Cancer is never a part of the plan. But a diagnosis certainly does not have to mean your dreams are over. Just ask multiple myeloma survivor Paul Pebley.
When Pebley was diagnosed with multiple myeloma, he had never even heard of the disease. So once the clarifying word “cancer” met his ears, he was utterly shocked. The 63-year-old retired sales and marketing director for MDM Hotel Group had no inclination that cancer was even a possibility in August 2020, as his diagnosis came from investigating the pain in his back caused by herniated discs and compression fractures.Read More
Pebley began treatment at Sylvester Comprehensive Cancer Center in Miami in September 2020. First, he underwent a three-drug chemotherapy regimen of Revlimid (lenalidomide), Velcade (bortezomib) and Dexamethasone – also known as RVD – from September 2020 until February 2021. Then, he had a stem cell transplant on April 2, 2021.
“The treatment that the oncologist initially laid out in August went almost exactly what he would have considered to be the ideal case in terms of its effectiveness, it’s treating the cancer cells, the numbers getting under control,” Pebley said. “I feel very blessed.”
Now, he takes a maintenance dosage of Revlimid 21 days out of the month.
Pebley’s “Plan B”
Like many cancer warriors, Pebley found a way to distract himself throughout treatment. But what makes his cancer journey unique was that it wasn’t painting or reading or puzzles that kept him busy – it was travel planning.
“When you’re diagnosed with cancer and COVID is happening and you really don’t have options other than to basically sit at home, you think about should I take up basket weaving or pottery or whatever the case may be?” he explained. “And I guess I’m just not, I’m just not that kind of person… My hobby while I was going through treatment was really just kind of refining this plan as to how I was going to travel, where I was going to travel.”
Pebley retired from his job in April 2020. Prior to the Covid-19 pandemic and his cancer diagnosis, he had planned to hike through Europe. But just because things didn’t look as he had expected, doesn’t mean he was going to give up.
“When I was diagnosed, I said, ‘The universe is not going to ruin my retirement plan,'” he said. “I worked too long, too hard to have it just, you know, dissipate because of multiple myeloma.”
So, Pebley bought himself a shiny new silver Ram 2500. He bought a cap for the bed and even had a friend help him build out the back so he could sleep there during his travels and store everything he needed. He calls it Plan B.
“When I get in that truck and I get on the freeway and I know that I’m headed somewhere where the landscape’s gonna be gorgeous, my entire day is transformed,” he said. “It just puts a smile on my face.”
After allowing himself about three months of isolation while his immune system recuperated after the stem cell transplant, Pebley began a four-month-long 20,000 mile road trip across the United States. He called it his “post-treatment reward” and the beginning of his “retirement excursion.” He trekked from Miami to California, Arizona, Utah, Idaho, Minnesota, Michigan, Vermont and Maine – among other places – before returning to Florida. He watched the herds of bison at Yellowstone National Park, took in the beauty of the rivers and mountains in Idaho and enjoyed the fall foliage of the Northeast.
“It was really a mental shower to just kind of cleanse myself of feeling tethered to something,” he said. “You have multiple myeloma and you’re stuck inside for 10 months, there’s nothing better than camping in the Grand Canyon.”
And even though he felt a newfound freedom when he hit the road, Pebley still had to take his maintenance oral chemotherapy and find places along the way to have his blood drawn about every six weeks to monitor the state of his cancer.
“While I was traveling for four months, I was still very much engaged in monitoring what the health situation was and maintaining a good level of communication with my oncologist so that he was comfortable that there weren’t things that I needed to be doing at that time, and that everything truly was under control,” he explained.
But everything went just swimmingly for Pebley. The solo traveller even made time to visit friends and family along the way.
“I visited a lot of people on that trip,” he said. “Some of them were people who had supported me through the entire journey – even though it was long distance – but in many other occasions, I connected with people whom I went to college with 40 plus years ago and hadn’t seen since then.”
Pebley does expect he’ll probably have to undergo cancer treatment again in the future, but for now, he “[doesn’t] worry about that.” He’s focused his intention on enjoying every moment before him and doing all the things he’s always wanted to do while his cancer is under control.
“Life becomes more precious once you’re diagnosed with cancer,” he said. “It’s the time to take advantage of the days that we have.”
Understanding Multiple Myeloma
Multiple myeloma is a blood cancer involving plasma cells — a certain kind of mature white blood cell in the bone marrow that helps fight infection by producing proteins that help your immune system fend itself against germs. So, in order to understand multiple myeloma, it’s important to talk about the bone marrow.
“The bone marrow is the factory that makes all of the cells that wind up in our bloodstream,” Dr. Mikkael Sekeres, the chief of the Division of Hematology at the University of Miami Sylvester Comprehensive Cancer Center, tells SurvivorNet.
The bone marrow makes red blood cells which bring oxygen to our tissues, white blood cells which fight infections and platelets which help stop bleeding. For people with multiple myeloma, cancerous plasma cells, or myelomas, grow uncontrollably in the bone marrow and crowd out healthy white blood cells. This, in turn, inhibits the immune system’s ability to fight off infection which can lead to fatigue.
Eventually, the myelomas grow too large in the bone marrow which can cause bone fractures. Myelomas can also lead to kidney damage because these cancerous cells release abnormally high levels of antibodies into the bloodstream which eventually build up in the kidney since its unable to process these extra proteins.
University of California at San Francisco hematologist-oncologist Dr. Nina Shah says cases of multiple myeloma can be grouped into categories that help physicians decide on the appropriate courses of treatment.
“We tend to (divide them) based on how risky the myeloma is, whereas other cancers will be staged based on how far the cancer has spread,” Dr. Shah tells SurvivorNet.
Technically, there is no cure for this disease, but recent advances in medicine have made room for hope — especially with early diagnoses.
However, Dr. Shah adds, “we want to make sure we make people understand that it’s a disease that you can live with — not necessarily have to die of.”
Staying Positive throughout a Cancer Journey
It’s very normal to have negative feelings throughout your cancer journey – and it’s okay to express them too! Anger, shame, fear and anxiety are all to be expected. But doctors will tell you that people who find a way to work through the emotions and stay positive tend to have better outcomes.
“A positive attitude is really important,” Dr. Zuri Murrell, a colorectal surgeon at Cedars-Sinai Medical Center in Los Angeles, previously told SurvivorNet. “I’m pretty good at telling what kind of patients are going to still have this attitude and probably going to live the longest, even with bad, bad disease. And those are patients who, they have gratitude in life.”
In a previous interview with SurvivorNet, Dr. Mona Robbins, a licensed psychologist at UT Southwestern Medical Center, shared that mindset can play a huge role in helping you throughout your cancer journey. She says it’s important to understand that there are some things you can control and some things you just can’t.
“There’s this connection with the mind and the body that if we adjust the way that we think, we can really help our bodies to heal,” Dr. Robbins said. “For areas where you can control, how can you either advocate for yourself, ask more questions, clarify the needs? Or even, then, where areas where you can’t, how can you take things one day at a time? Recognizing some of the good that may be present in the day, as opposed to all of the bad you may think is there.”
And one way to stay positive and focus on the ‘controllables,’ as we saw in the case of Pebley, is to make exciting plans for the future.
“Have something to look forward to – either in a couple months, if not at the end of the week – so that that brings up your spirit and your energy so that you feel a little bit more hopeful about what’s happening,” she said.