It was only a few years ago when Tom Westrich recalls a conversation he had with family about how fortunate they were because cancer had not been a part of their lives. But by 2014, Westrich, husband and father of three adult children, had his world turned upside-down with a diagnosis of tonsillar cancer.
As a semi-retired pharmacist who spent years working with cancer patients at the former Jewish Hospital of St. Louis, Westrich already had an idea of the challenges he would face. “I saw a lot of neck cancer patients in the 1980s and cared for many as a pharmacist. I knew how difficult it was on the patient,” he says. “I was scared out of my mind.”
His diagnosis came following several months of watching a swollen lymph node on his neck appear and disappear. Initially, his primary care physician thought it might be an infection and advised Westrich to keep an eye on it and, if necessary, he’d prescribe antibiotics.
When the lymph node seemed to disappear, Westrich didn’t give it much thought until it came back in September 2014. Despite trying antibiotics, the swollen lymph node was not going away, and he was referred to an ear, nose and throat specialist (ENT) at Missouri Baptist Medical Center, a member of BJC HealthCare.
On Dec. 4, 2014, Westrich, who was 57 at the time, had a CAT scan and on Dec. 5 was told there was a spot on his left tonsil. After discussions with several physicians, he was referred to a head and neck surgeon at the Siteman Cancer Center at Barnes-Jewish West County Hospital and Washington University School of Medicine.
Westrich and his surgeon discussed treatment options and, following his own research, Westrich agreed to participate in a clinical trial. “Being a pharmacist, I appreciate the value of a clinical trial to provide answers for future patients. The two common treatment options offered in the current trial for my tonsillar cancer — surgery with only follow-up radiation vs. surgery with follow-up chemotherapy and radiation — have both been used,” says Westrich, who was randomized to have both chemotherapy and radiation.
Westrich chose to pursue his treatment at the Siteman Cancer Center at Barnes-Jewish West County Hospital, which was close to home. He became a patient of Washington University and Siteman Cancer Center radiation oncologist Mackenzie Daly, MD, and medical oncologist Loren Michel, MD, who see patients in a clinic dedicated to head and neck cancers.
“With the multidisciplinary clinic, patients can be seen by Siteman Cancer Center doctors closer to their home,” Dr. Daly says. “We can talk about the wide array of treatment options available and open clinical trials. Whenever possible, we try to provide all the care that we can through Barnes-Jewish West County Hospital to reduce travel time and patient inconvenience.”
Although clinical trials have very specific criteria, Siteman Cancer Center patients have access to hundreds of trials, Dr. Daly says.
“Our job is to constantly ask, ‘How can we do better?’ But without patients who are willing to participate, we can’t find answers. That’s why I think it’s so important what Mr. Westrich has agreed to do,” she says. “He may or may not receive personal gain by participating in this clinical trial, but he is playing a crucial role in making things better for the man or woman who walks behind him.”
After undergoing a six-week treatment regimen that included chemotherapy treatment every Monday and concurrent daily radiation treatments for about 20 minutes Monday through Friday for a total of 30 treatments, Westrich is happy he joined the trial.
“I think it’s important for future patients to know if they get any significant benefits from the addition of the chemotherapy or if treatment with radiation alone after surgery would provide the same outcome with less toxicity,” he says. “I was willing to participate knowing that I might be randomized to the group that received both because participation in a trial typically means you will be followed more closely by a medical team. Also, if the addition of the chemotherapy to enhance the effects of the radiation treatment might mean a small percentage in my odds, I was willing to find out.”
Although it’s been a year since his last radiation treatment, Westrich will continue to see Dr. Daly regularly. “As time goes on and he continues to do well, we will reduce those visits to once every six months and then eventually once a year,” she says.
Westrich considers himself fortunate. He says as a pharmacist he even received a greater understanding of how medications, particularly for pain, can impact your healing and possibly leave you with symptoms that are difficult to understand.
“I think I was so successful because I was diligent about everything. Patients must talk to their doctors about concerns and stay on top of things,” he says. “I could not have made it through without my wife, Sharon, who was the angel through all of this.”
He has nothing but appreciation for everyone involved in his care, from those who greeted him when he arrived for treatment, to his nurses, technicians and physicians who showed him “nothing but empathy and compassion.”
“They realize that patients have a difficult challenge ahead of them and need their support and understanding,” he says. “This was the most brutal thing I have ever gone through, and I would not wish it on my worst enemy.”
To schedule an appointment with Dr. Mackenzie Daly or another specialist, call 314.542.WEST (9378) or toll-free 844.542.9378 or request a call for an appointment.
Click here to find a clinical trial at Siteman Cancer Center.