. Otherwise they could start growing again, and I would be back to where I started, and that could have been my end.

The surgery would be a two-part procedure. First, Dr. Head & Neck would go up my nose to clean out the cancer in my sinuses as best he could. Then the neurosurgeon would give me an incision from ear to ear, like a woman’s headband. He would then pull my brow forward, cut a hole in my forehead, scrape the cancer from my brain. Afterward, he would reassemble me.

(Yes, that description was a lot for Marie and me to handle, too. But it was much like the French energy who was asked why his country had so much nuclear energy. He said, “There are four reasons. We have no oil, we have no gas, we have no coal, and we have no choice.” Yep, Marie and I knew we had no recourse but to undergo the operation.)

REVERTING TO FORM
Long story short, I had the procedure in September 2024. As I laid in the pre-op room, I was advised of how the anesthesia would work. And then… and then…

Next thing I knew, I opened my eyes in post-op. I scanned the room and saw Marie. Then my daughter. Then my son and his wife. Behind them were the surgical staff, almost standing guard to see what I would do next.

“Well, I guess I made it,” I said to myself.

Apparently, I was quite entertaining while I was in that Twilight Zone between the lingering influence of the anesthesia and being completely sentient. Hey, you can’t keep a good comic down. The problem was that while I was semiconscious, I reverted to the oldest and worst jokes I could have told.

In the first case, my daughter baited me. She thought I might have been cold and pulled a blanket up on me. “Are you comfortable, Dad?” she asked.

I said, “I make a good living.”

Oh, Jeez, I resorted to Henny Youngman.

Then a physician came in to test my reflexes. I asked, “Doctor, will I be able to play the piano after this?” He said, yes, of course.

“That’s funny. I couldn’t play before.”

In case you’re wondering, I am ashamed of that. Even under anesthesia, I should have had better jokes. Apparently, my family was also ashamed, because they waited three months to tell me about this

The right hat adds a lot to
your release from the hospital!

Ultimately, there are many happy endings to this story. I returned home after six days with few complications; just some clots we treated with blood thinners. The hospital gave me a walker that I never needed and a cane that I used once for a walk on the city’s pavements. In four weeks, the neurosurgeon, pleased with my progress, released me, and I was driving again.In four more weeks, I was back on stage with a 30-minute set and hair. The next weekend I performed nearly an hour on stage as a closer. My stamina was back.

All of this is why I enter 2025 with hope and optimism, but mostly with a profound sense of gratitude. Beginning with that first frightening diagnosis, I had clinicians from New Jersey to Philadelphia to Baltimore weighing in with encouraging opinions. When surgery was deemed out of the question, the Tumor Board had a treatment plan as an alternative. And when that treatment did not work as expected, Dr. Head & Neck stepped in to cure me with the surgery that was too risky to consider at the start. In that time, he also revealed a wellspring of compassion and advocacy that he previously quelled so I could give informed consent and comprehend all the hard facts and risks of the procedure – an operation that he and the neurosurgeon performed exquisitely to save my life. 

Yes, I am alive. That is the best news of all. And you know what? I have more good news. You’re alive, too!

What will we do with that fact? What will you and I and all the people around us do with however much time remains for each of us?

I know that I will be recommitting myself to my comedy. Goodness know we can all use a laugh these days. So look for me on a stage near you. I intend to entertain you and make you feel as happy as possible.

Just don’t expect me to play the piano. Despite what that doctor promised, I still can’t do that.