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ON THE SCENE: Dr. Josh gets anticipated diagnosis ... it’s cancer

March 23, 2017
By NAJ WIKOFF , Lake Placid News

About the 15th of January, patients of Dr. Josh Schwartzberg received a letter informing them they needed to find a new physician as he was closing his practice within one week.

A week earlier, on Jan. 4, Dr. Schwartzberg learned that he had been diagnosed with pancreatic cancer, then confirmed as stage four.

Following his residency at Albany Medical Center, Schwartzberg started his medical career in the town of Webb and shifted to Saranac Lake, where he eventually joined a practice led by Dr. Frank Trudeau, before opening his own in Lake Placid located in the lower level of the Adirondack Medical Center. About a dozen years ago, he moved to Essex, soon establishing a second office in Willsboro while commuting to Lake Placid by private plane so he could continue serving his patients there, some of whom came from as far away as Tupper Lake and Malone. The impact of his letter was widespread.

Article Photos

Dr. Josh Schwartzberg
(Provided photo — Naj Wikoff)

Pancreatic cancer is very aggressive and usually not discovered until well advanced.

Stage four survival rates beyond a year are modest, but treatment options and outcomes are slowly improving. They include surgery, embolization, radiation, chemotherapy and other drugs. As is true of most diseases, attitude, family support and finding the right physician and medical team, coupled with living well - meaning good food, exercise and social interaction - matter profoundly. On that score, Schwartzberg's assets are broad and deep.

Doc Josh's patients learn patience, as seeing him on time is rare. Not rare are the peals of laughter wafting down the hallway from the exam rooms where he meets with his patients. Josh loves people. He always has a story, an opinion about the follies of humanity, an adventure he's contemplating, and he's a keen listener. "Tell me more," could be his catch phrase, usually expressed through a raised eyebrow and widening eyes.

Josh loves life, and he embraces it full throttle as if he can't quite get enough of it as he revels in its complexity, wonder, joy and ability to thwart the best-laid plans, which to him are like a red flag snapped in the face of a bull. He loves a challenge. A few years ago, he decided we should seek out the great pumpkin. A neighbor had been growing one and planned to truck it down to Cooperstown for the state championships. Two days later, about 8:30 a.m., he flew into Marcy Field in Keene, slipping in as heavy-laden clouds moved in.

A practical person might have tossed in the towel, but a radio check indicated openings in the cloud cover in Lake Placid. So we flew up through the Cascade Pass, startling a few people driving along the highway as we navigated our way into Lake Placid beneath the cloud cover. Once there, we circled up and into the blue sky above and headed south until what appeared to be an orange necklace lying on the ground outside a baseball diamond indicating we had arrived.

Taking the road less traveled has been a mantra of Josh's life. His parents were Holocaust survivors of Auschwitz, Bergen-Belsen and other concentration camps of Germany.

Josh was born in Munich Germany, and they arrived in January 1952 as immigrants from war-torn Europe through Ellis Island to start their life in America in the "Fort Apache" section of the South Bronx. They first moved to a small farming community in New Jersey, soon shifting to a North Philadelphia ghetto where his dad opened a mom-and-pop meat market, and Josh found himself one of two caucasians in a black-hispanic middle school. Bright and inquisitive, he was recommended for transfer into a magnet high school where one out of 10 classmates was a merit scholarship finalist, and the racial dynamics were the mirror opposite of his previous experience.

Josh had no passion for medicine; it was a challenge by a friend who decided his fate. At the time he was majoring in English at Temple University. One of his best friends received early enrollment into an osteopathic medical school in Philadelphia and challenged Josh to follow suit.

"I couldn't afford it," said Josh.

To dissuade his friend, he refused to even ask for an application form.

"So he sent it to me. Now what am I going to do? I decided to apply to just the one medical school just to get him off my back. Students even today apply to 20 or 30 hoping they'll get into just one. Next thing I know I come home, my mother is slicing bacon behind a counter, and she hands me an envelope. 'Dear Mr. Schwartzberg, we are happy to tell you' It was 1967. That's when I realized I was going to be a doctor."

