Meeting with Radiation Oncologist

I met with my radiation oncologist last Monday morning.  He introduced himself and, instead of me having to bring him up-to-speed, he told me everything he knew about my case.  I appreciated this.  It showed me that he has already taken the time to familiarize himself with me.  He told me to correct him if he gets anything wrong and feel free to add additional information along the way as I see fit.  I did.

After we went through everything up until now he confirmed that I'm on the right course doing the right thing.  Hearing that never gets old because fear and doubt creep into my thoughts on a daily basis.  It's one of the battles that I have to deal with.

He told me it's a bit early for him to do anything but I already knew that.  I let him know I realized that but that I just wanted to get the ball rolling so that after surgery I wouldn't have to worry about getting this duck sorted out.

I call all the things I need to do "ducks", as in ducks in a row or in a pond.  I like the pond metaphor better because sometimes they don't happen in a specific sequence.  Being open to that prevents anxiety and stress.

I also asked him, that I ask all the doctors I encounter, if he sees this cancer a lot and what he sees as the average prognosis.  He told me he does see this often and he said he's seen a 90%+ survivability rate.  That news made my eyes well up with tears of hope.

Life is funny.  I think we go about it not really thinking about death.  When in reality we can die any day, any moment.  Whether it be in a car crash, a random shooting or bombing (now-a-days), being struck by a meteor or a million other things that can spell our demise.  I know I did.

I mean, I occasionally did.  But I just pushed it out of my head, like I'm sure most people do.  Living blissfully in ignorance.  You can't very well go around thinking about death anyway.  That would make one pretty dreary.  Hell, I even planned on living well into old age, I still do, at least I hope I do but with a huge dose of reality that that may as well not happen.

Being courted by Death sure does put one on notice.  This death thing is real!  It can really happen, to me!

I was always one who looked to the future.  Waited for the weekend, saved for a rainy day, saved for retirement, waiting for a someday when I'll finally go here, or do this or say that.  Reminds me of a quote by a wise man...

"All his life has he looked away... to the future, to the horizon. Never his mind on where he was." - Yoda, Empire Strikes Back

Funny how I've heard those words many times but had never taken them to heart, until now.  Yes, they're words spoken by a fictional character from a movie, but that doesn't make them any less true.

Now, what this cancer has given me is a greater appreciation for the now.  An appreciation for today.  Who I am now.  Where I am now.  Who I'm with now.  What I'm doing now.  I am a now person living in today.

Anyway, back on track.

He did a brief exam of my neck and mouth which pretty much every doctor has done that I have seen.  He said that once the surgery is finished we'll know how to proceed.  He'll receive the reports from the surgeon and from that he'll know what and how to target my neck with radiation to kill any remaining cancer cells.

He went through the normal stuff like what I can expect, how long the treatment will take, and the side effects I may or may not experience.  One side effect that I'm concerned about is loss of saliva.

He said most people lose some saliva production, and some lose all.  Not only could I have the discomfort of a dry mouth but little or no saliva could cause severe dental hygiene problems.  It's manageable but I would have to keep a water bottle with me all the time and take sips constantly to wet my mouth.  Not the worst thing a person would have to live with.  I'm hoping for not a complete loss of my ability to salivate, but if I do I'll just have to deal with it and be thankful I'm alive.

That's about the extent of my visit.  Another positive doctors visit.  Those never get old either.  I'll take all those I can get.

Oncologist

So this is a little out of order.  I just realized it's been almost two weeks since my last post.  It just doesn't seem like I've had much time.  Not that a lot has happened in regards to this; just life.

On the 7th I saw my Oncologist.  It was a good appointment.  I brought him up-to-speed and he did a brief exam of my mouth and neck.  He said I was on the right track and I was doing all the right things.  We talked awhile and my wife helped with the questions and notes.

He didn't really seem like this was a big deal.  Sure he was concerned.  I mean, this IS cancer, but he seemed optimistic in the prognosis.  I told him I was concerned that it had spread to my lymph nodes so he examined them.  He said yes they were swollen but they weren't, relatively speaking, that big.  He gave me some examples of sizes that would concern him, I forgot the details, but mine weren't of much concern.  That definitely made me feel good.

