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Snow: ‘You don't get cocky with cancer’

NBC Chief White House Correspondent David Gregory interviews White House Press Secretary Tony Snow about his fight against colon cancer.  This is a transcript of their conversation, edited for readability. 

White House Press Secretary Tony Snow returned to work Monday just five weeks after announcing a recurrence of the colon cancer he battled two years ago. NBC Chief White House Correspondent David Gregory sat down with Snow to talk about his return and the fight he faces. This is a transcript of their conversation, edited for readability.

David Gregory: It seems like the most awkward thing to ask somebody who has got cancer, but how are you?

Tony Snow: Yeah, but I am doing fine. You know, it’s funny, it shouldn’t be that awkward. One of the things I have learned in the last couple of years is people get so scared when they hear the word “cancer” that they immediately let fears dominate them, and they let their imaginations run wild. You know, I lost my mom to cancer when I was a kid. And she didn’t have much have a chance. But now, you have got, oh, amazing research that is moving at an incredible speed. So a lot of conditions that weren’t treatable years ago are now curable or people are racing toward cures. So you see a lot more people — and Elizabeth Edwards is one of them — who is out leading a full life while getting cancer treatment. And it’s possible now to do that sort of thing.

Gregory: I remember talking to you before you took this job, and one of the things that you really hit home was, “Look, I am going to get a clean bill of health before I take this job at the White House.”

Snow: Yeah.

Gregory: And you got that.

Snow: Yeah. You know, it’s interesting that I did. Even before I went in for this surgery five weeks ago, it was pretty much anticipated that I was clean. The problem you have is that some of the very best diagnostic stuff you have is still fairly imprecise. So there is some things that you can’t see. I mean, like my PEP scan was clean, my CAT scan was clean, my blood work was good. And I am really glad that we decided to go ahead and be aggressive. And we had what we thought might have been an enlarged lymph node, and lo and behold it was a cancer. Having said that, you go back now and ask, “OK, so what’s a clean bill of health? Are you gonna be able to do your job?” And the answer is yes. One of the interesting things I have learned — just in the last five weeks — is how many people are walking around now, who have cancer, who are getting regular treatments, and who are doing what I am hoping we are gonna be able to do, which is to knock this into remission, and then basically do regular treatment to make sure we keep it there.

Gregory: What’s different today than when you were diagnosed the first time?

Snow: I think the state of medicine is different. For instance, we are gonna take a look at some of the chemo that I’ll be doing. Two of the agents, two of the three main agents, were really not in wide use just two years ago. So what you have are chemo agents that are more precise, that are less toxic for the person and therefore it enables you to undergo an aggressive chemotherapy regimen without getting yourself knocked out.

Gregory: What’s different about your disease than the first time?

Snow: I am not gonna talk a whole lot about the sort of vagaries of it. It’s still the same thing. It’s a colon cancer. And there are places where it is spread. And we are very lucky to the extent that we caught it. And we caught it very early. As I said, it was not detectable by standard means. And as a result, we are gonna go at it hard, and go at it early.

Gregory: Let’s go back to, when you first talked about it publicly, because I remember very well that briefing, and you said, “Look, nobody should jump to conclusions about all of this. And we don’t know what this is.” And everybody remarked that your spirits were pretty up and casual that day. And then fast forward and, and you get the news that you got. What went on inside your mind?

Snow: You know what’s interesting? Because I said this many times — you don’t get cocky when you have cancer. So I sort of prepared myself in advance for hearing that. So my first reaction was, “OK, what’s the prognosis? What is it? Can you deal with it?” I was asking practical questions. It’s interesting, because when you get in a situation like that — at least my reaction — is you immediately get aggressive in terms of thinking how we fight this. You know? What do I need to do, to get myself in a position where I can grow old with my wife, and hound my kids about their homework, and continue to do my job? So it was not the sort of thing where I was suddenly feeling seized by shock or fear. There were a couple of times where it’s like, “Oh, it’s back,” you know? So I don’t want to imply that there weren’t times that I wasn’t a little bit scared or a little bit down, because of course you are.

Gregory: Right.

Snow: But on the other hand, my sense is always the same, which is people have beaten worse, so let’s figure out how to beat it.

Gregory: We talk about family. How do you talk to your three young kids about this?

