Ric P.

Diagnosis: Nasal/Sinus Squamous cell carcinoma
Treatment: Surgery and Proton Beam Radiation

Six years ago, Ric Paulson began having difficulty breathing through his nose, and then he started having troublesome nosebleeds. He was in the prime of life, balancing two jobs, extensive community activities, public speaking, an active social life, and a passion for travel and photography, which he shared with his wife Lynn. One Sunday Ric’s nosebleed was so severe that he went to a local ER and was advised to see an Ear, Nose & Throat doctor, who recommended surgery for the removal of a mass. “Ten days later the doctor’s secretary called and asked me to come in with my wife. I was kind of preparing myself for the worst but still hoping for the best. Well, the doctor looked me right in the eye, bluntly said, ‘You have cancer’ and started going on and on about major surgery, giving lots of gory details, using lots of medical terms. I don’t really think I heard anything else anyway after he said ‘cancer.’ I just kind of floated away.”

“They referred me to a specialist who talked about doing a huge surgery that involved a lot of risk and a long recovery. Even though he was compassionate and approachable, it felt like a nightmare that kept getting worse. I thought to myself, ‘I don’t think so.’ It was just too much to process.

Ric and his wife, Lynn asked about other treatment options, including proton beam radiation, a new treatment they had heard about through her family. The surgeon referred them to Dr. James McIntyre in the Radiation Oncology Division of the MGH Cancer Center. “We were in his office within three hours, and right from the start he gave us hope, support, and encouragement. He has been our guide throughout this whole incredible cancer journey. He is a complete physician in that he was a healer, adviser, and friend.”

“Still, after he described the side effects of the proton-beam treatments, I felt scared, so I said to him, ‘What if I do nothing?’ Dr. McIntyre leaned forward and looked at me and said, ‘Ric, you can’t do nothing. You’ve got to do something.’ He told me to weigh my options and get back to him the next day.” That night Ric reflected on his earlier conversation with Dr. McIntyre and thought, “This guy is awesome. He’s laid it all out for me. He didn’t promise me the world, but he wasn’t all doom and gloom either. It was a tough decision because we wanted to go for a cure, but we didn’t want to commit to something that would mean a decreased quality of life. It came down to my gut feeling, and that night I decided to go for the proton beam.”

After three weeks of intense preparation, Ric began proton therapy at the Harvard Cyclotron Laboratory. “For five and a half weeks, I had daily proton beam therapy in a room that looked like a physics lab right out of an old horror movie.” The treatment was really new and the accelerator at Harvard was one of the few places in the world where they could do it. [The Northeast Proton Therapy Center now on the MGH campus is the first hospital-based facility of its kind and is one of only three in the country.]

In the fourth week of treatment, Ric began to experience side effects. At first he got really tired. Then he developed a severe burn in a sharp stripe down the middle of his face. “The pain was excruciating. They gave me painkillers, but there was only so much they could do.” What kept him going through this difficult time? “I had a super support system beginning with my wife, Lynn. She always came with me for appointments. She was always there for me. She talked when I needed to hear someone talking, and she was quiet when I needed to be quiet. I don’t know how people without family can go through something like this—I know I couldn’t.” He also speaks of meeting regularly with Chaplain Mike McElhinny and of finding meaning and hope in the Wall of Hope, a collection of portraits and stories of people with cancer.

Ric was also grateful for visits with a Network for Patients and Families volunteer. “It was really helpful to talk with someone who had had the same kind of cancer I had as well as a similar type of treatment.” In addition, he enjoyed being with his Proton Beam “family.” “The nurses and techs were fantastic. We had lots of hugs and tears, and I really bonded with them. I could tell they felt bad when my face hurt so much. Sometimes when I was in the waiting room, one of the techs would come out and start joking with me. Having someone like Eliot come out and jaw with me made me feel like a real person.”

A month after he finished treatment, Ric went for a follow-up appointment. Dr. McIntyre entered the room with a big smile and gave an enthusiastic thumbs-up—the scans showed no evidence of cancer!

Even with great news, Ric describes the difficult time he had during the year after treatment. The severe facial pain went away after a month, “just like they said it would.” However, he still had nosebleeds, and his eyes watered constantly because the tear ducts had been burned. Breathing through his nose was difficult, and he sounded as if he had a head cold all the time. He felt exhausted. Ric felt worn out psychologically too. “Everybody noticed I was out of the loop, and I just didn’t feel like talking. For a long time, I was really angry and bitter—my job was gone, I had no income, I couldn’t do the things I used to enjoy doing, I felt lousy, and my nose kept bleeding. I felt like my whole world had been blown apart. And then I had to go on disability, which was a real blow. What’s the first thing you talk about when you go to a party? What you do for a living, right? Well suddenly, I wasn’t doing anything, and I couldn’t. I felt like I was in a rowboat without any oars.”

Things slowly started to get better. “It took a good year to get my confidence back and not feel like I had this aura of cancer floating around on my shoulders every place I went. Now things have pretty much evened out.”

Ric began re-establishing old friendships and making new ones. Lynn was always there for him, but he also began to think about his experiences at the hospital and how meaningful it had been when people reached out to him during treatment and recovery. “I realized that I felt better when I talked to someone like a Network Volunteer. There I was at home, and I had met so many nice people at the hospital, I thought, maybe I should volunteer in the Cancer Center. The people had been tremendous, and I wanted to come back and be a part of it, too.”

Ric began volunteering in the Cancer Resource Room, talking to people about his experiences, and providing support to patients and families. Ric’s assistance in managing the large supply of literature was so significant that it led to a part-time position.

Ric and Lynn also became members of the Patient and Family Advisory Council, and their efforts contributed to important programs that make the Cancer Center more hospitable. “When I first came to MGH, I didn’t know anything,” Ric comments. “I didn’t know about the Cancer Resource Room or where I could go to rest. There were no welcoming videos or patient guides. Coming to MGH is like trying to find your way around Buckingham Palace, and patients aren’t in the best frame of mind to figure it all out. They’re too sick. They’re too scared. They don’t know anything. I thought that maybe by volunteering, I could help people get through it all a little easier.”

With time, Ric’s confidence grew. “It was like going back to my old self, but with new dimensions. I started doing public speaking again. Before I got sick, I could go to a group, stand up, and speak spontaneously without notes or anything. All of that has come back, and I have a life again. I’m working. My job might seem like a low level activity compared with what I was doing before, but I really enjoy it, and it gives me peace of mind and a sense of purpose. I enjoy going out with people, but I also enjoy spending time at home with Lynn and the animals.” They share their home with two horses, a miniature horse, several guinea pigs, and a community of rabbits.

As he became more active, Ric noticed some important changes. “I started to feel this transformation which made me appreciate life. When I really thought about it, I realized that cancer did do some things for me: I was able to repair my relationship with my mother and other people in my family. My experience with cancer made me believe in myself and know I can do anything I put my mind to. And I’m a lot healthier than I was before I got sick. I was on my way to a heart attack—lots of coffee, no exercise, and stress, stress, stress.” He now maintains a healthy weight, follows a physical activity program, and enjoys a new outlook.

What advice would he give to others? Ric smiles, in response. “Enjoy each day and be good to yourself. Don’t wait twenty years to take that vacation. Do the things you’ve always wanted to do. And now, I really enjoy the little things like watching the children on the subway or seeing the grass blowing in the wind on a beautiful day.”

“It’s been a hell of a six years,” he continues reflectively. “Before this all happened, I’d tell myself, ‘I hope I never have cancer, because I’ll never get through it.’ Well, I did have cancer, I did get through it, and here I am still standing” . . . and he’s doing a whole lot more.