I've Got What?

CANCER!!!! 

Where did that come from???  OK, we can do this, a little surgery – snip snip, a little radiation – zap zap and Joe will be well and flying off to work and our lives would go back to normal.

I would like to take a break here and share that my normal doctor method search was a total failure this time.  We, rather I, picked a doctor with no personality, no bedside manner and no tact.  Needless to say, we replaced him as soon as we could.  From here on when I refer to him in this blog, I will call him Dr.R1.

Dr. R1 wanted Joe to go that day and have blood work so off we went to the lab.  I think we were both not dealing well with this news and I was treating it, in my mind, like, well like a sore throat.  While we were waiting, the dr.’s office called and had scheduled Joe for a CAT Scan the next day and a neck biopsy the following week.  We looked at each other and with unspoken words told each other that this was obviously pretty serious.  Most of this we took in stride.  Sort of like when you go to the dentist and you need to come back for a crown.  There are several little appointments that lead up to that final step. 

On Monday July 31, the date of the biopsy, Joe received a call from the hospital asking him to bring copies of the scans and the findings when he came for the biopsy.  Copies?  Findings?  “Yes”, they said, “they are waiting at the imaging lab where you had them done.  Just pick them and bring them.  Our courier is running way behind and it would just be faster.”  Ok, so off to the lab we went and had this very large envelope in our hands with 3 hours before we had to be at the hospital.  Inside this envelope would be answers to what we have yet to ask.  Do we open?  Do we read them?  They DO belong to Joe and it is HIS body and condition so open them and read we did.  The problem was, neither one of us are medical professionals and we did not understand one word of the report.  We both took a page and sat down at the PCs and began to google.  Over the next months we would hear the words we were just learning many times.  Words that we had NEVER heard before but unfortunately would become part of our daily conversation. 

Impression

Large lobulated mass seen in the base of the right tongue, which appears to be extending laterally along the right oral cavity and inferiorly into the supraglottic structures.  This may be involving the epiglottis, which is not clearly identified. 

Large necrotic lymph nodes seen along both anterior cervical chains and right posterior triangle extending to the lower neck.  This is consistent with metastatic disease.

Questionable small nodular density involving the right true vocal cord.  No definite tumor extension is seen in this location.  This may be incidental.

Nonspecific adenopathy in the base of the neck.

OK, we knew a few of these words but the rest just sounded, well, scary.  What we did get from this is there was a “mass” of something in his throat that had spread into the lymph nodes in his throat.  So again, snip snip, zap zap all is good and life is back to normal.

On Wednesday, July 27, Dr. R1 called and spoke with Joe.  He told him that he had the results back from the biopsy and needed to talk with us.  Joe said “Ok, when”?  Dr. R1 replied “now”.  We immediately got in the car and drove to his office to get the results, plan the snip snip and zap zap and go on.  This was not what we heard.  This is not even close to what we heard. 

Dr. R1 took us to an examination room, sat down and literally stopped our world from revolving.  He reported that Joe was diagnosed with Stage IV Cancer of the throat and neck.  He told us that the CAT Scan had indicated that Joe had a mass that extended from the base of his tongue into his esophagus and covered his trachea.  He said that he was surprised that Joe could even swallow with something that large covering his throat.  He went on to say that his main concern at this moment in time was that this flap was going to cover his windpipe while he is sleeping and block his air and he would smother while sleeping.  He wanted to admit Joe into the hospital immediately to perform a tracheotomy to remove the chance of suffocation until he could get his team together to do a 14-hour surgery known as a radical neck dissection.   He asked Joe if he smoked or drank heavily and Joe replied that he was known to have a cigar and a glass of wine occasionally but never habitually.  The profile of a patient with throat and neck cancer is a heavy drinker and smoker and an average age of 70.  Joe was 58 and had never smoked a pack of cigarettes in a week.  Dr. R1’s reply “well then, you’re just in the unlucky 10%”.  Dr. R1 told Joe he wanted to get a chest x-ray to see if the cancer had spread into his lungs and he would set up an appointment with an internist to get the tests started and schedule the hospital for the tracheotomy.  After the surgery, Joe would have had a 10 - 45% chance of living beyond 5 years.  He also said that if the cancer had spread to his lungs his chance of survival would drop to 5%.  Since Joe did not have a doctor, he suggested he contact one and have physical tests to see if he could even survive the surgery.

Joe told Dr. R1 that his contract in San Jose was going live in mere days and he had to go back to be there when it happened.  Dr. R1 told Joe “you can go back for a week or so to take care of what you have to, but you do not have a month.”  He told us that we needed to take some time to get wills and other papers up to date.  We walked out of the office in total shock, fear, unbelief, a feeling of basic hopelessness and that death was imminent and there would be no snip snip zap zap.