There are always two ways of looking at things. Sure I have a new cancer, my third actually, and given my medical history and the state of my immune system, perhaps not the last. After all there was a time when I did not think I would live much beyond a year. That was twelve years and four months ago. Much has happened in those intervening years, most of it good. My sons have grown into adulthood. I have four beautiful granddaughters. I have returned to cancer nursing. I started this blog. I have had the opportunity to give back, to make a difference.
And then there are these pesky problems – having my spleen and part of my pancreas removed last summer in order to avoid the transformation of precancerous nodules into malignant tumors, and now having had another temporarily disfiguring surgery to remove a dangerous high-grade parotid tumor. But it had all been good news. Both surgeries were successful – no post-op complications, clean margins. And now I am about to embark on a new chapter, going thru radiation therapy. Surgery, radiation, chemotherapy, biotherapy, stem cell transplant – I will have experienced all the common treatment modalities for cancer.This experience can inform my writing and how I relate to the larger world of cancer survivors.
The good news continued last week. First on Monday we met with my surgeon. He reported that there were clean margins. That means he thinks that “he got it all.” He also excised 32 lymph nodes and there was no sign of cancer involvement in any of them. He did recommend that I go through radiation therapy as an adjuvant treatment. Even though there was no evidence of disease spread, microscopic disease may still be present. High-grade suggests a highly active tumor with a propensity to spread rapidly if it gets a foothold. He says that some of his patients elect not to go through radiation for various reasons. We tell him that we have decided to do the treatment and have an appointment with a radiation doctor the next morning. On the way home Tish makes several phone calls to various family to share the news.
On Tuesday morning we meet at the Cancer Pavilion at the IU Health Cancer Center. Radiation centers are frequently located underground or in the basement of a building. Machinery can be enormously heavy and the walls must be shielded with lead, I had previously sought out recommendations for doctors from my colleagues at work. As a patient I was able to use the valet parking service, a small treat. We took the elevator to the basement. Registration was simple, quick and painless. A male nurse took us back. It turns out that we went to college with Tish and I, although he graduated between us. As he took my vitals he shared that he was a tongue cancer survivor of fourteen years.
The next person we met was a young female resident, a doctor who has chosen radiation oncology as their specialty and is doing training under an established physician, in this case, Mark Langer. We spend some time reviewing my, at this point, rather complicated medical history. We were impressed that both physicians asked us about our own understanding of both my disease and its treatment. Too often discussions with doctors can be one-sided – the doctor asking very specific questions and the patient providing, sometimes hopefully, short, to-the-point answers.
Not surprisingly they both recommended radiation treatment, six weeks, Monday through Friday. One of my bone marrow doctors pointed out once that if you go seeking advice from a guy with a hammer, his recommendation will include using that hammer. Their main reason was the high-grade nature of my particular disease. The type of cancer I have is called mucoepidermoid carcinoma. Most times these are low-grade and behave more like a benign tumor. Mine behave like a squamous cell tumor.
I am given a folder of educational material as well as an internet source of teaching material. I give them high marks for this as patient and family cancer education is the focus of the special project that I have been working on the past year. The good news continued when he said that he did not recommend having a G-tube placed for feeding. Since there was no lymph node involvement, the radiation field will be fairly small and isolated near the corner of my jaw where the parotid gland recently resided.
So that pretty much brings us up to date. I have found a way to keep my mind off the cloud but that is material for another post. I am writing this the day before my first treatment appointment. This is called planning and simulation. And I will write about that in due course. Until then,
Take care, Dennis