Towards the end of the appointment he said I looked "worried".  "Uh, ya!  I have this cancer thing in me.", I thought to myself.  Again he reassured me with a positive prognosis and told me of the woman with the mushroom sized tumor growing in her mouth.  I talked about it in a previous post.

Oh, he also asked me what was the first thing I noticed that caused me to go see a doctor.  I told him the swollen lymph nodes.  He was surprised that the degree my lymph nodes are swollen would have alarmed me enough to seek medical advice.  Almost even baffled.

I'm not one to shy away from a doctors office.  I've heard plenty of stories of how women, being typically more health conscious than men, seek medical advise more frequently and therefore have higher chances of catching diseases early and as a result generally have a more positive outcome treating their illness.  I've also heard enough times how early detection, especially in cancers, is the key to beating it.  Besides,  I have insurance, might as well use it.

Although, I have to say, if I were more in tune or sensitive about my health I may have caught it even earlier.  For about a couple years now I've been doing this, pretty consistent, clearing of my throat.  I only noticed it through a video recording I had made where I could hear myself clearing my throat in the background.  Now I remember...I purchased a dash cam after getting in this accident that this guy outright lied.  I was viewing some video after I had just gotten it and noticed me clearing my throat constantly.

At first I thought it might be a nervous tick or something.  Then, as I was aware of it now and listening for it, I noticed that it seemed to be more prominent after drinking coffee.  So then I just thought it was a reaction to coffee.  I even quit coffee for awhile to get rid of it so I was pretty convinced that it was coffee related.

Come to find out through researching this cancer that "frequent clearing of the throat" is one of the early warning signs.  I'm not sure how long I was doing that before I noticed it on the video.  But I think it's safe to say this has probably been growing in me for a couple years.  I think my wife told me or I read somewhere that cancers are in you for six years before they start to manifest.

But whose to say it would have been detected that early.  I may have gone to a doctor who just said it's acid reflux or something and told me it's of no concern.  Still,  I think the point is, be aware of your body.  If there's even the slightest abnormality get it checked out and get an answer as to what's causing it.  And second opinions never hurt.

Second ENT Doctor

I met my second ENT doctor yesterday.  He seemed very practiced and confident.  Maybe too confident?  He gave me a positive prognosis.  He's pretty sure it's in my tonsils based on the CT scan.  He doesn't think the PET scan will provide more information except if it's spread to other organs.

He said there's two routes to go; a lot of radiation and chemotherapy or surgery and less radiation.  He recommended surgery because he's pretty sure of where it is.  If they didn't know where it is or can't find the tumor then the only option would be radiation and chemotherapy.

So he wants to go in and remove what he thinks is a tumor on my right tonsil, which corresponds to the side of neck where the swollen lymph nodes are.  That would go straight to pathology to confirm that's the cancer.  If it's confirmed then they remove my lymph nodes and the next day I go home.  Recovery from surgery is about 2 weeks then after that I do 2-3 months of radiation.

If it's not in the tonsil then he would feel around for it.  He said they have a 98% chance of finding it in surgery.  If they can't find it then they just end the surgery and I go the radiation/chemotherapy route.

He said the survival rate is on the plus side of 70% and if I survive this the chance of it coming back is rare.  I asked him if age is a factor in the survival rate and he told me not really.  He said a greater factor is how well your body deals with cancer and how aggressive the cancer is.

We talked about the cause and I asked him if he thought it was smoking/alcohol or HPV related.  I had an HPV test but haven't received the results back yet.  He said it's almost definitely caused by HPV and was sure the test results will come back positive.  He said typically the alcohol/smoking caused cancers don't manifest until you're older.

Regardless, he said no alcohol, including mouth wash would be a good idea.  I knew alcohol contributed to cancer but I didn't realize that just gargling with it and not drinking it did too.  He said 1-2 drinks a year would definitely not be a problem, 1-2 drinks a month would probably be OK, but more than that significantly increases your risk of cancer in the mouth and throat.  So, ya, I'm staying away from alcohol.  Maybe after I pull through this I'll have an occasional glass of wine, beer or scotch.

So, along with no more alcohol, I'm further hedging my bets and doing everything I can nutrition/diet wise to give my body the advantage and cancer the disadvantage.  A fight is not won by sitting back in an arm chair; it's won by getting up and fighting.