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By Natalie Robins

June 28, 1999 | November 27, 1995

Late this afternoon I was diagnosed with cancer. I learned that I had a form of non-Hodgkin's lymphoma called "malt," for "mucosa-associated lymphoid tissue." My oncologist, J. Gregory Mears, M.D., said that mine "was not a bad story," because my tumors were "indolent," slow-growing. Not a bad story? Doesn't just about everyone know that non-Hodgkin's lymphoma is incurable? I have incurable cancer. Jackie Kennedy Onassis recently died from the same disease. What was good about any of this? Dr. Mears's words were hard to take in, but my husband, Christopher, and I strained to listen carefully.

There are two basic types of lymphoma, cancers of the body's immune network: Hodgkin's and non-Hodgkin's. Cell structure determines which is which. The microscope had shown mine to be one of 10 forms of non-Hodgkin's lymphoma. Mine was low grade. When I brought up Jackie Onassis, Dr. Mears said that her lymphoma had been very fast-growing and was completely different from my disease.

"Malts," a fairly recently defined medical entity, are tumors that grow outside the lymphatic system, in odd places like the gastrointestinal tract and lungs (or even, heaven forbid, in the tear ducts). I have a visible five-and-a-half-inch indolent tumor sitting in the fatty tissue of my lower back, and CAT scans and MRIs taken over the past week also revealed a smaller tumor in my thoracic region, lesions at the base of my lungs, as well as two tiny tumors in the pelvic lymph nodes themselves. A test had revealed that there was no bone marrow involvement, the only good news as far as I am concerned.

Although my cancer is incurable, it is "manageable," Dr. Mears says. "Think of it as a chronic disease." I must now regard myself as having a condition like, say, diabetes. Dr. Mears emphasizes that none of my symptoms is "terribly threatening," that he does not see "grave" danger to my life "now," and that "the picture is not black." There is a relatively new chemotherapy drug called fludarabine that has melted away tumors like mine. Dr. Mears says that the B cells in my tumor "have forgotten how to die," and that this drug "makes the cells learn to die again." (B cells are one of two types of white blood cells -- or lymphocytes -- crucial to the body's immune response. T cells are the other type.)

I had a hint of what was coming on November 22, when a biopsy revealed "lymphoid cells where they shouldn't be," as a pathologist put it. The next day was Thanksgiving and my husband and I and our 17-year-old son, Noah, a high school senior, somehow managed to crawl through it. We had dinner at a neighbor's house. Our 26-year-old daughter, Rachel, a graduate school student in California, was spending the holiday with friends in San Francisco. She was worried and comforting at the same time, phoning often throughout the day and night. Noah, the family computer expert, printed out pages and pages of important news about lymphoma from the Internet. He gave them to me only after my diagnosis was certain, and then only the pages concerning non-Hodgkin's.

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