A Project Manager’s Game Plan for Dealing with Incurable Cancer

Introduction and About the Author

I’m Carl Pritchard. I have stage four cancer, diagnosed in 2021. It’s a cancer of the lung and neuroendocrine cancer of the liver. I will never forget my meeting with Dr. Hudhud for my persistent nausea. 

You have cancer of the liver.  It’s incurable.

You need to understand that Hudhud was among the nicest doctors I’d ever met. He had a warm bedside manner, and up to that time, had seemed like the practitioner you’d want if you ever had something serious coming down the pike. In that moment, however, he seemed like the bearer of the proverbial ton of bricks.

As my wife and I sat in his office, we contemplated what he had just said.

You have cancer of the liver.  It’s incurable.

As part of my family history, I should have seen this coming.  My grandmother died of cancer.  My mother died of cancer.  My father survived colon cancer in his 50s. My sister survived breast cancer in her 50s. I made it all the way to age 63 without cancer. And now, POOF!, I am in Stage Four cancer.

Stage four has two distinctive traits.  For one, it’s largely seen as incurable. For two, it’s metastasized to at least one other organ.  There was no Stage one, two, or three on the journey here.  Whack.  Congratulations.  You’re at Stage Four.  Neuroendocrine cancer is unlike those cancers where you have a mass to fight. Instead, it’s like dozens and dozens of little BBs. Each is a mini-mass in its own right.  Each is pouring out cancer markers (chromogratins) like nobody’s business.  The average person has less than 100 chromogratins when they’re living without cancer.  I had over 40,000. Not a good sign.

I should have seen it coming. I had started a diet almost ten years ago, striving to get down from my massive peak weight of 283 pounds.  I had a 46-inch waist and wore 2XL t-shirts. I had been religious about the Atkins Diet and had very slowly, over 7 years, dropped my weight to just over 200 pounds. But now, in a matter of months, I had dropped another forty, and there was no end in sight. That, coupled with a constant state of nausea, was what drove me to Dr. Hudhud in the first place.

(Mind you, I didn’t mind suddenly weighing 160 pounds.  That part was actually kind of fun.  I hadn’t weighed this little since college).

I felt blessed that it all hit during the COVID epidemic. I didn’t have to face anyone, and I was able to bow out gracefully from a lot of work that I had scheduled.  That was kind of important, since I was working like a dog, even virtually. It was much easier to scale back on work when everyone was hiding in their homes, wearing masks and avoiding all human contact. As a project manager and professional trainer, human contact had been very important.  The paradigm shift for COVID coincided rather fortuitously with my diagnosis.

The other obvious BIG question for Dr. Hudhud was, How long do I have?

His reply was nothing if not ambiguous.  Somewhere between a year and 15 years.

That’s a big span.  I could be 64.  I could be 78.  There’s a lot I planned to do between 64 and 78, quite frankly.

At first, I believed we were looking more at the Age 64 side of things.  The fatigue was coming on strong, and I often only had three or four functional hours in a day.  People would call, and after 20 minutes, I was completely wiped out.  I found myself drifting in and out in the middle of conversations, and had abandoned all hope of being in front of a room (virtual or live) to teach a class. I’d be on the phone with someone, and suddenly realize that I had nodded off in the middle of our chat.  (It’s pretty embarrassing).

The trappings of Stage Four were undeniable at that point.  They included the following:

  • Naps.  Lots of them.
  • No Driving.  Falling asleep on Interstate 68 is not a worthy plan.
  • Acid Reflux.
  • No worthwhile walking or other exercise.

As a hard-core project manager and risk manager (I actually was named “best of the best” in project management by the global Project Management Institute in 2019), I quickly came to the realization that this was not your conventional project.

Projects, by definition, have a defined end. They have a specific goal.  They serve unmet needs. They integrate a variety of resources, and exist within a specific environment. Some of the elements of the definition fit my cancer future quite well.  Others did not.

In the course of this blog series/e-book, I’ll be looking at the Stage Four Project in hopes of helping two audiences:

Audience #1: Project Managers who need to recognize that classic project management (yes, and even Agile) don’t always fit into a nice mold, but still need the guiding hand of a PM.

Audience #2: My fellow cancer patients, who need to recognize that breaking the experience down and looking at the work elements can make the whole thing a little more tolerable, even when you know the ultimate outcome.  

Next Up? Is it a project? And what are the unmet needs. (Spoiler alert: It’s a project)