{"id":31875,"date":"2020-05-18T11:12:33","date_gmt":"2020-05-18T17:12:33","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=31875"},"modified":"2022-08-16T12:36:33","modified_gmt":"2022-08-16T18:36:33","slug":"cancer-care-close-to-home-in-highlands-ranch-for-long-married-couple-both-dealing-with-cancer","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/cancer-care-close-to-home-in-highlands-ranch-for-long-married-couple-both-dealing-with-cancer\/","title":{"rendered":"Eighteen months to live – 20 years ago"},"content":{"rendered":"
<\/div>

The key to a successful relationship is the ability to adapt to the inevitable surprises and setbacks life throws one\u2019s way. Good luck finding a better example of that than Tom and Peggy Pighetti.<\/p>\n

They\u2019ve had more practice than most of us. They\u2019ve also had more surprises than most of us. None more extreme than two cancer diagnoses \u2013 one his, one hers \u2013 two decades apart.<\/p>\n

Tom, 74, and Peggy, 69, met in 1956 when he was 10 and she was 5. Their families lived a few blocks apart in Pueblo. Her older brother and Tom were the same age, fast friends, and Cub Scouts. Peggy\u2019s mom, a Cub Scout den leader, hosted meetings. Peggy, the self-described \u201cpesky little sister,\u201d baked a chocolate cake for one of those gatherings. The boys scarfed it down before she could get a slice.<\/p>\n

While, as the adage goes, \u201cThe way to a man\u2019s heart is through his stomach,\u201d a few years would pass before Tom and Peggy clicked romantically. Both attended Southern Colorado State College (now Colorado State University \u2013 Pueblo), and Tom joined Martin Marietta (now Lockheed Martin) after graduating in 1968. Peggy graduated with a teaching degree in 1972; they married and she joined Tom in one of the model homes of Littleton\u2019s Columbine Hills subdivision. A short commute to Martin\u2019s Waterton Canyon facility was a central consideration, though the commute got a bit longer when the direct route south was submerged under Chatfield Reservoir.<\/p>\n

Peggy taught fifth- and sixth-grade classes until daughters Vanessa and Jolena came along. Tom worked on space programs \u2013 Titan MOL, the Viking Mars landers, classified missions \u2013 and then as a software-engineering manager until his retirement in 2009 after 41 years of service.<\/p>\n

\"Peggy
Peggy and Tom have been through a lot together since they met as children back in 1956. They married and each faced a cancer diagnosis too. Photos by Cyrus McCrimmon for UCHealth.<\/figcaption><\/figure>\n

His cancer diagnoses had come nine years earlier. In April 2000, Tom had returned from a business trip and wasn\u2019t feeling well. He told Peggy he was going to go to bed and see how he felt in the morning.<\/p>\n

\u201cNo, you\u2019re not,\u201d Peggy said. She was worried that he was having a heart attack.<\/p>\n

He was admitted to a community hospital, then transferred to another. Two liters of fluid had been drained from his chest cavity before a CT scan showed a mass tucked behind his sternum. It was tough to access even for a biopsy. When the analysis came back, the news wasn\u2019t good: squamous non-small cell lung cancer, relatively localized but stage 4. Smoking is a major risk factor of this sort of cancer. Tom had never smoked. Doctors told him he had a year, max 18 months, to live.<\/p>\n

Attitude matters<\/strong><\/h3>\n

Tom went on chemotherapy \u2013 Taxol (paclitaxel) and carboplatin \u2013 then 45 days of radiation. In August 2001 came more chemotherapy, this time eight rounds of Gemzar (gemcitabine) and cisplatin. By April 2002, \u201cThings were pretty clear,\u201d Peggy recounted.<\/p>\n

\u201cThey would never say he was in remission, but they said it was controlled,\u201d she said.<\/p>\n

In 2004, that control lapsed, and his oncologist, Dr. David Link, prescribed Iressa (gefitinib), and then, in 2005, Tarceva (erlotinib). That year, Link went in for his own cancer treatment, and his colleague, Dr. Radhika Acharya<\/a>, temporarily took over Tom\u2019s care, changing his chemotherapy to Alimta (pemetrexed).<\/p>\n

When Link came back, Tom stayed with Acharya. Over the next couple of years, Acharya prescribed different chemotherapies to keep Tom\u2019s cancer in check: Tarceva and Nexavar (sorafenib); Taxotere (docetaxel), and finally Navelbine (vinorelbine) and Gemzar. These weren\u2019t random choices, Acharya says.<\/p>\n

\u201cOncology is not a perfect science,\u201d she said. \u201cWe have to go on how he feels; we have to follow data, but we have to cater to him.\u201d<\/p>\n

