Wayne Nolan of Benton City in approximately six weeks time will be a featured speaker at the Audrain County Relay for Life at the downtown square of Mexico. The relay is intended as a way to support cancer research, along with those who are either directly or indirectly affected by cancer.
This is the first in a series of stories with cancer fighters and survivors from Audrain County ahead of the Sept. 14 relay.
Nolan takes his life one day at a time after he was diagnosed with chronic lymphocytic leukemia in 2016. A year later, the cancer started having a greater effect on his lymph system and became Richter's Transformation, an aggressive form of non-Hodgkin lymphoma. Richter's generally has a prognosis between five to eight months and in rare cases 11 months. Nolan has outlasted this prognosis, surprising even his oncologist Radwan Khozouz at the Harry S. Truman Memorial Veterans Administration Hospital.
Nolan credits his health to Khouzouz, the infusion of Keytruda he receives every three weeks and all of the people who pray for him.
"The VA has been fantastic to me. I can't even begin to describe how good they have been to me," he said.
Richter's is a very rare form of incurable cancer. Approximately two percent of those who have lymphocytic leukemia develop Richter's, he said. Nolan started with traditional chemotherapy before switching to the Keytruda infusion, which goes into a port in his chest. He had his 20th infusion Tuesday and will have approximately two more before the relay.
"It takes about half a day by the time you go and so far they say, 'Go back home and live another month and come back the next month.' I've been very fortunate to have gained some time," Nolan said.
Blood work is necessary before he receives an infusion. They check liver function, white blood cell count, and other factors to make sure it is still OK to continue using Keytruda. His wife, Sue, said they take their lives one day at a time since the bloodwork determines if Nolan can continue treatments.
"Usually [my doctor] is surprised. He says, 'I cannot believe how good this is working for you,'" Nolan said.
Keytruda helps boost the immune system of those with a variety of cancers, according to its website. It is not traditionally used to treat Richters, though. Nolan opted not to take a bone-marrow transplant, because it would require a one- to four-month commitment in Tennessee, and instead began the immunotherapy regimen.
Nolan entered the U.S. Marine Corps at age 17 and served from 1964 to 1967 in Vietnam, where he drove trucks and did other transports, including of the chemical herbicide Agent Orange that was used as a scorched earth weapon throughout Vietnam. The side effects of Agent Orange exposure still affect U.S. service members and the Vietnamese to this day. Nolan's brother, Darrel, was an infantryman who died from Agent Orange-related cancer. Nolan said he has Richter's because of Agent Orange.
"Anyone who was in-country was probably exposed to some degree. I'm guessing some people had a better ability to fight it off than others and some don't. I guess I turned out the be one of the don'ts," he said.
A 2003 study published in the British Medical Journal found a link between Nolan’s type of leukemia and exposure to Agent Orange. A 2014 article in the Leukemia and Lymphoma Medical Journal also looked at the impacts of Agent Orange on chronic lymphocytic leukemia. While Richter’s develops in those who are and are not exposed to Agent Orange, those who were exposed to the chemical had a higher likelihood of their leukemia becoming Richters.
Nolan said he was bitter at first about the diagnosis, but he now has a deeper appreciation for everything in his life, because he does not know how long he will live, he said.
"I have a lot of support groups. My church, my family of course first, then my military family. We're getting ready to have another reunion in October. We fight the war all over again, have a few beers," Nolan said. "So many things get unsaid. If there is something I need to say or someone I need to apologize, I want to do that."
Strangers have approached Nolan at Walmart to say they were praying for him. Knowing that people he doesn't know take time out of their day to pray for him makes him feel better, he said.
"I guess you could say I'm a true believer there too. I believe in the power of prayer. I think that coupled with the good care I've had has given me more time," Nolan said. "I try to be a positive person and look at the good side of everything."
While Nolan is still as active as he can be, he does rely on his wife to help him keep track of various health care aspects. This includes his treatment schedule and daily medicines.
"We'd be nowhere without Dr. Khozouz. Absolutely nowhere without him," Sue Nolan said. "If I call [the VA], it is set up now that if I call, they'll know that I need something and they'll do whatever we have to do."
Her husband is an inspiration to others who are sick, she said. A neighbor who has observed him mowing his lawn was inspired to push through and do the same despite using oxygen, she said.
"[Wayne] won't give up. I won't give up,” she said. “We're doing everything we can. I know it's hard when they stick that [needle] in his port, but we're a team.”