Quite a Start for the New Year

When last we left I had just had my PET scan and been told that there was an "increased activity" in my left groin. The word "cancer" was not used for it, but certainly I had to mentally prepare for it in case it was. Since that time I have gone to my oncologist, Dr. Y, to discuss this with him. His first suggestion was that I need a biopsy of the area to determine exactly what the problem is so that he can address a plan for it. So today (Thursday) I went to see Dr. Ondrula, who would be doing the surgery, to get his opinions. We had prepared for this by getting a CD of the PET scan, which visually shows what is going on inside of me. We took a look at it ourselves and it is rather interesting to see your insides like that, including seeing my organs like lungs and kidneys.

However, Dr. Ondrula said he didn't need it. He had the written report. Then he checked my groin area and said, "Yeah, I can feel it in there." So we kept the CD. He said we could set up the biopsy for Monday and I thought, "Whoa, that's fast." But I learned from Round 1 that you don't want to waste any time when fighting cancer so I was fine with that. A biopsy has been scheduled for 2:00 p.m. on Monday, Jan. 3, 2011 (got to get used to writing that year) at Good Shepherd Hospital in Barrington. It will be an out-patient procedure for which I will be put under. It may be sore "down there" for awhile and I was cautioned that I may need the proverbial "frozen bag of peas" often used by vasectomy patients to assist my healing. Can't wait for that!

I asked Dr. Ondrula what my options were regarding the biopsy. He said there are three possibilities:

1. The "increased activity" is not cancer but something like an inflammation which is showing up on the PET scan and causing my tumor counter in my CEA blood tests to be high. In that case, I might be prescribed an antibiotic and have this area monitored in future tests.
2. The activity is based upon my previous rectal cancer and perhaps could be treated with similar chemo. He said if this was the case, the location of the activity would be highly unusual, as rectal cancer, if it spreads, tends to go north into organs such as the liver or lungs and not south into the groin. But it is still a possibility.
3. The activity is a new lymphoma, as it has attached itself to lymph nodes, and will have to be dealt with accordingly.

In any case, surgery to go in and excavate any tumor or cells will not be necessary. If it is cancerous, then an analysis of the biopsy will need to be made to determine the specific "designer cocktail" of chemo drugs to treat my condition, based upon what the cells are sensitive to. Then I will undergo more chemo treatment (length and frequency TBD) which should not only kill the active cells but hopefully also reduce the chance of something like this coming back again. That's because, unlike surgery which only removes cells from one area, the chemo circulates through your whole body and thus affects all your organs so hopefully anything that could have potentially spread to another body part will also be killed. I understand that nothing is guaranteed, but if it is cancer again this time and I undergo more chemo, I certainly hope the new cocktail does all but guarantee any return.

Whatever one of the three options wind up needing to be taken, I am prepared for each one. As I have lived through 9 months of chemo in the past (with the side effects), I won't be thrown a curve ball that I haven't seen before. Depending upon the treatment, I may have different side effects (maybe I'll lose my hair this time, which I didn't the first time), but I'll deal with whatever I have to.

Also this week (supposedly an "off" week for me, as our office is closed) I had a sleep study which confirmed my sleep apnea. To address the problem that was diagnosed during the first half of my night, I was given a nose CPAP device which I wore the remainder of the evening which did allow me a longer sleep than normal. Now I wait a couple of weeks for the computer results of the study. I was covered with all kinds of wires to measure various aspects of my physiology and behavior during my sleep. I suspect that I will be given (well, not given, as insurance will pay for it) a CPAP along with training on how to use it. If it allows me to sleep longer at night, not snore (and bother my wife!) and not hold my breath while I sleep, then it will be worth it. I will write another blog soon on "Unfounded Fears", such as "Fear of the CPAP".

So that's where we stand right now. The biopsy is obviously the important next step which will ultimately determine where and how we go next. I'll hope for option 1 above, but I'm prepared for any of the three. What's the old saying, "Always expect the worst and you'll never be disappointed."

My 2011 is thus getting off to an unusual start for me. We're addressing my two most pressing health issues (cancer and apnea) at the same time. Hopefully by this time next year, both of these issues will be things of the past.