story by DAWN KLAVON
Life threw the Marshalls a curveball. In 2006 at the age of 43, Liza was diagnosed with high-risk breast cancer. Her husband John, a Georgetown University medical oncologist specializing in gastrointestinal cancers, was forced to look at cancer from a whole new perspective.
The Arlington-based couple's experience resulted in their book, Off Our Chests: A Candid Tour Through the World of Cancer. The deeply personal book walks readers through Liza’s treatment and the complex decisions the couple made about her health, from mastectomy to chemotherapy, radiation and finally, the elective removal of her other breast.
“We really brought different perspectives to it—the caregiver, the physician, the patient, the clinical trial, the advocate—all of those pieces. - Dr. John Marshall
As for Liza’s part, she shared about the uncertainty and shock that came from being diagnosed with triple negative breast cancer, the most deadly form of the disease, whose survival rate at the time was just 50% percent.
“It’s disbelief—I think particularly at a young age, it just doesn’t seem as if that could be right,” she says. “I was incredibly lucky that I had somebody (John) that already had his oxygen mask on.”
The book came about after an article from a local magazine was published about the couple in 2013. A friend encouraged them to collaboratively chronicle their experiences in a book to benefit others going through the ordeal of cancer. The book took the couple six years to find the right time to write.
“We needed the head space and the distance,” John says. “We went to separate corners and didn’t tell the other what we were writing.” After writing their own perspectives, the Marshalls collaborated, piecing together the book.
“We did view it as a joint project,” Liza says.
Not only did Off Our Chests delve into Liza’s journey with breast cancer, but also how John’s perspective treating his own cancer patients changed.
“I could no longer be very objective,” he said, and began giving out his email address and cell phone number to patients.
He also began sharing his ‘vote’ on what treatment should be while allowing patients and families to have a vote as well. At Georgetown University’s Lombardi Cancer Center, where Marshall worked, he also attempted to build infrastructure that could improve the patient experience. Marshall started giving much more credence to caregivers who accompanied patients to appointments.
“After the experience, I sort of saw them as the most important person in the room,” he says. Caregivers, after all, would keep on top of prescriptions, upcoming appointments and other vital details.
FINDING THE HUMOR
The Marshalls have a witty take on their experience, which may come from being cancer free for 17 years.
“Our cocktail party joke is, ‘1st wife, 5th set of breasts,’” John says, lightheartedly reflecting on Liza’s multiple surgeries over the years.
The couple wholeheartedly reflects on lessons learned from their cancer experience, noting it came at a time when John was busy with his career and Liza, a former attorney, was all in as a homemaker.
“The cancer itself brought us back together,” says John. “We were already in parallel play back then—the cancer said ‘nope, you’re back together.'"
Up until that time, John had been outspoken in his resentment and envy of the dominance of breast cancer advocacy and research over other cancer specialties.
“They figured out how to get it through advocacy, through savvy marketing and they understood the importance of that fundraising,” he says. “That’s really what I was more jealous of, of that dominance.”
WORDS OF WISDOM
Nonetheless, the couple advises cancer patients who have just been diagnosed.
“Say yes to people when they offer to help,” says Liza. “A lot of us don’t want to be a burden on people—but everybody wants to jump in and do something for you.”
Both Marshalls also stress the importance of obtaining a second opinion for a cancer diagnosis, noting it could validate or confirm what doctors already believe, or it may present another approach.
Also, finding an outlet to talk is another suggestion from the Marshalls.
“Women talk to each other about it; men go to their basement and worry. From a man’s perspective, there are big gender differences on how we manage cancer,” John says. “It affects you, so what kind of help do you get? There’s advocacy groups, there’s [therapists], there’s church, there’s exercise, there’s so many decisions. Recognize the emotional impact as well as the physical.”
Off Our Chests: A Candid Tour Through the World of Cancer has been well received, winning 10 literary awards, John notes.
"Off Our Chests offers an unusually intimate and revealing glimpse into the reality of dealing with a cancer diagnosis,” writes journalist Katie Couric on the book’s website. “At once deeply personal and bracingly universal, this book can offer cancer patients and healthcare workers alike the chance to meet one of life's most devastating situations with a rare sense of mastery and, yes, even hope."
Other notable locals agree.
"This book is a must-read for anyone going through cancer of whatever kind,” wrote Washington Commanders Head Coach Ron Rivera on the book’s website. “As with so many, I was blindsided by my cancer diagnosis. I felt lost on an unfamiliar field, facing an intimidating foe. Off Our Chests is a captivating and informative playbook for anyone thrown into the cancer game, but it is also a candid story about one couple's experiences with cancer which strongly resonated with me and my own recent cancer journey."
For now, the Marshalls continue to lend support and advice to those walking through cancer and believe their book can be a positive resource.
“It was good therapy for sure to do it and we’re hoping it's helpful to others,” John says.
One way in which the Marshalls continue to support cancer patients is through their work with Hope Connections for Cancer Support. Hope Connections provides professionally led programs, in person and virtually, throughout the greater Washington area and beyond to help people with cancer and their caregivers deal with the emotional and physical impacts of cancer. All programs are provided free of charge. Liza was a founding member and is a longstanding volunteer for the organization. John serves on the Medical Advisory Board and is actively involved in their programming. Hope Connections serves 4,000 people a year through programs such as disease-specific, caregiver, bereavement and general support groups, yoga and Pilates classes, social programs and a lovely boutique of gently used items run by current and former participants.