‘Once she explained it to me, I could just let go’
“I want to get the word out about important hospice is,” said JoAnn Nadeau of Mashpee, when she agreed to tell her story.
Her husband, Paul, died of esophageal cancer this past May and, with the help and support of the VNA of Cape Cod Hospice & Palliative Care team, he was able to die comfortably at home.
“I had no idea how comprehensive their help was going to be and how it was going to extend out to my family,” said JoAnn. “I am so grateful for their support, and the caring and gentle way they took care of Paul.”
His cancer journey began in July 2015. While he did go to Dana Farber Cancer Institute for initial consultations, the couple decided after meeting with Cape Cod Hospital specialists they felt more comfortable having Paul’s treatments at Cape Cod Hospital.
A PET scan showed that the cancer had not spread, which made him eligible for an esophagectomy, a surgery to remove the tumor in the esophagus, according to JoAnn. Jeffrey Spillane, MD, a surgeon at Cape Cod Hospital (CCH), performed the surgery on the couple’s 45th wedding anniversary in November 2015.
After a lengthy recovery, Paul and JoAnn met with Jaclyn Flanigan, MD, a medical oncologist at Davenport-Mugar Cancer Center at CCH in January 2016. She had to break the news to them that the most recent PET scan showed Paul’s cancer had spread.
“They saw a lesion on his liver and after doing a biopsy, it became clear that they weren’t looking for a cure,” she said. “Instead, they were looking to prolong Paul’s life as long as they could with chemotherapy.
“I’d say in the whole scheme of the two years that we were going through his diagnosis, treatment and hospice, that was the biggest shock for me. We were told with this type of cancer that it could spread seeds to other areas of the body, but I never thought it would happen.”
Deciding On Hospice
Paul was pretty healthy when he began his weekly reduced-dose chemotherapy treatments, according to JoAnn. As time went on, he became more fatigued and his appetite dropped off. He told his wife that if could get his strength back, he would be OK.
“Paul is Finnish and one of the words for tenacity, or courage or digging deep is ‘sisu,’” said JoAnn. “He talked a lot about needing sisu during this time.”
In December, the couple decided to take a brief trip to Oregon where their two daughters live. Paul, who loved music, had the opportunity to hear one of his grandsons sing in a choir.
“It was a good decision because it was the last effort he was able to make,” said JoAnn.
Two months later, JoAnn decided she needed more help with Paul’s care because he seemed depressed and he was shutting down.
“He had to put all his energy into just functioning,” she said.
They met with Jeff Gaudet, LICSW, OSW-C, survivorship program manager at Davenport-Mugar Cancer Center, and he suggested palliative care with the VNA Hospice program.
Everything was set into motion and after meeting with a representative of the program, Paul had a physical therapist, nurse, and dietician scheduled to come to the house to evaluate him and start care.
In April, 2017, as Paul’s condition continued to decline and after two falls, one that caused a brain bleed and a brief hospitalization, his nurse from the onset, Christine Eaton, RN, talked to him about moving onto hospice.