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A doctor and patient form a partnership on cancer journey

Dr. Jim Radford treated Kathy Dorsam, who suffered from a rare and aggressive form of cancer, and has been cancer-free for 18 years. PHOTO BY BRITTNEY STORM RANKIN/Formation PR/

By Bill Moss, Published: June 8, 2018

In early 2001 Kathy Dorsam had severe pain in her jaw that no one could diagnose.

For weeks, she darted through the health care maze, feeling like a patient in an episode of the TV drama“House,” in chairs and exam tables and beds, from a dentist to a chiropractor to a TMJ specialist to an oral surgeon to an ear, nose and throat specialist.
After a test that spring, an ENT physician called. That alarmed her because he called her at home on a Sunday afternoon. “Should I be worried?” she asked. “‘Yeah, you should be worried.’ I told him, ‘I’m alone. My husband’s at work.’ And he just kept talking.”
Kathy would come to recognize the pattern. A lot of smart, educated, confident health care people are better at talking than listening.
I’m listening to Kathy tell her story because she wants the world to know about an exception to that, about her own experience that went from bad to good and, she says, saved her life. Kathy and Dr. James “Jim” Radford have allowed me to hear their story of a cancer experience in a rare inside-look at what patients and doctors go through. We’re sitting at a conference table at the Pardee UNC Health Care Cancer Center, where Radford’s oncology practice is based. Kathy’s not here for an appointment. She’s here to thank her doctor — but not for the reason you might think.

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After many twists in the road, Kathy was diagnosed with Ewing’s sarcoma, an aggressive cancer that is rare in adults.
“It almost always happens in children,” Dr. Radford says. “Very few adults. Most of the adults it happens to are in their 20s.”
Months before she’d heard of Dr. Radford, Kathy, then 42, was referred to Bowman Gray Medical Center at Wake Forest University and into the care of a renowned oncologist there. Only “care” would not be the word Kathy would use to describe the experience.
“He looks like he lives out of a grocery cart on the street,” Kathy says. When she tried to have a meaningful conversation with him, he seemed preoccupied. When she wrote him a letter, he ignored it.
The aggressive cancer called for an especially aggressive form of chemotherapy.
“Five drugs, three of which were known to cause secondary cancer,” she says. “I was getting 11 hours a day for six days at a time.”
Discombobulated and drugged up, “I couldn’t see anything but people’s shoes,” she says. After three rounds, she sat in her hospital bed, anxious and depressed. She expressed her misgivings to a cancer ward psychiatrist, a counselor who had by then gotten to know her. He leaned in close to Kathy’s face. “You don’t belong here,” he told her.
The psychiatrist told her he knew of a cancer doctor who he thought would be a good fit for Kathy. The best part? He practiced only a few miles from her home in Hendersonville, at a Pardee oncology practice. It was Dr. James Radford. Radford was well-known in oncology circles, often landing on “Best Doctors” lists. Kathy didn’t know that and, what’s more, didn’t really care. More than anything, she wanted someone who would listen to her and remember her name.
“I go meet with him,” she says. “First time, every time, he treats me like I’m the only patient he’s ever had. And he treats every patient like that.”
In the small conference room, Dr. Radford is listening to Kathy again, not interrupting, only pitching in medical details here and there. But this is the fork in the road when he joined her journey, when he became not just her doctor but her partner in navigating what could be life-or-death choices. I ask Dr. Radford how much attitude matters.
“Patients come in to their cancer diagnoses and treatment with different attitudes,” he says, “and as physicians, some physicians prefer that patients not have much of an attitude. ‘We’re going to do A, B, C and D. Sign here. Come back next week. Nice meeting you.’
“A lot of us prefer exactly the opposite,” he goes on. “And I think that’s partly because many of us don’t like having the responsibility of making all the decisions on treatment. There are all kinds of judgments that have to be made. When people don’t have their own opinion about what they want then you have to make all those decisions and the consequences of those decisions are all on you.”

