Monday, October 26, 2009
Here's one thing you never want to hear a doctor say to you in a solemn tone during an examination:
"I wish we didn't have to have this conversation."
When my radiation oncologist Dr. Chen uttered those words to me on Monday, I crossed my fingers and hoped that his next words would be something like "But we've been hearing complaints about a patient with uncontrolled flatulence in our waiting room and we think that you're the problem, Mr. Serchia."
Instead, I heard the very words from Dr. Chen I hoped never to hear again for the rest of my life:
"It appears that your cancer may have returned."
What? I thought. Back for a rematch —already? Well, that was a short honeymoon.
It was less than three months ago when Dr. B1, my head and neck surgeon, reviewed the results of my last biopsy and declared that the procedure showed no evidence of malignancy.
"That means at this point," Dr. B1 wrote, "we cannot see any more active cancer cells."
Dr. Chen's appraisal of my situation today is based on several factors. One, the nuttiness going on with my face that is rapidly making me unrecognizable to myself is occurring in parts of my mug that were not exposed to radiation during my 33 sessions in winter and spring. Two, the results of the CT scan that was performed on me earlier this month look "suspicious" to Dr. Chen and to another doctor who looked at it today. And three, it is unusual to see symptoms such as I am presenting so many months following the conclusion of radiation therapy.
Dr. Chen's assessment does not necessarily reflect what is truly going on with me. Even he said so. The next step, Dr. Chen explained, is another biopsy, which I hope can be performed during an already-scheduled appointment with Dr. B1 on Wednesday.
That biopsy could support what Dr. Chen said to me today, or it could contradict him.
If the biopsy shows malignancy, however, Dr. Chen says that he is not sure anything more can be done.
Certainly no more radiation, at this point. And my chemo treatments were halted earlier than expected this year after my blood counts dropped, so I imagine that also might limit my treatment options.
I didn't know quite how to respond to Dr. Chen's news so I reacted honestly: I cried.
But my afternoon at Kaiser was not over yet. Next up was a visit with Dr. Y, my maxillofacial specialist, just down the block from the building that houses the radiation and oncology department.
It's possible that osteonecrosis is causing the problems in my jaw and face, but Dr. Y doesn't think that's likely, after looking at my CT scan and two thorough inspections of the tissue in my mouth. If I had osteonecrosis, Dr. Y explained, there would be evidence of exposed bone, and he can't find any.
And believe me, he looked. Today he and an assistant inserted tongue depressors in my mouth to force it open and then Dr. Y ran his finger along the interior of my mouth.
They weren't messing around. The tongue depressors were used as if they were the Jaws of Life, to the point that my mouth began to bleed. The bleeding didn't appear to faze Dr. Y but it scared the crap out of me, reader, and I wasn't thrilled about being sent on my way following the exam with a paper bag filled with gauze.
I didn't shake Dr. Y's hand at the end of the visit because I had blood on my fingers. But I know I must have come across to Dr. Y as grumpy and he probably is hoping that Kaiser doesn't mail an anonymous survey to me to complete about today's visit in Maxillofacial Surgery.
On Wednesday, I'll get a biopsy and then can decide what my next steps are.
Wednesday is also the day that Alice Cooper is bringing his Theatre of Death show to the Nokia Theatre. I had a killer seat in the sixth row of the pit in front of the stage, but I'm letting a friend use the ticket instead.
There's way too many creepy theatrics in my life now to expose myself to whatever fantasies Alice may have cooked up.