Just as Americans who were alive when President Kennedy and John Lennon were assassinated remember where they were and what they were doing the moment they heard, so people living with cancer remember the exact moment when they received confirmation of their diagnosis. It's a moment when their lives change, and in many respects not for the worst. While people I know living with cancer would never wish the disease on anybody, for many it provides a shift in attitude and focus that can almost be described as a godsend.

"I have a strong family history of all kinds of cancer," said Josh. "In contrast, I've always tested myself for heart disease. I have no heart disease, so I always knew I'd probably die of cancer. My mother, her brother and my father's uncle had pancreatic cancer. So statistically it was likely. At UVM a gastroenterologist giving a blood test every year to people who had a family history of pancreatic cancer. I'd participated in his study for several years, and my results were always negative. It's not fool proof, but there is a strong correlation. In October of last year, my test results were perfectly normal."

In November, while ona "foodie" vacation with his son Ezra, he noticed an unusual bloating sensation. He first thought it had to do with a change in diet. When he got home, he felt fine, but then it came back. He felt something was not right. A repeat blood test showed a marker slightly elevated. "I said, 'Aha!'" said Josh. "So I arranged for a CAT scan. Knowing all the staff, I asked if I could go in with the radiologist rather than wait for a report. I walked in, and he had a glum look on his face. I said, 'I've got pancreatic cancer, don't I?' He said, 'Yes.' It was already metastatic (spread well beyond the pancreas)."

Josh is not afraid of dying. We all will die. He views it as another aspect of life, and he plans to make the most of that experience, which for him means spending as much time as he can with his wife Beth, his sons and grandchildren, and doing things that he loves, like fly fishing and sharing stories with a few close friends.

He also plans to give pancreatic cancer a good tussle. His first step was to find a good team.

"I'm stage four," said Josh. "When I was diagnosed, it already had spread to the liver. That's a brick to the forehead. I've been a doctor for 44 years. It's hard for me to go to another physician. I've been my own doctor for a while."

Josh started with a very good oncologist at CVPH that he's known for years. At the same time, he wanted to take advantage of cutting edge research and treatment, which led him to the chief of medical oncology at Beth Israel Deaconess Hospital in Boston, a Harvard teaching hospital.

"He's spent his career doing work and research on pancreatic cancer, plus I liked him a lot and the people working with him," said Josh. "So I am a patient at Beth Israel, as well as in Burlington and Plattsburgh for differing levels of expertise."

Josh first looked into participating in a clinical trial, but he didn't find one that was a match, one where he fit the criteria. Therefore, Josh decided to pursue an aggressive approach using chemotherapy that includes four drugs. He had his second infusion last Tuesday and is tolerating the treatment "rather well." Josh feels that his medical knowledge, coupled with the benefit of doing a lot of research, asking questions, and finding a medical team he trusts and likes provides him an advantage. He urges those facing similar situations to ask questions and seek second opinions.

"It shifts the survival rate to the right," he said.

Josh is no less aggressively strengthening his emotional wellness, such as a recent weekend of skiing with his Beth and some of his sons and planning a fishing trip to Alaska's panhandle this summer.

Josh has agreed to share his journey with his community. There will be future columns, which will include the voices of his children and others. Josh remains a family physician, and if his experience can help others, he's all for it.

"We all don't know when the end is coming," said Josh. "You may be 90 and frail, or 90 and vibrant. You may be 50 and drop dead. You don't know, and I don't know either, but at least I have it tightened up. It's an incredible gift because it provides you the opportunity to focus. It's not that I've had a revelation that's changed my life. I've always been one to stop and smell the roses, but my focus now is incredible. I have no hesitation. It's an amazing experience. I wouldn't wish it on anyone, but those who have to succumb to cancer or fatal disease, there's the potential for wisdom."



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