Snow: The first thing you do is you are square with them. It was interesting, because we felt we did the first time around, but all three of them were a little frustrated, in that they didn’t get as clear a sense of what was going on. Now, each of them is two years older than they were and my oldest is now a ninth grader. And I think some of their questions may be a little more detailed than they were in the past. But the one thing we have said is: Well, first, be square with them about what’s going on and, and the approach. And second, you have got …  You know, if it’s bugging you, you gotta let us know.  Now, you know kids, they are not gonna do it. But sometimes you’ll be able to tell. And so, when you do, you try to draw ’em out and have a conversation. Again, having been through it, having been somebody who was a child who had a parent with cancer, I have a better sense of it too, because one of my frustrations at the time was that I didn’t talk more with my mom about it. So I want to make sure that any curiosity or any fear or whatever they may have, that we find some way to address it. And like most pieces of parenthood, you cannot make it up as you go along. There are a whole lot of handbooks about this. But I don’t want to hide from it. And at the same time, I don’t want them to be unnaturally scared, and I don’t want them to be unduly cocky. I want ’em to know what the situation is.

Gregory: Do they talk out loud about Dad not making it?

Snow: No. And I don’t really talk about it that way. I mean, we have gotten very encouraging reports. But again, you don’t want to be cocky. You don’t want to say, “Yeah man, and I am gonna beat it.” But that’s what we intend to do. Having said that, I think what happens with kids is they are gonna see how we are doing. And if they see changes, they are gonna want to know what they mean. And it is my determination to fight as hard as I can, because I love ’em — you know how that is.

Gregory: What will you say about your prognosis about how serious this is? Because I don’t have to tell you what the coverage was like after the initial information came out. So people are now checking back in and saying, “He is back, but wait we felt this is pretty bad.”

Snow: Yeah. And I don’t want to get too much into it. But let me put it this way — it has not hit any vital organs — it has not compromised any vital organs — but it’s cancer. So it’s serious business, but it’s treatable. And we are treating it.

Gregory: Is it in your liver, or attached to your liver? Because I know that’s an important …?

Snow: Yeah, it’s, it’s … and it’s not in, no. It’s attached. And so, it’s not something that is gonna compromise the functional liver. And the strategy here again is to hit it and hit it with drugs that will stop it or shrink it. And if at some point you need to go back and do additional surgery, we’ll think about that later.

Gregory: Why are you back to work? Why does that matter a lot to you?

Snow: You know, because it makes you feel better. The most important thing you want to do, well, not the most. But there are a lot of things you want to do when you are sick. And one is to make sure that you don’t act sick. You know? You don’t sit around and feel sorry for yourself. I love this job, and I get a lot of pleasure out of it, and it makes me feel fulfilled, it makes me feel like I am doing something important, and I just like it. My spirits are better. And it’s the kind of job that I wake up every morning thinking, “This is great [LAUGHS] that I get to do this.” And when you are fighting something like cancer, you want to use everything in the toolkit. You want to use your faith, you want to use your family, you want to use medicine, you want to exercise, diet. And having the kind of job that makes you feel good is part of it. The first time through cancer, I was doing a radio show and a TV show. I was working six days a week. And I would actually come on sometimes, on television — and have a chemo pump hooked up to me. And this time, I am not gonna do that, because I’ll be able to take some pills. An important part of fighting is to lead a normal life, if you can. And, and fortunately, I can.

Gregory: How is your wife doing?

Snow: She is doing fine. At first, she was really scared. She cried a lot, because again, you hear it, and you are not quite sure what it means. What has been kind of heartening is that the more we have talked to doctors, the better we felt. That’s a lot better than the alternative. And at one point, we had a long consult with doctors. And we sent our stuff out to a number of places — to key cancer centers. And when we went through it, and we felt like giving ourselves high fives, because what we have been given is realistic hope. Again, a lot of people who have been in tougher circumstances have been alive five, 10, 15, 20 years. But you know, you are now thinking different windows; you think two, three, five years. You know, you, you want to make it to this benchmark … knowing that research moves so rapidly that the situation — and the atmosphere — is gonna be a lot different just a few years from now.

Gregory: You don’t have a lot of privacy from this. And you have seized that platform to talk about it very positively and emotionally. What gets you?

Snow: You know what’s touching … is love. And I mean, I went in the press room today, and I swore I wasn’t gonna get choked up and, you know, and guys were clapping and stuff, and I got choked up. You never feel like you deserve it, but man, am I not gonna turn it down? Because it really does make a difference. It is so unbelievably palpable and helpful. And one of the things I try to encourage people is — if you got some kind of cancer, don’t try to do it alone. That there is — in every person — a desire to do something, and to help somebody else out. And that anybody who has been through it, and I am sure you have been through it. You know, whether it’s that you lose somebody in the family, or you got a house fire or whatever — people come out of the woodwork to help. They want to help. And they do. And so it has been an unbelievable blessing. And I don’t know what it is. The times that I have gotten most emotional has not been because of my diagnosis; it’s [LAUGHS] because of how wonderful people are.

