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Grace Reade, diagnosed in June with pancreatic cancer, fights a spirited battle Publication The Daily News Author Cathy Zimmerman "Let's be brutally honest. I could die." This story was Grace's idea. Weeks after she was diagnosed with pancreatic cancer, Grace Reade, a 58-year-old Longview woman and Liverpool native who writes a food column for The Daily News, suggested that we document her experience in a feature story. We worried that we were too close, but our editor, Cal FitzSimmons, argued that Grace's invitation presented an opportunity, not a conflict of interest. So we started, tracking the path of an incurable cancer in the lives of our friend and her family. This is a first installment. As Grace's husband, Bill, says, "the journey's far from over." The July day Grace went in for surgery to remove what doctors said was a benign pancreatic tumor, she took a purple magic marker and drew a message on her belly so surgeons could read it. "Caution!" it said. "Open c/ care. Contents under extreme Pressure." Dropping her slacks below her navel, she got her husband to take a photo of the prank, which she then passed around for friends to see. Grace Reade, 101 A Brit from Liverpool who moved to Houston 19 years ago to marry her second husband, Grace became a columnist at The Daily News after she and Bill Reade were transferred to Longview with his company, Solvay Interox Inc. Her passion for cooking, Britishisms and goofy, sometimes bawdy humor were soon peppering the bimonthly "Grace at the Table." She was as likely to write I chose Mushrooms Royale, which came with shallots, brandy sauce and goat's cheese crostini, available with or without smoked bacon she was to describe passing gas on an airplane. Naturally, in a column about her spring trip to the U.K., she shared the first inkling of a problem. One day I was in a local supermarket, happily filling my trolley, when suddenly --- Whammo! Very nasty chest pains as I got up to the checkout, and for one minute I though the grim reaper was about to take me away. Having had a couple of heart attacks in the past, I was convinced that I was about to end my days ignominiously on the floor there at Tesco. Daughter Sue Thompson, 38, who works in the Portland area but recently moved to Longview to be with her mother, said the supermarket incident didn't cause a firestorm of concern. "Mum's been so sick with different ailments in the past, I just kind of went with it," Sue said in the clipped harmonics of her native England. "I thought it was her heart, to be honest with ya." Grace survived polio as a child. She has had heart bypass surgery, eye surgery related to Graves' disease, high blood pressure, and according to Bill Reade, "pain in her bladder and kidneys in Houston, but it was never diagnosed. She had chronic stuff that would flare up. This time, we both thought, 'Oh, it's acting up again.' " When she got home, Grace's Longview physician, internist Mark Thorson, did a test that showed inflammation in the pancreas. "You need to go into the hospital," he told Grace. "You've got pancreatitis," a painful condition related to the gland not digesting fat. Bill clicks off the things Thorson lined up after diagnosing pancreatitis: the tests, the contacting of specialists in Portland and Seattle, the painful endoscopy when "they put a camera down there." That's when doctors first saw "a lesion, causing one of the pancreatic ducts to be constricted," Bill said. A combination of factors -- finding a specialist who was available on short order and a facility covered by the Reades' insurance -- landed Grace at Virginia Mason in Seattle. There, surgeon William Traverso decided to remove the tissue mass on her pancreas, as well as her spleen and gall bladder. Telling her friends about the surgery, Grace waved shapely fingers in the air -- no biggie! -- and grinned deviously about putting the message across her tummy. At home, she was not so cheery. "We had a very bad feeling," Bill said. "It was a major operation, and Grace has health issues. But we thought, even if it is malignant, they'll take it out." Bill Reade is angular where his wife is round; reticent while she bubbles with one-liners; the anchor to her impetuous flights. He has run 32 marathons and specifies that he trained for them by running "300 minutes a week." A chemist who worked for Solvay for 31 years, he retired as manager of the Longview plant last summer, anticipating time to putter and travel. "Bill is incredibly