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News of a cancer diagnosis tends to quickly jolt its recipient into the realization of life's brevity and a renewed focus on what really matters. This was true for one New Brunswick man when he received a diagnosis of multiple myeloma nearly 26 years ago. After decades of various treatments, he knows what to expect and he knows the anxiety a patient experiences in these situations. The man makes himself available to similarly-diagnosed patients to help them mentally prepare for the impacts these treatments will have on them.

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Raoul Breault is more than acquainted with a full plate of hard work along with a side dish of diversions to clear his head.

At 44, the rugged Neguac man was enjoying his work as Area Chief Conservation and Protection for Eastern New Brunswick with Fisheries and Oceans Canada. He loved spending his free time with his wife Noella and their three children, fly-fishing for trout or salmon on the local river systems, cutting and stacking wood for the winter and enjoying games of pick-up hockey on one of the local old-timers hockey teams.

Rough and tumble at times, bruises, cuts and pulled muscles are among the common and expected perils of hockey. It was during one game, however, that Raoul experienced a pain in his groin that he sensed was a few notches higher than what his opponents could throw at him. It was enough to prompt a visit to his family physician for a yearly medical and routine bloodwork.

Time passed and Raoul continued with his work, family and leisure activities as before until the day he was summoned back to Dr. Gauthier's office in Shippagan, where the Breaults lived at the time.

It was June 1, 1993 … a cool and sunny pre-summer day. Dr. Gauthier set aside the paperwork and flashed a look of concern, one that didn't need words for accompaniment. The test results were not normal.



"I would not be surprised if you had leukemia," said the family physician.

There it was. Blunt and raw and hanging in the air like a frozen puck from a slapshot headed straight between Raoul's eyes … with no room to duck.

"I tell you, it was a shock of my life," said Raoul. "I went home and told my wife and she was in shock," he said. "I told her 'I'm gonna pull through this' and we embraced each other. We kissed … and I went to work."

He decided against sharing the solemn news and resolved to do his job, trying to keep his thoughts and emotions in check.

"I wanted it to stay in the family," he said.

But June 1 wasn't an ordinary day on the job. His boss, unaware of Raoul's condition, gave him more responsibilities to handle. Under normal circumstances, Raoul would be up for the challenge but the grit and resolve to carry on was dissipating faster than the steam from a freshly flooded ice surface.

"I don't know how I'm going to do it," he said but continued to carry on.

Dr. Gauthier had already booked an appointment for Raoul with Dr. Sheldon H. Rubin, the renowned hematologist/oncologist at Horizon's The Moncton Hospital.

It was at his first appointment with Dr. Rubin that the seriousness of his diagnosis was confirmed. Multiple myeloma, a cancer of plasma cells. At the time of his initial diagnosis, the ten-year survival rate was less than 15 per cent. In fact, Dr. Rubin never raised hopes of a cure, but rather, if Raoul would take care of himself by following prescribed treatments and aftercare and let his doctor know of any issues immediately, he could expect a good life.

He assured his new patient he would do all he could, conceding, "I'm not God, just a doctor."

Later that summer, during vacation, alone on the water in a canoe, Raoul finally allowed himself to release the burden of living with this diagnosis.

"Let me tell you, I did some crying then." He thought about his life and his kids and his priorities. Without his health, the money he had put aside for the future no longer had meaning. It was then that he resolved to overcome: "I'm not going to let this beat me. I can live with the 'c-word' as long as I can see my family grow."



The doctor/patient relationship continued to grow years beyond Raoul's expected survival rate--even to the end of Dr. Rubin's career. Before retiring in 2016, Dr. Rubin transferred Raoul's care to Oncologist/Hematologist Dr. Nizar Abdel-Samad.

At one of his last visits before the transfer, Dr. Rubin reiterated some words of comfort to his long-time patient: "Raoul, you will not die from this."

Because he was so familiar with Dr. Rubin, Raoul experienced some apprehension at the thought of starting again with a new care provider. His fears were relieved soon after the care transfer, describing Dr. Samad as dedicated and genuinely concerned about the patient.

"He's a doctor that listens a lot," says Raoul. "When he talks, you know he's read your file. Even though he's quite busy, if you bring something to him, he will listen."

"I think listening is very important," says Dr. Samad. "Understanding the patient and what he wants is important and also to be knowledgeable about what is the best treatment customized for each patient because every patient is unique."

Dr. Samad acknowledges that at the time of Raoul's diagnosis the expected survival was about two years, however the treatments have come a long way since, placing average survival rates at about 5.5 years. Raoul has beaten the odds nearly five times over.

"And now over time we have a lot of new treatments that have changed the survival rate for patients that make them live longer with better quality of life," he says. "So fortunately for Raoul, he had a treatment that has given him longer survival and now he is in an era where we can better control the disease, thanks to the new generation of therapy."

Throughout his patient journey, Raoul has endured several rounds of chemo and three bone-marrow transplants, his last one in 2013.

When none of his nine brothers and sisters were a match he was given what is known as autologous transplants. These procedures use a person's own stem cells from the bone marrow. Stem cells are collected from the patient and frozen. The patient then receives intensive chemotherapy before the patient's stem cells are returned to the body to help it produce healthy red and white blood cells, or what Dr. Samad calls "young blood".

According to Dr. Samad, studies show that this type of transplant for multiple myeloma is better than from another person because there is no risk of rejection and is less toxic. "It's the doctor's job to have the best treatment for the patient," he says.

These treatments, Dr. Samad believes, have been key to Raoul's incredible survival for more than a quarter century. That, and Raoul's diligence in following doctor's orders.

"I'm very happy having Raoul as a patient because he's complying and he follows the instructions," says Dr. Samad. "He's proof of success of our treatment."

"Today I feel good about it," says Raoul, "because I can pass on my experience to other patients who are going through the same thing who call me and ask me about the procedures…'does it hurt?', 'is it painful?'"

Raoul offers hope and encouragement to any patient who wants to give him a call, making himself available, "anytime-seven days a week."

If the will to live Raoul has retained throughout his ordeal could be transplanted to other patients, that would make him an even happier man. He tells them, "I did it … you can do it too!"

Raoul is too humble to divulge the number of patients he's talked with other than to say, "quite a few." He prefers to share his optimism one patient at a time.

"It's interesting because I feel a part of them," he says. "It's helping them and that's what life is all about."

Raoul recently turned 70 and only sees Dr. Samad every three months now on a maintenance schedule. Reflecting on a life he might not have had without advances in treatment, Raoul is admittedly happy. His doctors were right. He has lived a good life and he hasn't died from it.

He still can do the things that some men his age cannot. Every fall, Raoul cuts and stacks his wood for the winter. He continues to tie his own flies for fishing trout and salmon.

And he still loves the thrill of being on the ice with friends. Not with a hockey stick at the rink, but on the river in winter with a fishing line in hand. That's where he's most reflective, contemplating a life well-lived.




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