Gregory: And you spoke, I thought really movingly as well, at the correspondents dinner, where you served knowledge that “This is how to behave with one another,” right?

Snow: Yeah. You know, and I have heard from Democrats and Republicans, and you guys in the press corps have been incredible. The fact is, Washington sometimes can be a petty town, but sometimes it can be a really warm town, too. It’s a small place. And we have been here long enough to know. And after a while, you do get to know everybody, and it does become a community. And in a time when politics sometimes just seems like people are just pounding each other all the time, it’s good to know that, in fact that there is a lot of warmth and compassion in this town that folks outside the Beltway wouldn’t understand — and sometimes people inside the Beltway wouldn’t understand.

Gregory: And it is a pretty intense time for this administration. What was it like sitting on the sidelines, with all this going on?

Snow: You know, I was spending more of my time, I was watching, but I was sort of distanced from it, in the sense that I would, I would like, my Blackberry or read the news every day. But for me, the last four weeks really since I came back from the hospital, I have been driving the kids to school, and picking them up from school. And it’s been in, in many senses, a wonderful time. And I have written a magazine article — somebody asked me to write one about my faith — and I did that. And I’ll be doing a commencement address coming up, and I have worked on that a little bit. You know, it’s the type of thing about the things that are really important for you. And in some ways it was stimulating to do that. The other thing is, I was really proud of the staff. I mean, Dana Perino was just great, and so were all the other people in the press office. And they all pulled together, and they didn’t need me, but I think I need them, more than they need me.

Gregory: Well, what was the president’s reaction like, and what kind of communication did you have with him over this time?

Snow: He was great. I mean, he called right away. And for the first couple of days was calling and encouraged me to call him as often as possible. But on the other hand, if I thought, you know, “You are busy.” [LAUGHS] And so, it was really nice. He knows how to handle these things. And he was very friendly, he wanted to know how I was doing, offered any support. Said, you know, “If you want to be phone buddies, we’ll be phone buddies.” And that’s all I needed; I didn’t need to take his time.  But it was wonderful and nice. And again, people may not realize it doesn’t take much just to give somebody that little extra bit of strength and, and happiness; a little phone call, an e-mail. And people did that. That was nice hearing from everybody.

Gregory: We have gone through this period of the last month I guess, between you, between Elizabeth Edwards. Jonathan Alter from Newsweek, he wrote about his experience with cancer. Where the country is having a kind of — if we have such things as “national conversations” — the country seems to be having a conversation about cancer. What is that about?

Snow: I think it’s because you have had visible cases. But I also think it’s because the situation has changed so much. I have gotten an immense amount of satisfaction in the last couple of years being able to help cancer patients. Some made it, some did not. But you talk to ’em about what’s going on. And so many people have been touched by cancer, directly or indirectly. And I think what’s happening is that we are in a position of transition. It used to be the scariest disease there was. You heard somebody had cancer, you thought, “Oh, I am gonna get ready for a funeral.” Now, you hear somebody has cancer and you think, “Well, what are you gonna do about it?”  And there are a lot of people running around, and I get it all the time — somebody comes up and says, “I am a five-year survivor. I am a seven-year survivor. I am a 12-year survivor.” And there are a lot of cancer survivors out there right now. And I think it’s one of these times where you can say to people, “You know, you can do something about this. You can fight it, and you can … you can enjoy and relish every moment of life. You have life, this amazing blessing, and you can make the most of it.” So I think, as a country, we are starting to shed a little bit of our fear, and that’s a good thing; maybe get a little more defiant about it, and at the same time, support people who are fighting cancer through the research. And also those who are doing it the old-fashioned way, in the sense of lending your support — because it’s not just the medicine that helps; it’s medicine, and the support and love of others; and really taking an active role in making yourself fight it and feel better.

Gregory: Describe that moment when you hear about this for a second time, and you think about your mother’s experience and now your own experience.

