ROUND TRIP TO RECOVERY
Stoic but scared, she helped her husband through nine weeks of daily treatments
"it came out of the blue!" That's how Hilary Borthwick of Doylestown, PA describes her husband's shocking diagnosis. It was in May 2007 when David Borthwick went for a prostate test. He had been feeling fine, but it had been three years since his last test, and at the age of 72 he was troubled that several younger colleagues had prostate cancer.
The urologist discovered that David's prostate was enlarged and his PSA count was an alarming 7.1. After further tests, the couple was informed that David had cancer.
"For the first 10 days we were in shock-because he'd had no symptoms," Hilary says. David's initial reaction was to become "very quiet," she recalls. "I knew he was thinking it over. Fortunately I'm not a person who panics. I go the other way, totally stone-cold." But she admits to the unspoken fear of so many spouses: "We'd been married for 40 years, how could I live without him?" And, she was haunted by the fact that her father had died from prostate cancer. "Then I told myself, it's not going to kill us, we're going to kill it!"
Perhaps her attitude came from having been a nurse. Originally from England, Hilary had gone to Scotland to work in cardiac surgery. She'd met David, a native Scotsman, one night in 1966 when her "flat mate" suggested they go to a local dance to escape their cold apartment. They were married a year later to the day and had three sons. In 1986, David was transferred to America by an industrial machinery company to become the firm's president here. For Hilary, this meant giving up her nursing career. "I would have had to re-qualify in order to work in the States." Also, the two younger boys, 13-year-old Michael and 16-year-old Douglas, would be coping with new schools, and she felt they'd need her. (Their oldest son, Alastair, then a student at St. Andrews University in Scotland, would join them after he graduated two years later.)
To this day, she misses being a nurse. But her medical background stood her in good stead when David got his diagnosis. When the urologist prescribed surgery, Hilary knew-as she says, frankly- "There are surgeons, and then there are surgeons, and one slip of the scalpel could cause incontinence."
Determined to get a second opinion, she and David consulted Alan Wein, MD, Chief of Urology at the Hospital of the University of Pennsylvania in Philadelphia. He advised them to study all the options and come to their own conclusion. They investigated robotic surgery but found there was a very long waiting list. But Dr. Wein also advised that if he were in David's position he might have radiation therapy, instead of surgery. At his suggestion, they met with Neha Vapiwala, MD, a leading radiation oncologist in the same hospital, who recommended the Calypso System, a form of targeted radiation. It involves implanting transponders the size of a grain of rice into the prostate prior to each radiation treatment to track any movement of the tumor. "This would give us peace of mind, knowing that the radiation wouldn't damage healthy tissue," Hilary says.
Though the couple didn't know anyone who'd tried this therapy, they decided to "get on with it," to quote Hilary's favorite expression. So together they embarked on a daily marathon for the next nine weeks-driving over an hour and a quarter each way. David drove there, but after the treatment she'd do the driving back.
Hilary organized her days around those trips. "I like being useful," she says, "perhaps because I was a nurse." She'd been busy as a volunteer for Victims of Abuse and also was a member of a quilting club. "Since David's treatments were in the late afternoon, I was able to rearrange my schedule so I could do those other things in the mornings." Asked if she ever resented this disruption of her life, she simply says, "Once I knew he wasn't going to die, I was fine." David says if she hadn't been by his side, he doesn't know if he would have made it. "She was my rock."
The actual treatment took only minutes, but as most patients and caregivers find, much of the time is spent waiting. "We'd sit around with other cancer patients sometimes for a couple of hours," Hilary recalls. "We saw people coming in on stretchers, and a lot of children. But everybody sort of cheered themselves on." David passed the time doing Sudoku and crossword puzzles; she brought needlepoint to work on.
She also went to a lecture in the hospital given by a dietitian about "cancer and diet." As a result, she changed their diet. "Now we have a lot of green tea-David uses soy milk with it-and a lot of fruits and vegetables. David used to enjoy steak, and he still has it occasionally when we dine out, but most of the time we have fish."
He endured the treatments well-no pain, Hilary reports-but she recalls that he was tired most of the time, sort of washed out. "I think a lot of that was stress, and going in and out of the hospital every day." Also they were traveling a long way and into the city, through lots of traffic. David has a slightly different recollection of himself as a patient. "I was able to golf early in the day. And I didn't feel particularly tired because of my sunny disposition," he laughs, adding, "and besides, Hilary did most of the driving!"
Since the treatments were over in the early evenings, they made it a habit to have a meal on the way back. "David said it was such a stressful time I didn't have to be cooking dinners too, so we'd stop at a diner for a small meal." For nine weeks those were almost their only outings. They did get together with friends on occasional weekends, but most of the time they were focused on simply "getting on with" his treatments. "Everybody called constantly," she says. "That's what friends should do, keep in touch."
Sometimes they had dinner with their youngest son, Michael, and his wife, Lynne, who live in nearby Collegeville. The rest of the family-Alastair and Douglas, and their wives, Jeanine and Heather-live in New York. "The boys would ring us up and talk to David about sports, but children have their own lives." Those busy lives included four grandchildren (there are now five). The grandchildren were so young (the oldest, Catharine, was only five at the time) they weren't told the details about their grandfather's illness. But they knew he was ailing, Hilary says, because he couldn't lift them or carry them on his shoulders, and they were instructed to "treat Grandpa gently."
Hilary fought the days when she felt down by "keeping busy by getting organized" for the daily trips to the hospital. She also found gardening very calming. "If you get depressed, the patient will, too. So you have to stay calm and try to look on the bright side." That "bright side," she adds, "is seeing how many people survive cancer these days."
After nine weeks, David was given welcome news: He wouldn't have to undergo any further treatments. He now goes for follow-up tests every six months and his PSA count has dropped to 1.1.
Because he hadn't had surgery, David was spared one of the common side effects, incontinence. As for the other common result-impotence-Hilary brushes off the question. "At our ages, David's 74 now, and I'm 68, we don't see it as a big problem." In fact, she says, "We have a good laugh about it. I just thank God he's alive and well."
They go to church (Episcopal) more frequently now, Hilary adds, to give thanks for David's recovery and to pray for a friend who's ill. "Religion has come back more strongly," she says.
David's illness also made them realize how close they are. As she puts it: "We've become more aware of each other." And, she adds, "We've learned to live for today because you don't know what tomorrow will be. Whatever we want, we do it now!"