Cancer counselor's role reversed
Published: Friday, January 21, 2005 at 6:01 a.m.
Last Modified: Thursday, January 20, 2005 at 10:15 p.m.
At 46, Gale Smith wants a second chance at life.
That second chance can only come from a total stranger.
Soft-spoken and slim, Smith sits on the living room couch in her Gainesville home, surrounded by family, and talks of life as a cancer patient.
As a licensed clinical social worker in the bone marrow transplant unit at Shands at the University of Florida, Smith counseled and comforted cancer patients. So she could not have been more surprised in October of 2003 when she was diagnosed with multiple myeloma.
"It was quite surreal suddenly to find myself in the position of being the patient," Smith said.
Multiple myeloma is marked by excessive growth and malfunction of plasma cells in the bone marrow, which interferes with production of red blood cells, white blood cells and platelets.
As the cancerous cells grow and expand in the bone marrow, they also cause pain and destruction of the bones.
"About 14,000 people are diagnosed with the disease in the U.S. each year," Smith said. "It used to be considered a disease of older black men, but I have seen it in women of my age and younger. It crosses all lines of race and socioeconomic status."
On average, those who are diagnosed with multiple myeloma live about three years. The best hope for driving the disease into remission is through a bone marrow transplant, replacing the patient's unhealthy blood cells with healthy blood-forming cells from a volunteer donor.
Gale Smith has yet to find a donor whose tissue type matches her own.
In February of last year, while her disease was in remission, Smith had an autologous transplant, using her own stem cells. When she found out that she had relapsed, Smith said the news struck her down as fiercely as the original diagnosis.
"I stayed in bed all weekend, and spent most of it in tears and pain," she said. "Anyone who has this disease knows that the bone pain is unreachable."
Her spiritual strength has gotten her through days when no medication could help her, Smith said.
"When I first was diagnosed, I never asked God, 'Why me?' All I know is that this is something that I have to do, and God is my number one strength," she said.
Smith's best hope of another period of remission is to get a bone marrow transplant. The greatest factor working against her is that she is African-American.
There are more than 5.5 million potential bone marrow donors on the national registry; statistics from the National Marrow Donor Program show that about 2.4 million of them are Caucasian and fewer than 500,000 are African-American.
The need for marrow or stem-cell transplants for African-American patients, however, has nearly tripled since 1995.
Blacks, Hispanics and Asian-Americans have greater genetic diversity than the Caucasian population, which complicates the effort to find a perfect marrow match from another individual.
Because tissue type is inherited, patients are most likely to match someone of their same race and ethnicity.
Twins and siblings have the greatest chance of matching DNA and blood type, but 70 percent of patients do not have a matched donor in their family. Smith has eight full-blooded living siblings; none were a match for her.
"I guess I have some unique gene typing, but we don't know what it is," she said. "That unique antigen might have come from one of my parents, and there may be someone else out there with that rare antigen who could be an unrelated donor. We just don't know."
With more than 13 years as a social worker at Shands, Smith said she always encouraged people to join the national bone marrow registry.
"You never know whose life you might be able to save," she said.
Now she is hoping that someone, somewhere will join the registry and prove to be a match.
Until then, she waits with her children, 30-year-old Latisha, 26-year-old Mironda and 23-year-old Charles, and three grandchildren.
"I know that a higher power has gotten me through a lot of challenges in life," she said. "He will get me through this."
Joining the registry is simple, according to Cate Boyett at LifeSouth Community Blood Center, the marrow donor center for North Central Florida.
You must be between 18 and 60 and meet health guidelines. You must provide a sample of blood for typing, and will be asked to donate a pint of blood as well.
There is no cost to join the registry if you are a minority. Your tissue typing information will be recorded, and if at some point it is a match for someone awaiting a transplant, you will be asked to donate your bone marrow.
"We hope anyone who joins the registry will follow through with making that donation, if the need arises," Boyett said. "A life is depending on it."
Boyett said that right now, LifeSouth staffers are asking people who wish to donate to sign up, but wait to donate blood until the upcoming donor drive.
"Saturn's National Donor Day is Feb. 14, and we will hold a blood and bone marrow registry drive from Feb. 13-19," she said.
"I want people to donate . . . not because it's for me, but because it could be anyone's child, sibling or parent who might need this treatment," Gale Smith said.
Diane Chun can be reached at (352) 374-5041 or firstname.lastname@example.org.
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