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Kathy wasn’t at a decision point yet, per se. She was just happy to meet a caregiver who didn’t have her on a stopwatch.
“Our first encounter lasted three hours,” she says. “I said, ‘This is me. Are you willing to take me as I am?’”
Dr. Radford’s answer was yes. “I wasn’t just part of a cattle call,” she says. “I knew he was as trustworthy as I was ever going to find.”
Under Radford’s care, she completed her initial chemotherapy, a process to shrink the tumor.
“If you just treat it locally, if you just remove it, 90 percent of people will die with metastatic cancer,” he says.
The surgery that came next was nothing short of groundbreaking in its enduring success.
“The guy that gets the credit is actually Dale Browne at Wake Forest,” Radford says.
Browne, chair of otolaryngology and ENT at Wake Forest Baptist Health, removed Kathy’s cancerous jaw and replaced it.
“It’s titanium. It’s like a bicycle chain,” she says. Recovery and training her metal jaw to do its job of chewing was arduous and long. Browne handed her a pack of tongue depressors, told her start with one to pry open her jaw. She worked her way to 18.
Meanwhile, in a medical journal article, Browne had written about his experience with titanium/bone graft jaw rebuilds.
“Four other people were in this study in the article and I was subject No. 5,” Kathy says. “I got a copy of it.” By then, her rehab was a success. She joked with her surgeon: “If you’re going to go present this and you need a spokesmodel, I can stand up on stage and eat corn on the cob now.” She turns serious. “But I read in that study, everyone else that had this done died within 48 months. Therefore, every year on my ‘cancer-versary,’ I tell him I’m still alive.”
Kathy asked an oncologist she met later if she could find other Ewing’s sarcoma survivors, so she might learn what’s next.
“She did a lot of research,” she says. “And she came back to me and said, ‘There isn’t anybody. There isn’t anybody out there that’s survived this long.’”
By 2002, Kathy and her husband, Jerry Dorsam, a veterinarian, had moved with their children to Charleston, South Carolina, where Jerry owned an animal hospital. Radford was still Kathy’s doctor. And she now faced another critical choice. A second round of chemo or … maybe not.
“Then you have a brush with mortality — you had more than a brush of course — and after that you start living your life a little differently, don’t you?” Radford says to her.
“I always thought that I lived in the moment,” she says. “And certainly when I realized what my odds were and what my choices were, I thought I’m going to follow my gut and see what you thought. I’ll never forget the look of panic on your face, and Jerry’s. My husband said, ‘Whatever you want to do, I’ll stick with you.’ He just assumed that I was going to do the opposite. He said, ‘I’m going to follow you. You can have one more treatment, you can have 10 more treatments.”
But her husband wasn’t the expert who had seen thousands of cancer cases and guided patients through difficult treatment.
Radford says, “This is when I got the panicked look in my eyes because at that point you took that attitude and said, ‘I don’t think I want to do that anymore.’ That was kind of a hard thing as an oncologist to swallow but when you have somebody who knows what she wants to do, all you can do is go with it.”
Tests had shown clear margins around her jaw — meaning no cancer cells had escaped — and turned up no sign that her cancer had metastasized.
Now, she is back in Radford’s office in Laurel Park, in November 2001, seeking validation or contradiction.
“You know what I know,” she recalls telling him. “You know I’m pretty clean. You know what my chances are. Let me ask you, If I were your wife, knowing what you know about me, what would you have me do? And he answered me honestly.”
Kathy pauses, emotional for the first time, remembering his response.
“And then we held hands and took a giant leap of faith together,” she says.
“So she bailed,” Radford says.
From 2001 on, Kathy returned to Hendersonville to visit, first every three months, then six, then a year. Appointments filled her with dread.
“I’d start to have little panic attacks, even after I moved to Charleston,” she says. “I remember asking him one time, ‘What is taking you so long to see my chest films?’ He was like, ‘It takes longer to see nothing than it takes to see something. Be patient.’ That was a good thing.”
After seven years, Dr. Radford made a unilateral call.
“I’ll never forget,” Kathy says to him. “I remember it verbatim. You said, ‘The anxiety that this visit provokes in you far outweighs the great results that you leave here with. I think you should go live your life.’”
“So I said, ‘I’m going to go live until I die.’ Therefore, I’m living until I die.”
“In 2007, we just kicked her out,” Radford says. “As an oncologist you always hate to use the C word — cure — because sure as shootin’ you have a breast cancer patient and she’s 10 years out and you’re (telling her) ‘Yeah, yeah, you’re cured,’ and then in year 13 she comes back with lymphoma.
“But this is a different kind of thing,” he says. “With this kind of cancer, if you get five or more years out, the chances are, you’re never going to see it again. So when we kicked her out, it was pretty much a done deal.”

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Kathy and her husband have not let her life-altering health threat derail adventure. After Jerry sold his veterinary clinic in Charleston, “We bought 10 acres of dirt in a little town right in the center of Big Horn Sheep canyon with the river on one side,” she says.
It’s Salida, Colorado, a town of 5,000 on the Arkansas River that calls itself “the heart of the Rockies.” Although Salida means exit in Spanish, the move marked anything but for Kathy and Jerry.
“Do you have horses? Cows, sheep?” Dr. Radford asks.
“Chickens,” Kathy says brightly. “We started an organic farm and we’re feeding the community already. We’re on our second season. We have a 90-foot by 20-foot greenhouse and my kids and Jerry and I just built our own house.”
She works part-time for a building contractor and part-time for Jerry’s Mountain Home Veterinary Clinic.
She still lives with a lot of pain and has ongoing consequences of all the digging surgeons had to do and the recasting of her face that replaced what God gave her with man-made parts. She has trouble retaining words. Her vision is going blurry.
“Every day I wake up it’s a new normal for me,” she says.
Yet she exults in a simple and stunning fact: She’s alive.

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Doctor and patient have been talking for an hour — covering their shared 18-year journey, with laughter, pathos and mutual respect. What is the takeaway? How can cancer patients make their situation easier? Kathy was a strong self-advocate, I say.
“It’s not just a self-advocate,” Radford says. “She knew what was important to her and how she wanted to play her treatment and her life. And that’s really important. And one other thing that’s really important — it’s kind of come up but not as much as it should — is that lots of cancer patients go through their cancer treatment and then they spend the rest of their lives — might be a month and it might be 30 years — as ‘cancer patients’ worrying about the cancer, worrying that the cancer’s back, going to doctor appointments.
“Kathy made the decision that she went through the treatment as much as she was willing to and then she was going to live her life. And that’s what a lot of people don’t get. You come through treatment and the whole reason you’re doing the damn treatment is so you have a life to live. And if you just identify yourself for the rest of your life as a cancer patient you’ve taken some big chunk out of that.”
Radford continues: “I feel sometimes like I just want to slap ’em all and say, ‘Wake up. Go fishing. Go to the movies. God’s given you a month or a year or 30 years. Let this go and go live.’” (Radford is an avid fly fisherman.)
“So you’ve got somebody here who did that. She said bye to the cancer thing and bought a farm in Colorado.”
If she’s cancer free and liberated from fear, Kathy remains strongly in tune with the medical experience and how much difference one care-giver made. On what she called her “17th cancer-versary” — and 11 years after Radford “kicked her out” — she flew back to North Carolina to thank him.
“I never thought I’d see my 60th birthday, which I celebrated last year,” she says. “I owe Dr. Radford my life.