Diagnosing Cancer

I went with a friend for her oncology appointment a couple of weeks ago and just now posting. My friend was diagnosed with rectal cancer few months ago and completed 5-6 weeks of radiation and chemo. She had an endoscopy/ultrasound last week and the appointment was to discuss the results and next steps. The biopsy they took from this procedure indicated no cancerous cells – a good sign, but not necessarily enough to base a final treatment plan on. So the next step is for a surgeon to remove the entire tumor (or as much as they can without going into the wall – basically a colonoscopy where they remove more of the tumor) and have it analyzed.

I post this, not to tell my friend’s story, but to blog my reactions. I have known some of these things, but having a bit of distance – i.e., not me – allowed me an additional perspective. My first reaction is how capricious and non-precise diagnosing cancer is, as if the treatment wasn’t bad enough. They have tests, but they are basically indicators. If they find cancer in the tests, then you have it, but if the tests are clean, it doesn’t mean you are clean. The term – No Evidence of Disease – is about all they can really tell you. So, the CT scans and blood draws and even limited or what the oncologist referred to as “frozen” biopsies are not definitive. It makes me angry and scared. I think about my friend who is having to decide on surgery that would impact her quality of life substantially on something she may or may not need.

My second reaction was to the oncologist. My friend goes to a medical center other than the one I go to and I experienced the same caring and expertise I have experienced with my treatment. I know some people’s experiences and incidents have not had positive, but many more have been positive than have not. I think this is a positive sign that oncology is aware of the “human” side of things. Her oncologist talked more in everyday terms – like referring to radiation as “frying the person”. I found this very helpful in understanding the complex issues of cancer and treatment. At times, though, it was confusing, because a term would be used loosely, that would result in frustration to understand what was being said. An example, were the terms resection and excision, which he used interchangeably. I (and my friend) had thought resection was when they cut through the colon wall and reconnected you.