Fears

I go for an endoscopy and colonscopy tomorrow, as a result of the yearly, guideline CT scan that was done last month. A masslike tissue was seen in the anterior of the stomach. My husband's cousin is a radiologist and I had him look at the scan results. He said that the newer CT machines work very quickly and it is not uncommon for a muscle contraction (which happens since you drink the barium) to show up blurred. Usually, if the technician catches it, then they just re-run the test at that time. In this case, to be safe, the endoscopy is needed. Since I was scheduled for on in November, it is only bringing it in by a couple of months - so not too much extra effort.

I remember, however, that when I read the report and was discussing it with the oncologist - the man I trust and feel safe around - although he said similar things, I believed he was sugar-coating the news. I think my fear was so great, I couldn't be soothed. I felt better after getting the opinion a second time, but am still nervous about tomorrow.

I also accompanied my friend who has rectal cancer to her surgical appointment. The surgeon strongly recommended the full surgery - which would result in a colostemy bag, but she was adament about not having one and so will have surgery next Tuesday to remove what they can. My fear for her turned into anger at the disease. We were talking after the appointment in the appointment room and she suggested we go somewhere else so they could have the room back. I responded that I didn't care what they wanted, this was about what she needed. She said she couldn't allow herself to get angry, as it takes her to place of self-blame for not having the screening sooner. I figure that cancer happens to a lot of people and why is not known. Just like all other good health practices people should do so.

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.

Stomach Tumor

I had my one year CT scan earlier this month and a tissue-like mass was identified in the anterior of the stomach. My oncologist indicated that colon cancer metastisis does not usually present itself in the stomach and stomach cancer is rare. I am scheduled for an upper endoscopy (which I was to have in November) August 8, as a result. I have no other symptoms and the rest of the CT scan was clear of cancer.

It is difficult for my mind to stay in the present and just wait and see. I jump to in the implications – surgery, more chemo. It seems so unfair. I’m scared. It’s not quite as intense as the first time I got diagnosed, however. Maybe once to face your own mortality, you accept it more or maybe you just learn better coping skills.

CT Radiation

An article by Catherine Guthrie in Time magazine: "...researchers behind two recent studies that sound the alarm about the increased cancer risk associated with multiple CT scans... physicians ... evaluated the medical-imaging records of 1,243 randomly selected patients to calculate just how much radiation each patient had sustained in the past five years. Although CT scans were the biggest source of radiation, other offenders included X-rays and mammograms. The results of the study, presented in May at the annual conference of the Society for Academic Emergency Medicine, were disturbing: the average patient had received 45 millisieverts (mSv) of radiation. (The typical chest X-ray dispatches 0.02 mSv of radiation.) And 12% of patients had gotten more than twice that amount - 100 mSv or more. "Our focus is to bring awareness to the fact that people are getting large doses of radiation and it's not innocuous," says Timothy Bullard, the study's lead author and chief medical officer at Orlando Regional Medical Center."

Red's Benign Tumor

My two-year old dog, Red has a cyst-like bump on her ear. Last week, it looked like a pimple and today it had grown and was a bit bloody. I took her to the vet. My other dog, Blue, plays with Red by grabbing her ear and I assumed it was just a small infection that would need antibiotics. However, when I got to the vet, the vet wanted to do a biopsy - actually a needle aspiration of it. She then examined the slide, while I held Red's ear to clot the bleeding from the biopsy. I was sitting in the same office, actually, as when they took my previous dog, Cashew, to get X-rayed and then told me the news about her cancer. I kept thinking about that and I wished I had brought Red in last week. It was difficult.

It turns out it is benign and quite common in dogs under two. Her breed is not known for it, but the vet has seen it before. It usually clears up on its own, so no additional medical care is necessary. I will bring her back in two months to make sure it has cleared up and if it hasn't they will cut it out, while it is still same. Red was so brave. I held Blue on the table so she could be there with her. I think Red was scared of the attention and procedure, in general, but except for a small whine didn't seem to care about the needle going into her.

I, of course, am glad she is o.k., but it brings back the reality of my upcoming six month tests.

Colonoscopy Preps

About four months ago, I posted on colonclub.com a query about colonoscopy preps. The usual responses were forthcoming about the unpleasantness of the experience without any real good suggestions, until today. Someone indicated there was a new prep - Pico Salex - which was reasonable tasting. Usually GI doctor's have a preference, but I plan to inquire for next one in a few months.

EndoNurse Magazine, online, a publication for gastrointestinal nurses, has technical information on bowel preparation and clinical studies about effectiveness and patient tolerance including a 2006 Bowel Prep Update, Which Bowel Preps are Best for Your Patients,- http://www.endonurse.com/articles/bowel_preps/586_661feat2.html and Bowel Preps: the Current and Future Outlook.- http://www.endonurse.com/articles/bowel_preps/586_561feat1.html

Relay for Life

From the American Cancer Society Website: Relay For Life is a fun-filled overnight event designed to celebrate survivorship and raise money for research and programs of your American Cancer Society. During the event, teams of people gather at schools, fairgrounds, or parks and take turns walking or running laps. Each team tries to keep at least one team member on the track at all times. Visit www.relayforlife.org for up-to-date information.

The one for my city was held on Saturday, May 31. I did not join a group, but went on my own. It was amazing!!! It was held at the local high school track. There were tents pitched everywhere! The majority of people there were teens/young adults, enjoying being able to stay out all night. The message of courage was everywhere. To remember someone, you could write/color on a white bag. A candle was place inside the bag and lined the track. On the stadium bleachers, the word HOPE was spelled out with the bags. At night, all the candles were lit and you walked around the track reading each bag and seeing HOPE. It was very poignant.