When It's OK to Use the Word 'Lucky'

Nobody should say you’re lucky to get cancer, but luck is a matter of degree.

For example, an acute myeloid leukemia (AML) patient like myself is lucky compared to one who got the blood cancer before stem cell transplants became common practice. In great part, we owe our survival to the so-called Father of Bone Marrow Transplantation, Harvard-trained researcher E. Donnall Thomas, who I wrote about in a piece on what it’s like to be a chimera, a person with two types of DNA.

Lucky to have gotten AML in the age of stem cell transplants

In 1957, Thomas published a report of a new approach to blood cancer treatment: radiation and chemotherapy followed by the intravenous infusion of bone marrow.

"That publication represented the beginning of a long series of laboratory and clinical investigations; more than a decade would pass before the procedure achieved its first successes," Frederick R. Appelbaum, M.D, wrote in an appreciation in The New England Journal of Medicine.¹

“Bone marrow transplantation and its sister therapy, blood stem cell transplantation, have had worldwide impact, boosting survival rates from nearly zero to up to 90 percent for some blood cancers,” Gordon Todd and Kristen Woodward wrote on the website of the Fred Hutchinson Cancer Research Center, of which Thomas was a founding faculty member.²

In 2013, The Worldwide Network for Blood and Marrow Transplantation announced that 1 million stem cell transplants had been performed worldwide. If that number impresses you, how about the estimated 16.9 million cancer survivors in the United States, as of January, 2019.³ This amounts to a whole lot of people who could use a little help planning the rest of their lives, which brings me to the next reason that I feel lucky.

Lucky to have access to a survivorship care plan

That’s where another layer of luck – or maybe more accurately timing – comes in. I was diagnosed in 2003. Those more recently diagnosed have a greater chance of receiving a survivorship care plan to help them navigate all the complications of life after cancer.

In 2009, the American College of Surgeons (ACOS) Commission on Cancer (CoC) members began planning for a shift in accreditation standards that would require Survivorship Care Plans. That’s the year I finished treatment. Needless to say, I didn’t get a plan. They released the standards in 2012, and scheduled a Survivorship Care Plan standard for phase in beginning in 2015.⁴

If you’re a newly diagnosed patient, you might justifiably think, “What, me lucky?” But I’m just saying that being a chimera isn’t easy, and a survivorship plan could lessen the load.

Cancer program leaders have ranked the standard the most difficult to achieve. In response, the commission changed the timetable and scope, announcing that only 50 percent of patients needed to have a survivorship care plan by the end of 2018.⁵

When you’re diagnosed with a life-threatening disease, you have more pressing concerns than whether you’re going to get a survivorship plan, but it would be helpful to know.

Not lucky to get cancer, but lucky in other ways

So, while I'm not lucky to have gotten leukemia, I'm certainly lucky that I had access to new treatments and am grateful that tools like a survivorship care plan have become more commonplace.