She first began to notice that something might be wrong when she was skiing in the Italian Alps during February 1986. Cesca was out of breath. But she was skiing at seven to eight thousand feet. Who wouldn’t be out of breath? Still, she was a little concerned, and soon after began to notice some pain in her ribs. Well, she didn’t give those problems too much thought, attributing the shortness in breath to the altitude and the rib pain to a vague inflammation which could be caused by overuse. She was working out for hours on a ski machine, and after taking a strong anti-inflammatory drug, Feldene, the pain subsided. Back at her office, she took some chest X-rays and they showed nothing unusual. So, over the next few months Cesca went on with her life at the usual busy pace.

But then, in May, she goes to New York Hospital to undergo a tubular ligation. She was 42 years old, and felt that her child bearing responsibilities had run their course, and her professional career seemed to be on a non-stop track. Life was full, and having additional children was not something she wanted at this stage of her life. But while she was being prepped for the procedure, doctors and nurses began to gather about. It seemed that something wasn’t routine. It turned out that she would never have this operation. Her blood tests clearly showed that something was very seriously wrong with Cesca.

Her hematocrit was only 25! This represents the oxygen level in blood. It should be closer to 40. Cesca was seriously anemic – no wonder she had become out of breath, but amazingly, she was going on with her life normally at such a low “crit.” Other markers in her blood showed that she was truly a very sick person, and when a special immunoelectrophoresis was  taken to measure the presence of aberrant plasma cells, it comes back near the top of the charts. It is beginning to look like multiple myeloma. She remembers a friend, Anne Moore, who is a hematologist-oncologist, and calls her. The next day, Anne looks in on her, and then performs a bone marrow biopsy, and that cinches it –Dr. Francesca Thompson who specializes in bone disorders has her own bone disfunction – cancer of the bone marrow. The bone marrow biopsy showed at least 85 to 90 percent of the marrow covered with cancerous plasma cells – not an uncommon occurrence for newly diagnosed myeloma patients. Sheets of plasma covered the marrow. She went on to have an MRI which was just unwrapped and out of the box in 1986. Few doctors had experience with it, but Cesca wanted the best treatment that medical science could provide, and she never hesitated to go into that noisy, clanging, claustrophobic tube. She was actually intrigued by the whole procedure, but the MRI did support the diagnosis with cancer cells in multiple locations – throughout her bones.

What to do? Even as a doctor, Cesca knew very little about multiple myeloma, but she soon learned that the median length of survival after diagnosis was just 20 months – that was in 1986 when the treatment options were just chemo and more chemo. Her first initial crisis was how to break the news to her family while keeping it from her partners and patients. She wanted her life to go on seamlessly, and she feared that patients would never want to see a doctor who was dying from cancer. She worked too hard to establish her career, and she was not going to let some chemo treatment stand in the way. She wanted her life to be as normal as it possibly could be, and she didn’t want her family to worry. She decided that she would wait until her children finished school for the year before telling them. Heather’s graduation was coming up shortly, and she would not have to keep that secret very long. But she called her husband immediately, and broke the news to him. Jim was heartbroken, but strong, and he was going to be there for her.  She worried about her aging parents, especially her father who absolutely adored her. Both parents eventually received the news, her mother first, who was very much opposed to Cesca undergoing chemo – she was into alternative healing that involved powers which Cesca just didn’t accept. Part of Cesca’s obsession with secrecy included a fanatical search for just the right wig when her hair would fall out. The wig seemed to be a metaphor for keeping this cancer out of view.

Of course, something like multiple myeloma and its required aggressive treatment can never be kept secret for very long, and eventually Cesca admitted that it was a lot easier to tell the simple truth. Her partners were very understanding, and made sure that her job would be waiting for her when she was finished with her initial treatment. That treatment turned out to be groundbreaking.

Cesca asked Anne Moore to do a search and find out where the very latest and best treatment for myeloma was taking place. Twenty months of life seemed far too short for her. She was only 42 years old and just beginning to reach the peak of her profession. How could myeloma bring her down? She was not going to let that happen. She and Anne then looked at a number of possibilities, including an experimental procedure which was being conducted at Dana-Farber in Boston. Until that time, Cesca knew absolutely nothing about that research hospital in Boston. She didn’t know if Dana-Farber was one person, or two, but she soon learned that a young Dana-Farber researcher, Ken Anderson, was developing a procedure which might even cure myeloma patients. The procedure had been used for lymphoma patients at Dana-Farber, but never there, or anywhere else, for myeloma patients. The radical treatment involved high dose chemo and full body irradiation while extracting the marrow, treating it, and then returning it, fully cleansed, to the patient who has had all the other marrow destroyed through treatment. This autologous technique, of infusing one’s own marrow has now become common for stem cells procedures, but it is more rigorous for bone marrow transplants, and it was never available for myeloma patients until Francesca Thompson enrolled in the trial at Dana-Farber. As tough as it was going to become, she knew that this was the best chance for a cure, and she was going for it.

But it was tough, very tough. She had preliminary rounds of chemo through 1986 prior to entering the Dana-Farber experiment which got underway in earnest during February 1987. Through this period, she was working, full steam. In late 1986, she was operating on Washington Bullets guard, Frank Johnson, just before traveling to Dana-Farber for some high octane treatment. On February 8, 1987, she was put into isolation and the transplant procedure got underway. Cesca became very sick. For weeks, she could not keep food down, and of course, her hair was long gone. Her blood counts remained frighteningly low. Even after the marrow was reinfused, her disease fighting white blood cells stayed at a dangerously low level. She remained very weak. Not until the middle of March did her white blood cells show signs of recovering, but she still had trouble eating. By late March, after six weeks in the hospital, she was allowed to go home. But she was far from recovery. Months would pass before her strength would return, and during this time she had an attack of shingles which brought her back into the hospital. It wasn’t until the summer when she was able to see her own patients, once again, and only then, did her energy begin to come back in a major way. Importantly, her tests showed that the myeloma had been reduced to absolute zero. There was no sign of it in her new marrow, and the haunting protein spike that always seems to be present in the blood was totally gone.  The procedure was a success. Could Francesca Thompson really be cured? She thought so. Ken Anderson hoped so.