As every patient diagnosed with cancer knows, the disease affects not just your physical well-being, but your emotional well-being, too. I was just 35 years old when I was diagnosed with early-stage classical Hodgkin lymphoma this past summer, and the news came at a time when I was feeling in top physical shape and experiencing great professional satisfaction as conductor and Music Director of the Knoxville Symphony Orchestra in Tennessee. The diagnosis couldn’t have been more surprising; even as I progressed through the initial tests to determine what had caused a lymph node on the right side of my neck to suddenly become swollen, my mind refused to contemplate I could be seriously ill.
Even a call from my primary care nurse practitioner asking me to see her to go over the results from a CT scan—and urging me to bring my wife, Caraline, along—failed to set off alarm bells. It wasn’t until I learned I likely had a type of lymphoma or metastatic disease that my brain and emotions went into overdrive with the range of possibilities on how having a serious illness might upend my life.
Navigating the World of Cancer Care
Because Caraline is Clinical Research Manager at Memorial Sloan Kettering Cancer Center (MSK) in New York, we decided to travel to MSK to confirm the diagnosis and begin treatment. Being familiar with the surroundings of the hospital helped us navigate our way through additional imaging scans, laboratory tests, and two tissue biopsies, which confirmed that I did have early-stage classical Hodgkin lymphoma. Despite that familiarity, and even after a reassuring initial meeting with my oncologist, Alison J. Moskowitz, MD, the experience was still bewildering, and for a time I felt lost.
“Although serenity has never come naturally to me, I find I’m having a more measured reaction to the stimuli in my life now, and my emotions don’t run as high or low as they did before cancer.”— Aram Demirjian
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Cancer is scary and awful, and it puts everything in your normal life on hold. Dr. Moskowitz recommended a 4-month course of the combination chemotherapy regimen ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) to treat the cancer. Although I tolerated the therapy considerably well, like many patients going through chemotherapy, the persistent day-to-day side effects tested my emotional will and resolve.
Losing most of my hair was particularly defeating, because my hair has always been an important part of my identity. Its loss was a wrenching physical manifestation of how I felt like the disease was robbing me of my familiar life and sense of self.
The depth of the fatigue I experienced was also troubling. At its worst, even the simple act of reading or listening to music stimulated my senses to the point of exhaustion. All I could do the first few days following each infusion was lie on the couch and just exist.
But most concerning of all was the fear the chemotherapy would cause hearing loss. Many concert-goers might assume that orchestra conductors’ most important assets are their arms and hands, but they are actually our ears. A conductor is the only member of the orchestra who does not actually make any sound. Our principal responsibility is to hear all the musicians on the stage with clarity and help them arrive at a unified interpretation of the notes the composer wrote down. If chemotherapy were to leave me with diminished hearing, the career—and musical life—I love would be in jeopardy.
Fortunately, my oncologist was sensitive to my fear and took the time to assure me that my hearing would not be affected by the therapy. The fact that both Dr. Moskowitz and my entire medical team recognized not only the unique circumstances of my disease, but the unique circumstances of my life and career as well, made a huge difference in the confidence I had in my treatment and in my overall recovery.
Finding Comfort in Brahms
During this time, I found myself particularly drawn to the German composer Johannes Brahms. I have always had a relationship with Brahms’ music, and as I was undergoing treatment, I recalled how one of my teachers described any moment of Brahms’ music as “always living on two sides of one emotion.” In both his music and his life, what Brahms showed the world on the surface often belied a yearning and a layered depth of complexity internally.
The introverted quality of his music was speaking to me at this time, perhaps because so much of my day-to-day existence was inside my head and body. I was reluctant to share the full weight of that experience externally, even, at times, with the people closest to me.
Living Life as a Cancer Survivor
On January 3, I finished treatment, and 1 month later was declared cancer-free. Although, of course, I’m beyond grateful to have this outcome and a return to good health, I am still processing what it means to be a cancer survivor. I know having cancer has changed my life, but I am still learning a little bit every day about how it has changed me. I just know that I feel different.
Despite the terrifying nature of receiving a cancer diagnosis and having to fight for your life, you still must contend with the reality that your life independent of cancer goes on. You still must contend with the same ambitions, frustrations, and petty concerns you had before the diagnosis, as you incorporate the new challenges cancer brings into your life. A sense of new perspective comes slowly.
After completing treatment, I initially had a lot of anxiety about how to do life beyond treatment again without the imminent threat of cancer hanging over me. Although serenity has never come naturally to me, I find I’m having a more measured reaction to the stimuli in my life now, and my emotions don’t run as high or low as they did before cancer.
Recently, I have returned to the orchestra podium (conducting, among many pieces, Brahms’ Second Symphony) and am so grateful to everyone who helped get me back to the career and life I love. Most notably, I’m thankful to my wife, Caraline, and my medical team, as well as to my parents, friends, and colleagues.
I have always been fortunate to have great relationships with my family and close friends, but having cancer has amplified how important these people are in my life. Their love and encouragement sustain me and give me the strength to face the future with a renewed sense of optimism and without fear.
Mr. Demirjian is a conductor and Music Director of the Knoxville Symphony Orchestra in Tennessee. He is the 2020 recipient of the Sir Georg Solti Conducting Award, Solti Foundation, U.S.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
