SANTA FE, N.M. — Dressed casually, standing in the morning sunshine packing the station wagon for a camping trip with his wife, son, two daughters and the family dog, Dr. Fitzhugh Mullan looks like neither the highest-ranking health official in New Mexico nor a man nearly killed by cancer a decade ago.
In reality, Mullan, 43, is both. He oversees 3,300 employees and a budget of $160 million as secretary for health and environment to Gov. Tony Anaya, one of the nation's most controversial state house leaders.
More important, perhaps, as one of the most prominent cancer survivors in the United States, Mullan is a leader in the struggle for more widespread recognition that, because cancer is being cured more often than ever before, medicine and society have to learn to cope better with the problems faced by people who live through it.
He has been voicing these concerns for several years, attracting a small audience outside the immediate circle of medical specialists who treat cancer and the people who have contracted it and survived. One of their hopes is that President Reagan will prove, over time, to be a long-term survivor, too, and that his case will be as prominent an example of coping with the challenge of survivorship as it has been a public vehicle for new awareness of his specific disease--colon cancer.
Mullan and Dr. Robert McKenna, the Los Angeles cancer surgeon who is this year's president of the American Cancer Society, hope to attract more interest in survivorship. To them and others prominent in the developing field, the situation is both testimony to the growing success of cancer treatment and a statement about how medicine and the public at large have paid too little attention to the sometimes special needs of people who, though cured, bear both the physical and emotional scars of the disease for the rest of their lives.
Standing in the driveway of their house near downtown Santa Fe, the Mullans as a family look as if they were posing for Norman Rockwell:
--Judy Mullan, the social worker, wife and mother. Judy, who bore the months of sickness and the brushes with death as the interim chief executive of the home and who did the job so well that, she laughs now, when Fitz came home from the hospital, "I started to feel like I was sort of an Amazon. I was strong. He came home and he was sick and I had these images that I'd crush him or something. That was my conception of myself."
--Meghan, 13, the firstborn who was 3 when her father found his cancer himself one day, glancing at an X-ray of his own chest. (It turned out the cancer was a type called seminoma--a hard tumor that is usually a metastasis of testicle cancer, which Fitz did not have, but which sometimes occurs spontaneously in the chest.) Meghan, sharp and hoping for a career in journalism, came home from school one day when she was 8--Fitz had reached the sometimes magical five-year survival point by then--in tears, Judy recalls, because she hadn't really understood the ramifications of the word cancer until that day.
--Caitlin, 9, born while Fitz was still undergoing treatment for his cancer.
--Jason, 11, adopted later and the son who came to the family when he was 3 and added extra stimulation.
--Ranger, the golden retriever who wags his tail eagerly, impatiently waiting for the camping trip to begin.
--Fitz himself, his chest turned into a case study in reconstructive surgery, who has scars visible on his arms from where skin was transplanted to patch his radiation-burned chest. He does not follow fashion and leave the front of his shirts unbuttoned.
It is a happy, contented group. The kids find Santa Fe a little tame. They are impatient for the camping trip to begin.
Cancer survivors--and their families--emerge from the physical and psychological traumas of discovery of their disease, diagnosis and treatment scarred by surgery, sickened by chemotherapy and weakened by huge doses of radiation. They are alive--some times for a few months or a couple of years--but, increasingly, for many years or many decades.
Survival Rate Up
According to the American Cancer Society, there are 5 million people alive now who have been diagnosed as having cancer, 3 million of whom who have survived five years or more. The figure is up markedly since a National Cancer Institute survey in 1971 found 2.9 million people who had had cancer, with 1.3 million alive five years after diagnosis. Cancer experts say the number of long-term survivors is certain to grow quickly in the next decade and beyond.