Like any good third grade teacher, Kathleen Alexander’s response when she heard she had Hodgkin’s disease was to look it up.
“According to the encyclopedia, I didn’t have a very good chance of living,” said Alexander, who was nicknamed “Nan” as a child. “It was the wrong thing to do because my encyclopedia is very old.”
John P. Farnen, MD, her Gundersen Lutheran hematologist, quickly reassured her. “Dr. Farnen called me and said this is the most curable kind of cancer there is and said that if you have to have cancer, this is the one to pick. That made me feel better, of course,” she said.
Treatment has dramatically improved for Hodgkin’s disease, a lymphoma that attacks the immune system, due to research and clinical trials at medical centers around the country. Gundersen Lutheran and other institutions share information and research results to hasten identification of more effective, less toxic treatment plans. By participating in national studies, Gundersen Lutheran can offer Alexander and other patients many of the promising treatments available at major cancer centers in urban areas far from home.
While Alexander was naturally frightened to have cancer, even a treatable type, it was a relief just to know the cause of her medical problems. With a diagnosis, she and her doctors at Gundersen Lutheran could begin the battle for her life.
The first hint of trouble for 61-year-old Alexander, who lives near Readstown, Wis., came during her yearly checkup in July 2000 at Viola Health Services Center. Carol Dinges, MD, noted a low red blood cell count, an indication of anemia.
“I knew I was tired, but I also knew that people get tired as they get older,” she said. “I took iron, but it didn’t change my blood count at all.” She had looked forward to that fall because her third grade class at Kickapoo Elementary School was only going to have 12 students. “I taught 14 days and realized it was not fair to the students to have a teacher who was so tired, and it was not fair to my health.” Dr. Dinges referred Alexander to Farnen to help piece together the reason for her low blood counts.
At first, Alexander's anemia was baffling. Despite several tests, including a bone marrow biopsy, no cause for her low blood count could be identified. Fortunately, a breakthrough came from a clue provided by her husband, Ray. He noticed his wife awoke several times a week, confused, disoriented and physically cold. By taking her body temperature hourly each time this happened, he found it fell five degrees or more below normal.
Given this crucial information, Farnen suspected Alexander's blood sugar was dropping to low levels at night. A consultation with Gundersen Lutheran endocrinologist Gregory Pehling, MD, confirmed low blood sugar as a cause of these unusual symptoms. Alexander was then admitted to the hospital and tested for a possible pancreatic tumor. Farnen was surprised when radiologist Yung Kim, MD, gave him the scan results. There was no tumor in the pancreas, but enlarged lymph nodes were found throughout Alexander’s abdomen – a clue that pointed to Hodgkin’s disease.
The diagnosis was confirmed by a lymph node biopsy at Gundersen Lutheran. This procedure, performed by Larry Fundell, MD, allowed Alexander to avoid major surgery. A positron emission tomography (PET) scan at the University of Wisconsin-Madison Hospital and Clinics was correlated with CT scans at Gundersen Lutheran to determine how far the disease had spread.
With her medical mystery solved and a firm diagnosis at last, Alexander weighed her treatment options. One was an experimental protocol with chemotherapy and radiation therapy. The other was a standard chemotherapy only approach. She chose the second plan to save radiation therapy as an option should cancer recur.
Treatment began in April and included a regimen of four drugs every two weeks and booster shots of white cells between treatments. She finished the last treatment in September.
“It went really well,” she said. “I was never sick, which is really great. Sometimes chemo gave me extra energy. I could dance all night. Sometimes, I would be worn out.” All along the way, she was supported by her husband, family, friends and of course, the staff at Gundersen Lutheran.
“I can’t say enough about Gundersen Lutheran. It just amazes me how well the whole system works,” she said.
Any time she had questions, someone was there to respond. “They even called me to make sure that I had the information straight,” she said. “My husband went with me to every appointment and every chemotherapy treatment. If I didn’t ask a question, he did.”
Her husband also said she had wonderful care. “Did she ever,” he said. “I couldn’t pick out a bad one up there. I’m pretty proud of all the staff and the doctors.”
When she started treatment, Alexander marveled how well staff members and a volunteer seemed to know everyone in the waiting room. She soon realized that personal attention was just part of the caring. “They made me feel so comfortable,” she said.
Even a nurse, not normally assigned to the Hematology/Oncology Department, gave her a big hug on the day of her last treatment.
Alexander also developed friendships with others in the waiting room. “You develop a bond with other patients and their families.”
Over all, Alexander is clearly pleased. “I am so thankful to my doctors. They did the job,” she said, adding, “I think Dr. Farnen went above and beyond, to tell you the truth.”
Alexander is very excited about the Gundersen Lutheran Cancer Center, scheduled to open in early 2003. “I think it is wonderful. I figure we had to make a donation and help with the project,” she said. “It is a great convenience to have such a facility so close. We could be traveling and staying overnight to receive this kind of care.”
Alexander, who is on medical leave this semester, has decided to retire from teaching, believing it gives her the best chance to maintain her health. It was a difficult decision because teaching has been a part of her life for 35 years. During her career she taught her daughter, Lori Jensen, a Necedah resident; and her son Dan’s three sons, Daniel and twins Brad and Thad, who live near Readstown.
Since completing treatment, Alexander has found special pleasure in walking the land with her husband, particularly by their cabin, a relaxing getaway. “I love being outside in the fall and enjoying the weather. It’s been so great this year,” she said. “I was always in school. I didn’t realize there were so many nice days in the fall.”