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Bill and Ralph's Lung Cancer Story Lung Cancer

Bill and Ralph Patient Stories Cancer

They met in San Diego in 1997, spent a few years in San Francisco, and ultimately made Florida home. So how did Bill Cain and Ralph Madden, married since 2013, end up at Penn Medicine?

To hear them tell it: Serendipity.

“We never could have imagined we’d both receive lung cancer treatment a thousand miles away from home, in Philadelphia,” Bill says.

Of course, they never could have imagined they’d receive lung cancer diagnoses within two months of each other, either. 

The First Trip to Philly

Bill and Ralph’s shared journey to Penn began a few years before lung cancer struck. In 2017, Ralph needed urological surgery. A Florida specialist attempted the surgery twice without success. Frustrated, Ralph and Bill mentioned the dilemma to their friend John, who lives in Philadelphia. John encouraged Ralph to consider Penn Medicine.

Online research convinced Ralph that John might be onto something – that traveling to Penn Medicine might just be worth hassle, given its reputation and outcomes. Within a few weeks, Ralph and Bill were 30,000 feet in the air, on their way to Ralph’s appointment with Penn Medicine urological specialist Robert Kovell, MD.

“I knew as soon as I met him that I was in good hands,” Ralph remembers.

Ralph underwent surgery with Dr. Kovell, more than a thousand miles from home. Luckily, Bill had a place to stay.

“Our friend John was so generous, letting us come and go from his Philly condo as needed. Little did we know that in a few years, it would be our home away from home,” he says.

Another Choice, Another Trip to Penn Medicine

The procedure was successful. Ralph and Bill returned home to Florida where they resumed life as active semi-retirees. Bill ran a small landscaping business. Ralph kept busy with bookkeeping jobs. They both felt great, and prioritized routine health care – including some preventative screenings.

“We’ve both been non-smokers for more than a decade, but our doctor had us undergo CT scans on our lungs every six months in light of our smoking histories,” Ralph explains.

In early summer of 2019, Bill’s CT scan showed abnormal growth. His general practitioner ordered an exploratory biopsy by a nearby specialist, but that specialist couldn’t hit the right spot. It felt like déjà vu, and Bill decided to follow in Ralph’s footsteps. He pulled up Penn Medicine’s website and randomly chose Anthony Lanfranco, MD from the directory of pulmonary specialists.

“Knowing what we knew about Penn Medicine through Ralph’s experience with Dr. Kovell, it was a no brainer,” he says. 

When You Know You Made the Right Choice

Before they knew it, he and Ralph were once again traveling to Philadelphia and staying with their pal John. Ralph remembers Bill’s first appointment with Dr. Lanfranco.

“He sat with us for 90 minutes and listened so carefully. We immediately had the sense that traveling to Penn Medicine was once again the right decision.”

After reviewing Bill’s scans, Dr. Lanfranco told him that a biopsy wasn’t the priority. A partial lung removal was.

“He said, ‘You have cancer. Surgery should not wait.’ He was honest and clear, and I liked that.”

Dr. Lanfranco brought in a few more specialists, including thoracic surgeon Doraid Jarrar, MD, FACS, FCCP.

“They were both so personable,” Bill remembers. “We loved that we could crack jokes with them even as we talked about something so serious.”

Less than two weeks later, on August 14, Bill underwent a lung resection – an upper left lobectomy – to remove the cancerous section of his lung. Because the non-small cell cancer had spread, doctors also removed 12 lymph nodes.

Bill would need chemotherapy, which doctors agreed he could undergo back home in Florida. Before he was discharged, though, Bill developed atrial-fibrillation (often called a-fib) – irregular heartbeats that can lead to heart failure or stroke. It was frightening, but it was also the moment when Penn Medicine’s response showed him how much they truly cared. He realized that being a patient at the Abramson Cancer meant having access to specialty care across the entire Penn Medicine health system when you need it the most.

“My atrial fibrillation began during a shift change, when one set of doctors and nurses are leaving and another is coming in,” Bill remembers. “Within minutes of my symptoms, I had 15 nurses and doctors in my room – the incoming teams and the outgoing teams. I said to the outgoing team, ‘Aren’t you all supposed to be leaving?’ They said, ‘We’re not leaving until you’re stabilized!’”

Bill and Ralph Cancer Patients

It Gets Worse – Then Better

While Bill’s heart was being monitored in the weeks after, Ralph encountered his own health bombshell.

“I had come home to Florida for a few days to take care of matters here when I got a call about my last CT scan,” he remembers. “My general practitioner was concerned about what he saw.”

Ralph made his own appointment with Dr. Lanfranco and Dr. Jarrar for as soon as he returned to Bill’s bedside in Philly. Their news was shocking: Ralph, too, had lung cancer. The prognosis was very similar to Bill’s – though Ralph’s cancer thankfully had not spread to his lymph nodes.

Ralph’s lung resection surgery was scheduled for October 3. Bill had only recently been discharged from Penn’s Abramson Cancer Center when he returned by Ralph’s side a few weeks later.

“The nursing staff was like, ‘What are you doing here?’ and I got so many hugs. Despite the circumstances, it was really nice to be greeted like that.”

Ralph’s lung resection went smoothly and no post-surgery treatment was needed. Once again, Ralph and Bill stayed with John until they got the all clear to head back home.

Back in Florida, Bill continued chemotherapy, completing his final round on the day before Thanksgiving. His atrial fibrillation is stabilized. He takes a blood thinner and a beta-blocker and sees a cardiologist in Florida.

Ralph has fully recovered from his lung resection.

Looking Forward to the Future

The men celebrated clean bills of health with a trip to Europe in December, and have another trip on the books, too: A few days in Philly for follow-ups visits with the Abramson Cancer Center in April. In the meantime, they stay connected to their care teams through the Penn Medicine patient portal, myPennMedicine, where they can post questions and receive direct responses from their doctors and their larger team.

“I think it was fate that got us started on our journey with Penn Medicine back when I saw Dr. Kovell,” Ralph says. “If he and the urology team had not been so wonderful in 2017, we might not have bee-lined back to Philadelphia two years later, when the stakes were even higher.”

Traveling back and forth between Florida and Philadelphia for treatments wasn’t always the easiest, they say – especially when Bill wasn’t able to fly or take the wheel, leaving all of the driving to Ralph. But – as Ralph puts it: “We did what we needed to do.”

“And it paid off in spades,” he adds.