My cancer, the world’s Ukraine

My cancer, the world’s Ukraine

Looking back at a very difficult year with very real hope

Jonathan Lazarus  after his treatments began.
Jonathan Lazarus after his treatments began.

It’s been slightly more than a year since two events unfolded in my life, totally unrelated but nevertheless totally intertwined, one internal, one external. One thousands of miles away, the other closer than a heartbeat.

In February 2022, I was hospitalized in the oncology wing at Cooperman Barnabas Medical Center in Livingston, receiving chemotherapy while staying riveted to cable news reports on the massing of Russian forces along Ukraine’s borders. Tens of thousands of troops, columns of tanks and armored vehicles, and convoys of rolling stock stood poised to blitz the country in an operation that would take but a few days, according to the expectations of the Kremlin’s botoxed, bullying leader, the angry dwarf, Vladimir Putin.

(At this point, I wish to acknowledge my debt to the spot-on Ukraine articles in the Jewish Standard/and New Jersey Jewish News offering the insights and analysis of Alexander Smukler and the reporting and interviewing of Joanne Palmer, and to both especially for christening the diminutive, delusional Putin as the angry dwarf. And just last week, the pariah acquired an additional title: War criminal, courtesy of the International Court in the Hague.)

We all know how the dictator’s expectations blew up in his face and continue to do so as carnage and destruction not seen on the continent since 1945 surge into a second year. But as I sat in the hospital that day, absorbing the first chemo infusion for lymphoma, my thoughts turned repeatedly to a nation I could barely trace on a map just weeks before (even though it is Europe’s second largest after its tormentor, Russia).

A gripping David-and-Goliath drama unspooled before millions of viewers across the globe. I was born during World War II, when the Soviet Union was an ally, and then I came of age at the height of the Cold War, when it wasn’t, so I had watched newsclips of Moscow’s tanks crushing a democratic uprising in Hungary in 1956 and 12 years later doing the same dirty deed in Czechoslovakia during the Prague Spring. The Cuban missile crisis in between these all-too-short flickers of freedom put an exclamation point on East-West tensions and edged the world closer to the nuclear brink.

Later, when the Berlin Wall crumbled spectacularly and the Solidarity movement toppled the Polish Communist regime, I rejoiced for the oppressed people of Eastern Europe and hoped better days were ahead for the average Russian. I naively believed former Soviet republics now would be free to pursue their own destinies. We had gone to the moon and triumphed in the Cold War, and now I could look back at the Sputnik science scare and my 1950s civil defense classroom drills as illusory and unnecessary. It was time to let the Doomsday Clock expire.

Wrong, wrong, wrong.

Chechnya, Crimea, and Syria should have been the tells. I scarcely knew about Ukraine’s history (though my mother was born there and brought here at nine months in 1905), except that it had been brutalized by czars and starved by Stalin in the 1930s, during his collectivization frenzies. I had no appreciation of how deeply the seeds of democracy had taken root in a country that had served as a vassal state of the Soviet Union, or that it had ousted a pro-Moscow puppet president in 2014 after the Maidan Revolution, or that its current president was Jewish in a nation dogged by an antisemitic past, or that Ukraine had glorious artistic, linguistic, and cultural traditions of its own.

I did know, however, that when referring to Ukraine, we were to drop the THE — it no longer was the Ukraine. (My managing editor at The Star-Ledger, Andy Stasiuk, made sure the entire newsroom understood that.) I also knew that Ukraine had been in the Pale of Settlement, while Russia proper had not. Czarist decrees designating its Jews as shtetl-confined nonpersons still weren’t enough to exempt my grandfather, Max Adelman, from serving in Nicholas II’s army for five years before he fled to America.

In the before photo, he’s with his wife, Gail.

I also had come to know Ukraine as a focal point of MAGA Republicans in Congress, who tried to spin sinister scenarios about Hunter Biden’s role as a consultant for a corporation trying to do business with Kyiv before the last presidential campaign. Expect more yawn-inducing political theater as House GOP extremists attempt to resurrect this pseudo drama and other specious, shallow investigations in the months ahead. (This should not imply that Ukraine has earned a spotless reputation on eliminating government corruption.)

If you had asked me a year ago February if I thought I had a better chance of recovering from cancer (in my case large B cell lymphoma of the spleen) than Ukraine did of holding Russian aggressors in check, I would have said yes without a moment’s hesitation. Armed with the oncologist’s assurance that my form of the disease was highly treatable, I cultivated an optimistic outlook and eventually wrote about the experience for the Jewish Standard/NJJN.

My perspective on Ukraine then was markedly different from what it is today.

Like many others, I feared the nation’s position was untenable at best and something a lot darker at worst. But when I was discharged from the hospital after two weeks to continue receiving chemo as an outpatient, I, like the rest of the world, had witnessed and processed the deeply affecting spectacle of a defiant, resilient country of 45 million (now millions fewer, factoring in fleeing refugees and those killed, wounded, captured, or missing) standing up for its heritage and values.