\"Tom
Every year, Tom and Peggy Pighetti host a belated Christmas gathering to bring extended family together. This year, they held a large Christmas lunch on Feb. 29 before worries about COVID-19 halted such gatherings.<\/figcaption><\/figure>\n

Along the way, the Pighettis and Acharya came to know each other well. Acharya recognized patients who were, as Acharya put it, \u201csavvy and intelligent. They ask questions, but they don\u2019t over-question.\u201d<\/p>\n

\u201cThey\u2019ve chosen their health care team and put faith in us. We talk through things. I want their buy-in \u2013 it\u2019s a group decision,\u201d Acharya said.<\/p>\n

Tom\u2019s and Peggy\u2019s attitude toward to Tom\u2019s cancer fight has been notable, she added. Discussing the power of the mind is a fundamental aspect of Acharya\u2019s approach to cancer care, she says. Tom seems to have positive thinking deeply ingrained in his being.<\/p>\n

\u201cHe has such a remarkable outlook, such an even keel. He just never thought it was going to come back,\u201d Acharya said. \u201cHis attitude and expectations have a lot to do with where he is today.\u201d<\/p>\n

Tom explained it like this.<\/p>\n

\u201cHow do you cope? Basically, it\u2019s about having a positive attitude more than anything, because I\u2019m not ready to go yet. And then you take it one day at a time,\u201d he said<\/p>\n

\u2018Spoil her\u2019<\/strong><\/h3>\n

When Acharya\u2019s twins celebrated their first birthdays in 2009, Peggy \u2013 whose youthful chocolate-cake-baking skills evolved into those of an accomplished cake decorator \u2013 made them a cake with a rubber-duckie theme. Acharya learned about the Pighetti family\u2019s Christmas celebration, which can happen as late as March. Years ago, Tom and Peggy explained, they recognized that, to continue the annual family get-together despite geographic dispersion and scheduling conflicts, the best option was to adapt and be flexible. (In 2020, the celebration fell on Leap Day, Feb. 29. Thankfully, the family was able to gather before worries about the spread of COVID-19 prevented such get-togethers.)<\/p>\n

In 2015, the U.S. Food and Drug Administration approved Opdivo (nivolumab), one of a new class of immunotherapies that decloaks cancer cells so the body\u2019s own immune system attacks them. Acharya prescribed it for Tom soon after that. While there have been occasional setbacks, the drug has worked for the better part of five years now.<\/p>\n

Two years later, Tom and Peggy followed Acharya to UCHealth Highlands Ranch Hospital<\/a> where she is now the hospital\u2019s Chief of Oncology Services. That the hospital was closer to home was nice, but it wasn\u2019t decisive, Peggy said.<\/p>\n

\u201cWe would have followed her even if it meant driving across town,\u201d she said.<\/p>\n

In 2019, another surprise barged in on the Pighettis: Peggy was diagnosed with colon cancer. She became a patient of Acharya\u2019s, and Tom became the invested family member.<\/p>\n

\u201cIt was a role reversal. He was with her every single visit and advocating for her,\u201d Acharya said.<\/p>\n

Acharya told Tom she had high expectations for him.<\/p>\n

\u201cShe spoils you, Tom \u2013 now you have to spoil her,\u201d the doctor told her longtime patient.<\/p>\n

Tom did, and Peggy withstood surgery and her own chemotherapy, though that was a slog. Through the worst of her cancer fight, and ever since, her husband has been an inspiration, Peggy says.<\/p>\n

\u201cYou\u2019re hit with it, and you question: \u2018Why me?\u2019\u201d Peggy said. \u201cAnd you look at how he handled it, and the faith he had, and the positive attitude that he has exhibited the whole time, and the fact that you take every day for what it is \u2013 and you do the best you can and go on from there.\u201d<\/p>\n

Tom added, \u201cThe outcomes could have been much different without the tremendous support of family, friends, doctors, nurses, and coworkers.\u201d<\/p>\n

There will be more surprises in Tom\u2019s and Peggy\u2019s lives, and not all of them will involve cake, as nice as that would be. Certain is this: they will consider the facts, look on the bright side, and adapt as they always have.<\/p>\n","protected":false},"excerpt":{"rendered":"

The key to a successful relationship is the ability to adapt to the inevitable surprises and setbacks life throws one\u2019s way. Good luck finding a better example of that than Tom and Peggy Pighetti. They\u2019ve had more practice than most of us. They\u2019ve also had more surprises than most of us. None more extreme than […]<\/p>\n","protected":false},"author":23,"featured_media":31879,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[],"class_list":["post-31875","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care"],"acf":[],"yoast_head":"\nEighteen months to live - 20 years ago - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Tom and Peggy Pighetti met as children in 1956. 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