Michael Embick's answer is precise when asked what went through his mind when he received his first cancer diagnosis.
"I didn't want to die," he said simply.
Cancer almost claimed his life twice. His first diagnosis happened in 2016, when he began feeling severe pain in his left leg. The 66-year-old retiree coached youth sports for decades, so he visited an orthopedic surgeon thinking those years of movement and activity had caught up to his knee.
“That's not what happened," Embick said . "I probably wasn't home a half hour before the doctor called and said, 'I need you to come back over here, I've got some things that we need to talk about.' I'm thinking, 'Well, this can't be good.' I come to find out that I had cancer in my lower left leg.”
Embick had Diffuse Large B-cell Lymphoma, or DLBCL. It’s an aggressive blood cancer that affects the lymphatic system, which is the network of tissues, vessels and organs that fight infection in the body. He said he wasn't a high-risk patient, nor had he experienced any signs of cancer prior to the leg pain.
He endured five rounds of chemo and 20 radiation treatments. By July 2021, his cancer reports were clear. But by August, Embick began experiencing some strange symptoms, including leg and back pain and rapid weight loss.
"I broke out in a rash and it was probably one of the worst things I've ever had," Embick added. "It made my whole body itch and it was terrible. And from there, my skin started to blister."
Embick saw another orthopedic surgeon, where an MRI revealed cancer in his abdomen.
"That was a bit of a shock. I'm not going to orthopedic surgeons anymore," he said.
His doctor acknowledged the complexity of his case and referred him to The James Cancer Hospital at Ohio State University Wexner Medical Center. Doctors tried a variety of treatments, but Embick's journey included some grave moments — he nearly died twice.
A breakthrough treatment
Embick eventually received early approval for Epkinly, an injectable bispecific antibody treatment that has since been approved by the U.S. Food and Drug Administration for DLBCL treatment. It works by attaching to the body's T cells and B cells, binding them so the T cells can attack and destroy the B cells.
"So it truly is going to the site of the lymphoma, attaching to that area and then activating the immune system to cause an immune response," said Dr. Timothy Vorhees, Embick's oncologist.
Within two weeks of receiving his first injection, Embick said he felt his strength and stamina returning while he also regained weight. Now, he's achieved remission and returns to Columbus for treatment once every four weeks. He said he lives with few limitations.
"Life is good, and it's worth living. Don't be that person that tries to ignore something that's going on with you physically — especially if you're a man," he said.
Addressing cancer-related PTSD
But cancer has changed Embick. He gets a bit choked up when he discusses it, because though he's returned to an active lifestyle, the trauma of his diagnosis and treatment remains.
“What I'm experiencing is like a form of PTSD. And it's amazing what may trigger a day of sadness or being upset," he said.
A 2017 study found that PTSD is more common in cancer survivors than the general population. Symptoms include re-experiencing the traumatic event — like the diagnosis or treatment — usually in the form of flashbacks or nightmares.
PTSD following a significant diagnosis is a trauma response, which manifests differently in everyone, according to Melissa Turner, a counselor who specializes in PTSD treatment at Mind Trek Counseling in Cleveland Heights.
“A diagnosis of cancer, it can cause severe symptoms because [the patient's] body is kind of out of sorts," Turner said.
According to the American Psychiatric Association, 22% of cancer survivors suffer from some level of lifetime cancer-related PTSD, though only a small percentage seek mental health treatment. That can affect prognosis and recovery, because patients with untreated PTSD see poorer cancer outcomes, studies have shown.
Embick said he needed a counselor to navigate the impact cancer had on his body.
“There are so many things happen to you that nobody tells you are going to happen," Embick said. "And I understand why they can't tell you, I truly do. It is an act of kindness. But once you're through it, you need to talk to somebody who is not a family member.”
But family also needs support. Embick's wife, Kimberly, said she saw her role during his cancer battle as being an advocate for her husband.
"I had three very close friends and they each played a different role," she said. "One was a cheerleader, one was a support person, and one was my voice of reason."
Embick proactively sought out mental health treatment himself, but Turner said she often sees patients who are resistant to seeing more doctors or health professionals. Those feelings often stem from experience with neglect or disrespect from care providers.
Other cancer survivors may struggle over when to seek medical care, Turner said. Some patients avoid doctor's visits due to past trauma or fear of future diagnoses, while others may become anxious over small ailments.
"Some become super hyper-aware of all symptoms in their body, so they are running to the doctor over just a minor symptom," Turner explained. "And then on the opposite end, [some] just keep ignoring it because they don't want to get a prognosis that is out of their control again."
If someone isn’t ready to sit down with a counselor, cancer survivor support groups are a good starting point, Turner added.
“There is power in numbers," she said. "And having people that understand where they're at, that will also help the overall outcome of their treatment.”
Others say oncologists can play a more active role — by making sure they discuss mental health concerns with patients and letting them know help is available, often within the hospital walls.