By then, the conflict had exposed Russian forces for what they were, a Potemkin army led by inept generals waging war at the behest of a megalomaniacal leader.

While the fighting intensified and I continued watching the news as intently as possible, my perspective on cancer treatment also shifted.  I now realize that I had conflated the words treatable and curable during the first round of chemo. So confident was I that it was a one-and-done process, rather than rinse and repeat, that I asked the doctor to remove my chest port after receiving the prescribed course of six infusions. Wisely, he declined. After four “clean” months, the lymphoma returned, manifested by a swelling of the nodes. Biopsies sent to the National Cancer Institute confirmed the original diagnosis, with the addition of a Hodgkin’s strain.

My oncologist at Cooperman Barnabas felt that this gray-zone overlap of malignancies might qualify me for a relatively new type of cellular therapy known as CAR T. (The acronym is Chimeric Antigen Receptor T-cell.) In New Jersey, the Rutgers Cancer Institute of Robert Wood Johnson hospital in New Brunswick administers the protocols, one of only 50 health facilities nationwide authorized to do so. Since Barnabas and RWJ are part of the same corporate structure and interface patient records, the transfer and approval came about quickly. Barnabas is now in the midst of building a freestanding cancer center at its suburban Livingston campus and could qualify for CAR T in a few years. And Robert Wood Johnson, just blocks from where I attended Rutgers in the early 1960s, is also caught up in the bustle of a major physical expansion in a densely developed area between the fringe of the university and downtown.

During my initial interview, the head of lymphology at RWJ explained that in typically 60 out of 100 cases, the returning cancer is the same as the original. Thirty-seven patients present a new strain, and just three exhibit both the old and the new. I fell into the last rarified category, and in the next hour I received an indoctrination into CAR T 101.

Scans and tests over several weeks determined that at nearly 81, I could withstand the rigors of treatment. Then the collection of my ineffective T cells, a process called leukapheresis, began, with a catheter placed in the jugular. A pumping device circulated my blood and chemically filtered out cells in a painless procedure lasting about three hours. A small plastic bag held the precious harvest, which was shipped to a lab for reprogramming with the use of cellular therapy. Three weeks later, the new CAR Ts were ready for infusion. But first I received back-to-back-to-back chemotherapy treatments to prepare my system.

At Zero Hour, two tiny vials containing the potentially life-altering CAR Ts were slowly pushed through my chest port, sort of modern magic bullets. Three days later, as per protocol, I was admitted to the hospital’s cell transplant wing for monitoring of possible side effects, which could range from mild to severe. Needless to say, I felt extremely anxious in the days leading up to and following these procedures.

More than a month has elapsed since receiving my re-engineered cells. I was hospitalized for five days and discharged early after exhibiting virtually no reactions. A regimen of heavy meds has helped prevent infection, seizures, cytokine release syndrome, and neurotoxicity. Blood chemistry readings surpassed expectations and my immune system boosted back up. The care I received as a patient and during my weekly follow-ups reflects compassion and thoroughness. I’ve still not been given the green light to resume driving, but I have been allowed to return to JCC MetroWest for workouts, and I will be gradually weaned off my meds, except for the antibiotics. Blood work and scans will be part of my open-ended evaluation.

The irony in all this is that I’m not a fan of big pharma or the Food and Drug Administration (my father owned a small generic pharmaceutical company forced to accept a larger buyer by a heavy-handed FDA in the early 1970s). The CAR T therapy, though, involved a treatment called Breyanzi, developed by Bristol Myers Squibb and approved by the FDA only three years ago. Because of its newness, I gladly enrolled in a database tracking the progress of patients and also agreed to donate my harvested but unused T cells to a Rutgers study investigating the wider application of CAR T.

During this stressful period, the hospital social worker connected my wife and me to a support group funded through BMS called Cell Therapy 360. Since I live more than an hour away in West Orange and might have needed emergency care during my outpatient treatment, Cell Therapy 360 provided hotel and dining reimbursement in New Brunswick for me and Gail, who was as fully and emotionally invested in my recovery as anyone could hope for.

Clearly, cancer realities have dominated the past year. But as a lifelong reporter, editor, and news junkie, I felt myself drawn almost as much to the historic Ukraine struggle as to my own battle, both of which have played out on parallel timelines. Perhaps this is because Ukraine is providing me with a clear sense of what true suffering and deprivation can be, and how bravely the nation has held up under unrelenting duress while embracing the underdog role. Although there is absolutely no comparability between my cancer treatments and Ukraine’s fight for survival, both realities remain embedded in me, like double helix strands of DNA.

I’m not in the results business and have learned to keep my tendency to project in check, but I can let my hopes and prayers run wild, especially during springtime. So here goes: I hope and pray that the cancer is gone from my body and the Russians are gone (or ejected) from Ukraine.

Jonathan E. Lazarus of West Orange is a retired editor of the Star-Ledger and a copy editor for the Jewish Standard and the New Jersey Jewish News.

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