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December 23, 2004

Popping Cancer Reflection 12-23-4

Cancer may be the scariest disease going.

I mean, some diseases have scary side effects (ever see an Ebola movie? Eesh.) and some have scary final stages (AIDS is a horrific way to die, for instance) but cell-for-cell, my opinion is that cancer has them beaten.

My thoughts on the topic are two:

(1) Cancer is portrayed as hyper-scary and unstoppable in our culture. It is sold to us as a faceless, invisible killer that can strike at any time and is almost always incurable. When movies need that extra Umph! of tragedy, one of the stars can get cancer.

You feel fine and visit with the doctor on a routine basis and then WHAM! the next day you're in a fight for your life. There are very few popular culture treatments of cancer that don't horror-ify the disease. One excellent treatment of cancer is Michael Keaton's simply brilliant My Life, which resonated with me immediately. Keaton did his homework on that one. All the way through, the issues dealt with real, true-to-life struggles and triumphs and failures of cancer patients I have known and been.

Another interesting treatment of cancer is Julia Roberts' Dying Young. The movie as a whole is clearly more concerned with romance and with cashing in on Roberts (her star was rising then), but the nuanced emotions and choices of the cancer patient/love interest (two terms rarely used in concert) played by Campbell Scott are dead on. In a film that uses cancer as a plot device, the real meat is in the actions and reactions of Scott's character, Victor.

(2) Cancer is one of the few, and by far the most well-known, diseases that use your own body to kill you. With AIDS, a foreign virus attacks your body and causes systems to fail. In other diseases, organs are attacked. In car accidents, for instance, body parts are damaged or broken and need to be repaired.

Cancer (and this keeps me up nights) is an expression of your own body trying to kill you. Cancer comes from within, is created by your own body (with help sometimes, but not all the time, by outside factors - mine originally came from nowhere and this recurrence has its origins in the radiation treatments we used to kill the LAST cancer). Cancer takes over cells in your body, kills some and twists others to its own use. Think of it: your own body is trying to kill you.

And not just quietly, but aggressively. Cancer is the equivalent of a bully saying "Here I come. This is what I am. Stop me if you can." It spreads quickly, and inevitably, to important organs. Cancer never spreads to your little toe. It spreads to your lungs or liver or kidneys.

That's why chemotherapy is basically dumping poison into your system and hoping it kills more greedy cancer cells than healthy cells - you have to damage parts of the whole to remove the evil parts. It's literally a civil war.

That said, let's make this general discussion more specific: my meeting yesterday with a radiation oncologist.

Dr. Crownover (from Cleveland Clinic - finally a doctor that inspires my confidence. This guy is sharp as a really sharp tack.) met with me for over an hour.

There is a second growth near the area of the first, huge mass on my back (since removed), but this one is in the chest cavity, near my spine. It is separate, not just a part the surgeon missed when he removed the tumor on my back.

There is a chance it is fluid from surgery, or scar tissue, but since it just appeared (I do CAT scans every 6 months and to have two growths that aren't related both suddenly appear is a bit of a stretch to believe in), the doctor suspects that one of the masses is an original site and the other is the same disease spread to a new location (metastasized).

This leaves two possibilities. One, and most likely, that the huge lump they first took off my back was the source. This requires more surgery, probably, to make sure they got every little bit off my back, and radiation to kill the tumor near my spine (it is actually just behind my aorta - sarcomas like to spread toward the lungs).

If the origin tumor is the one in my chest, surgery is not an option, since it is so deep and my heart is already weakened (r.e. previous posts). So, if the source tumor is the little one in my chest, treatment becomes palliative instead of curative. Turn out the lights, party's over.

Next step? Shortly after Christmas, we set about defining the new, smaller lump in my chest, mostly with a petscan. Also, I meet with a surgery specialist up in Cleveland Clinic, then with my oncologist to put all of our findings together and create a course of treatment.

This meeting was the first one to actually establish that yes, I do still have an active form of cancer despite the most recent surgery and, yes, it has probably spread. For those of you waiting for definitive information before freaking out, now is the time. Get freaky.

My history is that, with a few exceptions, I only freak out when my cancer doesn't respond to treatment, so you'll forgive me if I wait for the formal freak-out until a few more weeks have passed.

For now, I have the ironic task of writing a hope-filled and joyous sermon for our Christmas Eve service at church. What a world.

my life.jpg

Posted by Dan at December 23, 2004 09:29 AM

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Good luck with the PET scan, Dan. I'm holding out for scar tissue, even if no one else is.

Posted by: folkbum at December 24, 2004 02:54 AM

You always were a romantic. Keep the good thoughts flowing.

Now, when you say you're holding out for scar tissue, I presume you mean that my new growth will just be scar tissue, not that you are hoping to get some of your own.

Posted by: Big Dan at December 24, 2004 08:35 AM

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