While genuinely happy to hear the great news that overthehillmedi reported earlier, I am unfortunately in a very different point in my own cancer treatment.
I had hoped to receive similar news last Wednesday when the results of my PET scan came in. But instead I got an inconclusive result that suggests the presence of lingering cancer in spite of very different expectations by all my doctors and by me and my family and friends. The PET scan showed a fairy high level of reaction in the same area where my main tumor had been on the base of my tongue.
My main otolaryngologist at the Medical College of Georgia, in whom I have the utmost confidence, said that she has a strong feeling that this indication must have some other explanation than residual cancer. To that end, she had me come in for a biopsy last Friday to see if she could find cancer cells or a different diagnosis in the area that lit up in the PET scan.
The operation was made all the more interesting because of the discovery during my recent surgery to close the hole from my tracheotomy, that the airway in my neck has so much stiff scar tissue caused by the radiation therapy that it is impossible to intubate me to maintain breathing while under general anesthesia. Instead, they had to use awake fiberoptic laryngoscopy to establish the airway before putting me under for the surgery. This involved a very strange bunch of sensations as they crammed all kinds of sprays, liquids and gels into my nostrils to deaden things and then the scope being threaded through my vocal cords. The strangest may have been seeing the anesthetists high fiving each other upon successfully threading the needle.
Now I await the results from the biopsy to determine whether I can relax and go on with my life, concentrating on rebuilding my strength and learning to cope with the permanent and temporary damage done by the therapy which (hopefully) eradicated the cancer. If the results are negative, I will have to undergo more tests, possibly MRI, CT or other types of imaging to establish just what it was to which the PET scan was reacting. Possibilities include scar tissue, infection, residual radiation activity and other things my doctor named and I couldn't understand or remember. As I said, she feels strongly that there is another explanation. I hope she is right.
If the biopsy does turn out to be positive, we will be faced with some very difficult decisions. Due to the sensitive nature of the tissues in proximity to the treatment area, there are short limits to the amount of additional radiation therapy that can be applied without causing unacceptable levels of damage. Given those limits, it is questionable how effective such treatments can be expected to be. The next option is surgery, but again the area involved (the tongue) is so sensitive and so vital, that the options there can be so brutal (nearly complete removal of the tongue and the resulting complete loss of ability to talk or swallow without mechanical assist) that I may very well refuse to accept it. Forgive me for being so morbid, but at that point I may be just looking for ways to delay the progression of the disease for long enough for me to maximize the time I have left to spend with my family and to enjoy my passion for riding bicycles. I do not envision my life ending with a series of futile attempts to prolong a progressively nonfunctional existence. I am more interested in quality of life than in quantity. A diagnosis of cancer forces you to realize the fact that nobody gets out of life alive.
I suppose it is no surprise that I was not able to bring myself to go to work so far this week. I do have a great deal of pain in my throat after all the poking, scraping and squeezing they did in there Friday. I also am having a lot of trouble concentrating on anything for long enough to be productive at the office, both from the emotional roller coaster I'm on and from the amount of pain medication required to keep me out of agony. I am getting enough sleep overall, but it is not coming in timely packages that will allow me to function at work. I have no intention to go in on Tuesday. On Wednesday I am scheduled to go to Augusta to review the results with my doctor and to plan where we'll go from here.
I can't recall ever being in a situation where such radically different future paths hinge on the results of a test. I have never imagined being able to relatively calmly discuss such terrible and wonderful possibilities with my wife, literally life and death.
To those of you who are still reading at this point, thank you for giving me the opportunity to air out these thoughts. It is cathartic to me to be able to talk about it. To that end, I plan to give my best friend a call tomorrow to see if he can come over and let me use him as a sounding board. I need to get some honest feedback about some of the things I am thinking, without the emotional aspect that is inevitable when discussing this with my wife, my kids or my parents.