February 22, 2021
They are moving ahead with the presumption that this is cancer, although it may not be. (Yeah, right.) The most important next steps are to gather as much information as possible in order to diagnose the particular kind and stage of cancer, and determine the appropriate treatment pathways. The data will come from a PET scan, which will show 1) if the lymph nodes are active for cancer; 2) if there is cancer anywhere else in my body.
The other test will be a brain MRI, to see if cancer cells may have traveled there. (The lymph system, if active for cancer, could be the transport mechanism for that. Of course, the lymph nodes might just be supremely pissed off and showing irritation through swelling. After all, that is their job.) These two things will happen in the next two weeks. This is considered very fast– it’s an indication of how serious the situation is considered to be.
The other data point will come from pulmonologists. They will get a biopsy of the lymph nodes via bronchoscopy. The lung mass is in a harder place to get to; the lymph nodes are so close to the airways that it’ll be easier to reach them. That’s done as an outpatient. They knock me out and go down my airways with a gadget that pokes needles into the lymph nodes to gather material to analyze. It’s possible they’ll hit the lymph node just right, where the tissue has active cells. Of course, if they hit the area that’s just plain old lymph tissue, it’s too bad, so sad in terms of a diagnosis. In that case, the surgeon will go in in. She’ll hang around while the pathology folks figure out what’s going on, then she’ll move ahead.
If the lymph node biopsy shows cancer, (if– ha) that changes what comes next. Then, the first line of treatment will be to send me to the oncologists for chemo. Maybe radiation. I’m not sure where surgery fits into the picture in that case– that mass needs to come out. The good news: I won’t lose the whole lung, just a lobe of it. (Jeez, to think that I see that as good news….) More good news: keep riding my bike!
We were with the thoracic physician assistant and surgeon for more than an hour. At one point, I looked at the physician assistant and said, “Well, this sounds like it’s a fucking big deal.” He nodded. “Yes. Yes it is.”
There was just so much information; at some point I could feel my brain just shut down. Luckily, Mark & Ruth were there, M sitting beside me and R participating via Zoom. They have all the notes. There’s not much more to do right now except get the tests scheduled, review my advanced directive & will, try to get a Covid vaccine.
I am suddenly really, really wiped out. I’m just going to sit here in my rocking chair for a while and let things settle in.
Image by Yatheesh Gowda from Pixabay