In October of 2010, my brother Herman "Po" Hogston II was diagnosed with cancer. What started as a lump in his neck became a very painful tumor that sat on a pocket of nerves. At the time it was believed to be Lymphoma, but in December of that year while he was receiving radiation and chemotherapy at Martha Jefferson Hospital in Charlottesville, tests results came back inconclusive. After pathologists at UVA studyed the biopsy, Po's oncologist determined he had Poorly Differentiated Carcinoma with an Unknown Primary (CUP). This meant that while the cells were definitely cancerous, they did not have the characteristic of any known primary such as lung cancer or breast cancer. Since it closely resembled lung cancer, Po was treated with chemo typically used for that type. As time progressed, Po experienced moments of sickness following treatment and had a overnight stay in Abingdon hospital for dehydration. He also suffered from a lot of intense pain from the tumor and was prescribed many pain medications. However by the Spring of 2011, Po was feeling the best he had in a long time. He even felt good enough to walk me down the aisle on my wedding day in May 2011. That summer he was bike riding, fishing, and traveling to visit college buddies. He continued treatment, and the tumor was shrinking and calcifying which was great progress. We continued to hope for the possibility of remission, but what we mostly heard was, "Let's watch it." Po had complete trust in his oncologist, and as long as he felt this way we supported him. In January of this year, Po took a trip to Nashville to see an oncologist at Vanderbilt. He was told the treatment he was receiving at MJH was working. They did however want to complete a CT and PET scan as a precaution. They also voiced interest in sending the biopsy to a lab in California that could perform much more extensive testing than had been completed. The scans soon came back showing a spot under his left arm. It seemed after this spot was found, Po began to have more pain. He had another stay in the hospital for the pain, and shortly after was transported to MJH so he could receive treatment from his doctor. At this point we were still waiting on results from the lab in California. After this stay, he felt well enough to drive himself back to Abingdon. This was in April 2012.
At the beginning of May, Po and our mom drove to Charlottesville on a Tuesday evening. Po felt he needed to be back with his doctor and his team. My mom was also beginning to notice swelling in his face and left arm. The pain was still there, and showing no signs of ceasing. By the end of the week, the results from California had arrived. After extensive testing of various cancers that included pancreatic, lung, liver, and even breast cancer, the results showed a 48% chance that the cancer was Sarcoma, a rare soft tissue cancer. This was not promising news, and his oncologist told us the type of treatment for this cancer was extremely aggressive and caused a lot of sickness. Even then, he could only give a 20% chance of it being successful. At this point, we began to consider a second opinion. My sister spoke to a friend about the Cleveland Clinic and we learned there was an oncologist that specialized in Adult Sarcoma, which gave us some hope. She quickly contacted them, and by the Friday of Po's second week in MJH, we were heading to Cleveland to have him admitted in the Palliative Care center. There they would get a grip on Po's excruciating pain and prepare him for treatment. Both my mom and myself were with Po those first three days, and saw a marked difference in his pain. The team in the Palliative Care seemed to have gotten his pain under control nicely, and that in itself was a huge relief. I headed home that Sunday with a heavy heart, leaving my mom and Po in Cleveland so I could finish the school year and return later.