Snow: Like I said, my, my first was, “Well, OK.” You know what my first question was to the surgeon? It was, “Is this terminal?” [LAUGHS] That’s the first question I asked. And he said, “No. [LAUGHS] At least not yet.” And, you know, it was the way he framed it was the way he did with Elizabeth Edwards, “It’s not necessarily curable, but it’s treatable.” It’s stoppable, I think is probably a better term, because when somebody says, “It’s not curable,” you think, “Oh, well, and that’s it for him.” But as I said before, what’s happened is that, the more we have dived into it, the more reassurance that we have gotten … because there is real hope. My mother’s case isn’t analogous, because by the time they found the cancer in her colon, she already had one, I mean, it was grapefruit-sized in her liver, too. I mean, she did have a chance, but …

Gregory: Right.

Snow: Here, we have got CAT scans and PEP scans, and we look very carefully at all the organs. And we have blood tests that talk about the organ function. And we see that, in fact, none of those have been compromised. So we have opportunities now to just go in there and try to sock it where it is.

Gregory: But you don’t talk about “beating cancer” anymore.

Snow: Well, not yet.

Gregory: You talk about “living with it.”

Snow: I think that’s the more realistic thing. But it has been interesting, because somebody else says, “Well, some people have beaten it. And in some cases it’s gone away.” Medical science itself doesn’t always understand why these things happen, so there is a real possibility that it could completely vanish. But even if it doesn’t, there is also a real possibility of stopping it. I mean, I am perfectly healthy right now. And so, if the situation were not to change, you know, something else would kill me, which I hope does happen, and I hope it happens a long time from now.

Gregory: What are people gonna notice as you start to go through the treatment?

Snow: I hope they are not gonna notice much. The agents that we are gonna be using this time, the — two of the three major agents — don’t really have major side effects. The one that does have side effects, I have had the first time around. It makes you tired. And you lose a little bit of hair and it sorta thins out. But the people who watched me on TV back then, didn’t notice. But I would see some on the pillow and in the drain and, [LAUGHS] that kind of thing. And that was an agent that I would take through infusion; that’s what I had the fanny pack for. Now what we are gonna do — or at least we are gonna try this out — is to take pills over a seven-day period. So the kind of exhausting effect, it would spread out over time. And I think probably they shouldn’t see a lot. But we’ll find out.

Gregory: What matters to you most now?

Snow: The same things that always have. My family, my faith. And you know, trying to live. What I have always told my kids is, “I want you to be good.” Well, no, something has changed a little bit in that there is more of a determination on my part to do things of service. And I mean, and I really like it. I have got a platform, I have got some experience, so I can help people. And so that is something. I had talked to people before about doing that; after I left the White House; it’s even stronger. And I don’t know what I am gonna do; I don’t know quite how to do it; but you got a chance to do something that’s good for people. And it’s not about you, it’s about them. And I am kind of excited about it, even though I don’t know what it’s gonna be.

Gregory: But this starts to space out your life in a different way, in terms of how you look at it.

Snow: Well, think of it this way. You and I live on deadlines. And I was the kind of guy who never studied for an exam ’til the night before. I have always wanted to write a book. Well, now you start thinking in two-, three-, five-year things. It’s like, “Well, I better finish the book.” [LAUGHS] And I haven’t even started one. I think what it does is it intensifies what you do. You know, it intensifies your desire to, to sorta get certain things done. But the other thing and I have told many people “You are a great dad. I have seen you being a dad.” Just to make sure your kids know that you love ’em, and that you are giving ’em everything you can. Because, you know, in our life, the only thing we know we are gonna be able to influence is the people closest to us. And I don’t know anybody. I am a press secretary, you know? But on the other hand, if, as a father, and as a husband, I have made the lives of the people I love better, that’s what it’s all about.

Gregory: And people that see you and I sitting here talking like this, and won’t be surprised. I have done some research in it.  And I think, really tough questioning, when you are up on the podium, is probably the best medicine for you.

Snow: Yeah. No, it is. Probably it is. And people ask, “What about Gregory?" And I tell ’em, “Because I really like you.”  And the other thing is — I like tough questions. They are interesting. It makes me do my job better. And it’s what you need to do. And again, there is an expectation that it’s always mortal combat in Washington. People oughta be able to disagree, and I have told you before and I said, lots of Democrats have contacted me. I have got dear Democratic friends [LAUGHS] who don’t agree with me on anything. And yet, I’ll tell you what — when the chips are down, they are the first people on the phone. And people would, would be astounded at how much love and support I have gotten from reporters. And that’s the way it oughta work. I mean, you, you guys oughta ask tough questions, and I oughta push back. But on the other hand, it’s not personal. What, what has been personal is the kind of stuff we have been sharing over the last five weeks. And I’ll tell you, it really does reaffirm my notoriously optimistic view of human nature.

Gregory: Thank you, Tony.

Snow: OK, and thank you.