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'A pretty lucky guy': Fargo Sanford president's routine heart screen catches cancer early

Paul Richard, president of Sanford Medical Center Fargo, is battling a rare form of cancer that was discovered when he went in for a routine heart screen. David Samson / The Forum

FARGO – Paul Richard wasn’t an obvious candidate for a heart screen. Heart disease didn’t run rampantly in the family and he felt healthy.

But he decided to get one anyway out of professional curiosity. As the president of Sanford Medical Center, he wanted to know firsthand about the offering for patients.

He’s glad he indulged his curiosity – unexpectedly, a scan found irregularities in his lungs.

A barrage of tests later determined that those “tree in bud opacities,” or small masses that resembled buds on tree branches, were a form of cancer called mucosal associated lymphocytic tumors.

Tests also found evidence of lymphoma in his stomach, a finding that jolted Richard, whose father died from stomach cancer at the age of 58.

“To hear that was like, whoa,” Richard, who is 62, said Tuesday, recalling his reaction to receiving the diagnosis in March.

Only months earlier, in November, Richard was named president of Sanford Medical Center. A nurse-turned-lawyer, he had spent his entire career – four decades – in health care and working for MeritCare in Fargo, then Sanford, first as outside counsel and later as its top lawyer.

Today, soon facing what he hopes is his last two-day round of chemotherapy, he appears to be free of cancer cells – and grateful they were detected much earlier than they likely would have been had he not gone in for the unrelated heart scan.

‘Incidental finding’

Doctors call it an “incidental finding.” Richard calls it an extraordinary stroke of luck.

“I had no symptoms, nothing,” he said. Before the lymphoma diagnosis, doctors had to rule out other possible causes of inflammation in his lungs, including lupus and rheumatoid arthritis.

“Every test came back negative,” Richard said. “So, we knew it wasn’t any of those.”

An examination of his lungs revealed redness and inflammation – “To me, it looked like my lungs were sunburned on the inside” – and ultimately the lymphoma finding.

The repeated tests, including six endoscopic procedures, made Richard quip that he’s become a “frequent flier in the endoscopy suite.”

Sobering reality

The first round of chemotherapy was sobering, a moment when the reality of his diagnosis registered in a way that hadn’t before.

Although he has spent his entire career in health care, the experience of battling cancer, with a care team involving multiple departments, made him see as never before from the viewpoint of the patient.

“It made me appreciative from a different perspective,” he said. He came away with renewed appreciation for the doctors, nurses and technicians – though he professes a bias – and the opinion that the cancer center waiting room needs more comfortable chairs.

The experience confirms Richard’s belief that a patient should be as informed as possible by obtaining diagnostic tests and actively consulting with the treating physicians.

“I’m very much a realist, and while I didn’t expect it, it’s one more thing to deal with,” he said. “What I want is information. I base my reaction on information. I don’t base my reaction on fear.”

His fourth, and he hopes his final, chemotherapy session starts Aug. 16, after which he plans a week of vacation. He hasn’t missed any work and takes his work laptop with him to his infusion sessions.

Even if he doesn’t require two more chemo sessions, he faces more treatments every two months over the next two years, and monitoring.

“I view it as something that is resolved and gone,” Richard said. “I consider myself to be a pretty lucky guy.”

By the way: His heart screen assessed his cardiac risk as quite low, confirming his primary-care doctor’s earlier assessment.

“That was the good news,” Richard said. “The heart scan came out just fine.”

Patrick Springer

Patrick Springer first joined the reporting staff of The Forum in 1985. He can be reached by calling 701-241-5522. Have a comment to share about a story? Letters to the editor should include author’s name, address and phone number. Generally, letters should be no longer than 250 words. All letters are subject to editing. Send to