kind, very sensitive ... a natural caretaker," said his stepdaughter Sue. "He's quiet until you get to know him. He can be silly, very funny. He's a real good impersonator. He sings all these Rugby songs." Bill and Grace share a love of food and drink, expansive generosity, lethal wit. But as doctors began sleuthing out her problem, the scientist in Bill took over. The pancreas — nestled like a fat squirrel's tail between the larger liver, stomach and intestines — is a workhorse gland that makes insulin and hormones that help store energy, and enzymes that help digest food. The organ was now front and center for the Reades. Bill asked astute questions, researched on the Web, made the appointments, kept all the records. Would the surgery leave Grace a diabetic? he asked Traverso. "He said definitely not" — there'd be plenty of pancreas left to produce insulin. All that was moot when they opened her up. In the surgical waiting room, Bill saw Traverso coming toward him. "I could see by his face it was bad news." The tumor was not benign but cancerous. It couldn't be removed because it was "very, very involved with the large blood vessel there." The cancer, Traverso told Bill, "had 'hopped on' the liver, some language like that." "I said, 'You mean it's metastasized?' He said, 'Yes.' " Family members were not allowed in the recovery room, Traverso said. "I'll be there when she wakes up. I'll tell her." You have to understand about Grace. She's always on high beam. For five years, she has regularly bounded into the newsroom, bearing gifts. Sheaves of British tabloids. DVDs of transvestite comedians. Soap from Covent Garden. Cards for every cultural blip on the calendar. And food. Key Lime Cheesecake, containers of still-warm casserole, a small jar of 100-proof apricot liqueur. Can you imagine the effect on a room full or reporters when someone drops by with a Chocolate Macadamia Cake? She's like that with friends, her husband's coworkers, fellow members of the Ethnic Support Council. Reading Grace's columns is like sitting in her kitchen. She chronicled her weight-lifting, her vacations, her grandkids. It was only natural for her to talk about her cancer in print. When I came around from the operation, my surgeon told me the news. The news from Dr. Traverso was that I had pancreatic cancer, which had started to metastasize into my liver. He hadn't been able to do anything except excise the tiny tumors he found in my liver and sew me back up again. This was, as you can imagine, somewhat of a shock. But I was still cushioned by the medications, so I went back to sleep. Later on, when I saw my husband, I really began to take in the news. A few days later, an oncologist came to see me ... Dr. Vincent Picozzi couldn't be more busy, with any weightier work. Still, he neither exudes energy nor sucks it up. Warm and modest as an uncle at dinner, the quietness of him fills the room. Picozzi said he never planned to become a pancreatic cancer specialist. Because of two colleagues and the patients they began to attract to Virginia Mason, he has come up with a type and dose of chemotherapy drugs that "extends the success" of treatment. He keeps thousands of people going by balancing the drugs that destroy their cancer with ones that mute their pain and exhaustion. What Picozzi dispenses is time. At his first meeting with Grace in July, he told her she had cancer of the pancreas, that it was stage four. As Bill puts it, "that's the end of the line." "Without treatment, you have two to three months to live," Picozzi said. "With treatment, I guarantee you will have Christmas. I can't guarantee you next Christmas." Could she go to England? Grace asked Picozzi. Would she be well enough to travel in December? "You'll get home for Christmas," he promised. Bill, meanwhile, scouted information about the oncologist. "Who's this guy, Picozzi?" he asked Thorson in Longview. Thorson asked around. "This guy" was good, he told the Reades. Picozzi saw a lot of pancreatic cancer patients; he had developed a plan of attack that was giving them twice as much survival time as other methods. Picozzi would rather not identify the details of that attack. He publishes his work for other oncologists, he said, but wider publicity floods his answering machine and e-mail with urgent requests from Ireland, South America, Tupelo, Miss. Months later, while Grace was off getting chemo, Picozzi did tell us why he loves his work. "I feel very blessed to be able to do what I do," he said. "In no other profession can you help