Maryland governor on cancer diagnosis: 'Like peeling an onion'

Underdog victor says he'll approach treatment as he had all of life's challenges

ANNAPOLIS, Md. — Maryland Gov. Larry Hogan didn’t feel sick at all last month when he found a golf ball-like lump in his neck while shaving. He thought it might just be a cyst.

But when Hogan told his primary physician about it after returning early this month from a trade mission to Asia, his doctor referred him to a specialist who ordered an MRI and CT scan. Twelve more tumors turned up in his neck and chest. After a full MRI, 20 to 30 more were found.

Hogan had cancer.

“It was like peeling an onion,” he said, discussing his diagnoses of B-cell non-Hodgkin lymphoma during a news conference Monday. “It was: ‘Let’s send you for this test … that’s bad. Let’s send you for this test, that doesn’t look so good. Let’s send you for this test, it’s even worse than we thought.’ But I didn’t really have any symptoms.”

The Republican governor spoke with the candour that often characterized his campaign leading up to a stunning upset victory last November in a heavily Democratic state. He choked up at times while also managing to puncture the sombre air of a hastily called news conference with humour.

With family, friends and staff by his side, Hogan, 59, vowed to battle the disease with the same underdog intensity of his unlikely November victory.

“I’m going to face this challenge with the same energy and determination that I’ve relied on to climb every hill and to overcome every obstacle that I’ve faced in my life,” Hogan said.

Hogan pledged to keep working, through the 18-week process, though he will miss time on the job because of treatment.

“All of the experts tell me that they believe that I’ll come out of that completely clear,” Hogan said. “They also tell me it’s going to beat the hell out of me, so you know, honestly they say you’re going to go through hell and back again, but you’re going to love it when you get back and the results are going to be good.”

Dr. Richard Fisher, a lymphoma specialist and president of Fox Chase Cancer Center in Philadelphia, said Hogan’s cancer is the most common form of lymphoma, and that most cases are diagnosed in later stages, as Hogan’s was.

Treatment involves intravenous combination chemotherapy plus the immune therapy drug Rituxan, usually six cycles, every three weeks, as an outpatient. The main side effects are hair loss, possibly fever and low white blood cell counts, which often can be prevented with other medicines.

“Patients usually miss only a day or two of work every time they’re treated and they’re usually able to continue their fulltime jobs,” he said. “The aim is cure.”

Dr. Catherine Broome at MedStar Georgetown University Hospital’s Lombardi Comprehensive Cancer Center, agreed.

“Therapy has come a long way in the last 15 years or so. We achieve remission in this disease over 70 per cent of the time,” and at least half of patients survive at least five years, she said.

Hogan said he has been feeling good and has had few symptoms, but he has tumors, a low appetite and some pain. He will miss some meetings while he undergoes chemotherapy, but won’t stop working, like many other Americans who undergo cancer treatment and stay on their jobs. He has missed some recent public appearances due to medical appointments and procedures, but he also has attended some events.

“I’m still going to be constantly involved” in running the state, Hogan said, adding that Lt. Gov. Boyd Rutherford will fill in more for him. “Boyd has my back,” he said.

Asked if there were any circumstances that would cause Rutherford to be governor over a long term, Hogan quickly said only death or lengthy incapacitation would cause that.

“I mean, if I died,” Hogan said emphatically, to laughter in the governor’s reception room.

“I mean, that’s hard to foresee, unless I’m completely incapacitated and, you know, unconscious and unable to make decisions, then I’m sure that that would take place, but I don’t foresee that happening,” Hogan said, as the news conference ended with applause from staff members.

The state’s constitution enables the lieutenant governor to serve as acting governor “when notified in writing by the governor that the governor will be temporarily unable to perform the duties of his office.” Hogan said that happened for about an hour last week when doctors “put me to sleep” for a medical procedure. The lieutenant governor also can serve as acting governor when the governor is disabled but unable to communicate the fact of his inability to perform the duties of office.


AP Chief Medical Writer Marilynn Marchione in Milwaukee, Wisconsin, contributed to this report.

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