A New Rhythm

Balderson was treated with high-dose steroids to bring down the inflammation caused by the tumor in his spine. After five days in the hospital, and still in some pain, he left using a walker.

He came under the care of oncologist Louis Frederic Diehl, MD — who he’d collaborated with professionally for years. Under his guidance, Balderson went through six cycles of an R-CHOP chemotherapy regimen (including the drugs rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) from February through early June 2015, followed by radiation treatments, advised by Chris Kelsey, MD, that were completed by mid-July. 

During the first couple of months of treatment, especially, there had been no getting around the fact that Balderson, who was so used to taking care of others, was now the patient. Used to being a bit of a work-a-holic, he was “off the grid.” His sister Ridgely, who’d help him start an online Caring Bridge journal, wrote in March 2015 that her brother was an “A + patient, with no complaints.”  

“He's finding a new rhythm to his days ... morning prayer, walking, shower, desk time and rest time,” wrote Ridgely in March 2015, a week after Balderson started his second treatment cycle.  “He is getting around really well and clearly relishing the extra time at home with Carter and Isabel (his kids).”  

Cleared of cancer by the summer of 2015, Balderson’s follow-up visits with Diehl through December 2015 continued to show “no evidence of disease.”  

While Balderson had worked as much his treatment schedule and side-effects allowed that summer by the fall he was back in clinic full-time; working toward establishing what many cancer survivors call “a new normal.”  For Balderson, this meant not as many late nights at home catching up on work, though there was always a lot to catch up on, and no more cycling or triathlons due to his still ailing back. Walking was now more his speed.

Then, in August 2016, a few weeks shy of a surveillance appointment, he started feeling “really rough and run down.” He made an appointment to see Diehl early. Diehl drew some blood and found Balderson’s LDH marker elevated, so he advised a PET scan. It showed a very large retroperitoneal mass (back of the abdomen), so Balderson began chemotherapy the next day. 

This time the treatment formula was R-ICE (rituximab, ifosfamide, carboplatin, etoposide phosphate), a more toxic chemotherapy combination than before. He endured three cycles, in August, September and early October, and had “a great response.” No tumors. The next step was a bone marrow transplant in November, using his own stem cells (autologous transplant) to rebuild his immune system. 

“It was hard; I never felt so sick in my entire life,” said Balderson, who was grateful to be able to receive follow-up supportive care in his home as part of a clinical trial.   

He had some complications — diverticulitis and “a little transient kidney failure” — that required a two-and-a-half week hospital stay, but he made it home in time for Thanksgiving. 

Community of Faith

Balderson said that throughout his cancer battle he was “held by an immense community of faith and prayer and love” that included friends, many of whom were colleagues, and family, and “in the best possible hands, at the best place on the planet to be a patient.” 

“When there were junctions in the road, I had great faith and comfort in knowing that the person whose hands were on the wheel at any given moment was the person that you would want there,” said Balderson lauding everyone from the pathologists, to the physicians, nurses and other staff who took care of him, including Diehl, Kelsey, his transplant physician Mitchell Horwitz, MD, and ABMT Clinic nurse practitioner Kristi Wiggins, MSN, ANP, APRN-BC. “They were at the top of their game. I cannot possibly imagine that I could have been taken care of any better anywhere else.” 

It was a cardio-thoracic surgery scholarship that first led Balderson down the path to Duke 20 years ago. He's been the PA for thoracic surgical oncologist Thomas D’Amico, MD, ever since. Balderson evaluates patients pre-operatively, performs clinic visits, and handles triage when needed. He’s also D’Amico’s “eyes” for complicated surgical cases by manually manipulating a vital camera.

Balderson said there’s nothing he can imagine that could matter more than continuing to care for patients who, like his colleague and friend Dr. D’Amico, continue to inspire him. 

“I see the way their minds wrap themselves around their diagnosis,” he said. “One minute they are sort of shrouded in terrible darkness and insecurity, like I was, and the next minute they’re putting one foot in front of the other.”   

Like many of his patients, Balderson is choosing to live in the present.

“You can’t live in the past because you’re angry and frustrated and you can’t live two weeks, two months down the road, because that’s such an insecure place to be, not being able to predict the future,” he said. 

He’s pressing on, through surgical innovation and compassionate care, with his mission to improve the quality of life of those he serves.