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David Farrell lives and works in the small town of Holyoke, Colorado. The 6'2" volunteer firefighter and emergency medical technician (EMT) had always worked out and stayed in good physical condition. He and his wife, Nicolette, have two sons, two daughters, and three grandchildren. They enjoy motorcycle road trips, camping, and going to NASCAR races. In fact, he dates the first indication of the cancer on the base of his tongue as about three weeks after getting home from the Talladega 500 in Alabama.
When he arrived at the Speer Cushion Company that September 2004 morning, one of the women who worked for him asked, "What's that bump on your neck?" Dave had seen no bump while shaving only an hour and a half earlier, but when he went to a mirror, there it was, about the size of an egg.
"Like a typical EMT, after ignoring it for a couple of weeks, I diagnosed myself," he says. Dave thought he had an infected lymph node that would fix itself. After a couple of weeks, with the bump still there, he called the local clinic. He learned that a nasty bug was going around and took the prescribed antibiotic. The bump caused no pain. "We all somehow convinced ourselves that it had gotten smaller," he says. "So I just went about my life as I always had and celebrated Thanksgiving."
In December, he had a regular periodic check-up with a chiropractor. She told him he should stop ignoring the bump, adding that it was nothing she could do anything about.
"Being a typical male, and feeling healthy, I ignored it through the holidays." Finally, in January, he had an MRI, which showed a mass in his neck about 3 centimeters (one and a quarter inches) in diameter. At that point, Dave says, "Everybody still thought I had an infected, clogged-up lymph node." His Colorado surgeon removed the lymph node and sent tissue to the local hospital pathology lab for testing. The results were inconclusive, so the pathologist sent the tissue sample to Mayo Clinic for further analysis. Mayo Clinic sent the cancer diagnosis to Dave's local surgeon.
"My wife will never forget that phone call on Valentine's Day 2005," he recalls. Nicolette wanted to deliver the news personally, so she drove over to the shop to tell him he had cancer. "At that point we still didn't know what we were dealing with. We'd just been hit with the biggest baseball bat we'd ever been hit with."
The surgeon referred them to a local ear, nose, and throat specialist, who suspected he'd find a small tumor and scheduled exploratory surgery. "When I woke up he was painting a pretty bleak picture. The prognosis was not good, and my quality of life would be different," he says. "Our heads were swimming."
That night he awoke at 1:00 a.m. from a vivid dream of being at Mayo Clinic. Although he had never been there, he had heard of it for years, partly because of his EMT background and partly because his family is from Minnesota. When he got up, he found the phone number on Mayo Clinic's Web site. Through his community volunteer work, Dave has had a great deal of contact with medical facilities. He was amazed at how simple it was to communicate with such a large organization. In 10 minutes, he had set up appointments for March 16, 2005.
From his first contact, he says, "I was treated with respect and care," he says. "Nothing prepares you for the way people behave at Mayo Clinic. If I could run a factory as well as they run that place, I'd be a top manager."
The first in his series of appointments was with a specialist in Otorhinolaryngology (Ear, Nose and Throat). From the minute they sat down with the doctor they knew they were in good hands. The physician had the pathology report that Mayo Clinic had sent to the Colorado surgeon. After examining Dave's throat, he explained that Dave would need to have a physical exam and some tests, and added, "We've got a fight on the road ahead of us, but your long-term prognosis is very, very good."
Dave's next appointment was in Radiation Oncology, where he was pleased that the doctor "was already abreast of everything and said he was going to give me something to think about." It was good news to Dave that new studies had shown that treatment for the squamous cell carcinoma at the base of his tongue need not be too extreme.
Dave and Nicolette were again impressed when he went to his appointment in Oncology. "I don't know how they find these people, but they're just amazing. You never get the feeling that anyone is stretching the truth or holding back."
Additional tests showed that the cancer was only on the base of Dave's tongue rather than throughout his body. His treatment team worked out a seven-week schedule of radiation therapy Monday through Friday. That treatment was accompanied by three doses of chemotherapy: one on the first day of radiation, another midway through the radiation treatment, and one on the last day of radiation. "They'd had a lot of good experience with that particular chemo drug," Dave says, "which was very strong."
He and Nicolette rented an apartment and stayed in Rochester. "The whole downtown community is set up for people who are sick," Dave says. "The treatment is a monstrous process. Every week they'd run the scope down my nose and look at that tumor. I spent the last three weeks in a wheelchair. The week before I was supposed to be done, they told me the tumor was completely gone. I was so sick then that I tried to talk the doctor into letting me skip my final treatment." When Dave heard the statistics, however, he did have the final treatment. He decided the prudent course was to take no shortcuts.
"The treatment takes only three months out of your life, but it takes two years to get back to a full life. For the first three months I was home, my throat was so messed up that I slept in my recliner. I was out of work for nine months." He recently got rid of the recliner, which was a reminder of the bad days.
"Getting cancer is life altering. It changes your interactions with your family and friends," Dave says. "I'm really blessed. My wife and my mom did a ton of work. It's got to be tough watching your husband and son fighting for his life. It took me a long time to find myself again, to regain my confidence. I bet it was a year and a half after my last treatment when I could say I'm normal."
Dave enjoys his work as a volunteer firefighter, and it seems clear that his fellow volunteers enjoy his participation, too. When he and Nicolette drove into town after his stay at Mayo, the ambulance service and fire department greeted them on the highway and escorted them back into town.
"My checkups are spotless now," Dave says. "I learned that the cancer usually recurs within the first two years, and my two-year checkup was spotless. I'm certain that the choice I made saved my life. I feel sure I'll get to celebrate my 70th birthday."