someone as directly as I do. "Grace is just a beautiful lady," he said. "She's intelligent, she's motivated, she's insightful and intuitive, she's got a great sense of humor. She brings out the best in me, and I want to bring out the best in her." His motivation, his reputation — these things probably didn't matter that much to Grace. She had bonded to Picozzi, and to his promise, at their first meeting. Now Grace and Bill had to tell people. That, too, she shared with readers. I've had to tell my children, all three going into varying states of panic and grief; my friends, who have been extremely supportive and upbeat. "Get well soon" was not an appropriate response, as that is not really going to happen. I can and will get much better ... but I am not going to get completely well. I am not classifying myself as a victim of cancer. Nor am I going to give up and just take it. I have months of chemotherapy ahead of me ... I will not lie down, roll over and present my decidedly flabby underbelly to the fates. I am in charge of my life, and I will be in charge of the end of that life, whenever it comes. On the PanCAN Web site, Grace connected with others in the same boat. The site posts her writings, which she calls the "Crab Diaries" because cancer is Latin for crab. "It's our cancer support group, for our crab, our beast," she said. She also hoped to educate those who don't understand this tough-to-detect disease. "That's my mission right now, to make people aware. God, I sound so darned noble!" Grace publicly thanked Bill for his "bravery and sheer goodfella-ness." She worried in print about her two children in England, Stu, 35, and Helen, 30, who felt helpless. She praised Sue, the daughter who lives in Longview, for being "marvelous," though "terrified." In private, Grace was frustrated with Sue. Her daughter's hysterics brought her down, she said, when she needed to stay up. "It's not about her," Grace would say. You could see her point. But in a way, it was about Sue. Cancer is about everybody. "I live on my own," said Sue, 38. "To have this going on and not have family around -- I was going crazy." When she first found out, she said, "I would cry and cry all night. I felt so lonely. The closest person in my life is 50 miles away and so sick ... she's in pain all the time, and I am not able to do anything." In late September, Grace's son, Stu, flew to the states with his 2 1/2-year-old son, Adam, for a couple of weeks. Grace reveled in her son and grandson, playing in the yard, wading at Willow Grove beach on an unusually warm day. In November, Sue organized a weekend trip to the beach for her mother's birthday. Grace was wiped out but had a decent enough appetite to enjoy the massive birthday cake. They put a paper crown on her head and got tearful over a scrapbook made by close friend Cindy Lopez. Sue decided to move into the Reades' large house to be nearer to her mother. "It's hard when I see her lying around, no hair, in pain ... She's a strong person, but she's like a little girl in a lot of ways. Funny and silly, and a little bit helpless." Sparks can fly between Sue and Grace, but after several weeks living with her mother, Sue said, "We're a lot closer. We talk more, we hug more. .. With me being there, we can watch nice movies, get take-away food. Last week she told me 'I really, really love you.' " Sue's perspective was changing. "People whine and complain about things that are doable," she said. "I'm more aware that we have no control. You don't know what's going to happen." The chemotherapy treatments meant weekly trips to Seattle, occasional overnight stays, the clotted traffic, the endless hospital hallways. The chemicals took a wicked toll. When the drugs made Grace's thick black hair start to fall out, she decided to have it shaved off. In her column, she called herself the "Bald Eagle" and described her hairdresser's tears. Her exuberance drained away. It hurt so much when she walked that she almost collapsed one day at Three Rivers Mall. She struggled to stay upbeat. "I'm scared witless," she said. "I've basically got my ticket to the great blue garden. I know I've got a finite time. How well I feel will depend on how well I respond, how I fight and kick my way. I'm conscious of this pain taking my life away." She abruptly addressed herself. "STOP it, Grace! Concentrate on daily life!" One afternoon in November she broke down during a phone conversation. "STOP," she said. "I can't take this any more. It's tearing me in half here. It hits my body so hard. I'm aching, aching. Even going up and down the stairs, oooh it hurts." Gasping in the garage one day, she slumped down. The Reades' two dogs hovered about. Heidi, a black, keen-eyed Rottweiler, and Beau, the lanky velvet Weimaraner, licked her bald head, Grace said. "They never do that." The dogs — who usually leap and bark and slather lovingly over visitors — became mopey one afternoon when a reporter came by. They draped themselves over the sofa arms, their eyes mournful. They could tell Grace felt sick. She took out her cigarettes. "Do you mind?" she said. How could we mind? Picozzi told Grace from the beginning that she could keep smoking. As Bill explained, "It doesn't make any difference at this point." Later that month, she called the newspaper, exultant. "My cancer markers are down!" she crowed. Blood tests that measure cancer growth showed steadily dropping amounts, in counts that went from 100 to the 40s, then to 15.9, then to 12. Cancers secrete proteins into the blood stream, Picozzi explained later. Most pancreatic cancer patients secrete CA19-9, an antigen which oncologists can measure to see what's going on. In Grace's case, the shrinking numbers showed that chemo was killing the cancer cells. "I don't want to hold my breath," she said. "But it's looking good, looking good all the time." Crunch time, as Grace called it, was Dec. 8 — a trip to Seattle for a CT scan before her trip to the U.K. for Christmas. These would be the first pictures of her tumor since chemo started months before. She needed the wheelchair that day. Coasting through the newly remodeled Buck Pavilion at Virginia Mason, Grace looked spent. The CT scan had been "like being in a cheese grater," she said. Bill quietly asked her if she'd taken her pain pill. "OH, BITE MY BUM," she barked. Moments later she softened. "Bill is my petros, my rock. Without him, I'd be a total mess." In Picozzi's office, she sat close to the doctor, Bill on the other side. The numbers were all down, Picozzi said. "That indicates the cancer is responding well to the treatment. ....We don't see evidence of the cancer in the liver or outside the pancreas ... "The tumor on the pancreas has actually died," he said. "There's a cavity where your cyst used to be." The hole was visible -- an empty space the size of a quarter, where cancer cells once clustered. Grace stared at him. "Do I have cancer?" "You're in remission. It's there, but we can't detect it." "I'm at a loss for words," she said. "Well, that would be a new thing," Picozzi said. They burst out laughing. Grace cried a little, but when she stood up she pumped a fist and let a whoop that ripped the hushed halls of the Buck Pavilion. She was going home for Christmas, she'd get a break from chemo, she was in remission. But Picozzi wanted her back to restart treatment Jan.7 -- two days after she would arrive from the U.K. "Left untreated, the cancer will get the upper hand," he said. Grace started packing. The Saturday before her Sunday flight, however, she was in such pain she and Bill decided to cancel the trip. Sitting in the darkened living room, they both looked slack. "She can't do it," Bill said. Then, early the next morning, he heard her moving around. "I'm going," she said. Bill stayed home to take care of Beau and Heidi; it's their pattern that Grace tends the dogs when he travels for business and he does the job so she can be with her kids for the holidays. Sue was able to get time off from work and followed her mother a week later. Wednesday, Sue e-mailed from Helen's place in Liverpool. "I think she is getting better each day, although she is feeling frustrated with her energy level being so low. She cried yesterday ..." Helen admonished her, "You beat cancer, Mum!" That night, a long aromatherapy soak soothed Grace's spirits. "Mum promised she'd be here and she is," Helen said. "The fantastic news has changed everybody's outlook. If only Billy were here with us, everything would be perfect." "There'll be 10 of us," Grace said, including Stu's 1-year-old twins, whom Grace calls the "two little Hobbits. Beautiful, beautiful boys. ... We've got lots and lots and lots of food, Christmas crackers, a mountain of presents, enough drink to sink a battle ship." In Sue's words, "We were imagining that this Christmas would be very sad. Now we feel that Christmas day will be a true celebration! Dr. Picozzi will certainly be in vocal blessings prior to us tucking into our Christmas day dinner." The Daily News
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