I've always felt blessed at the good fortune of my senior years. A wonderful wife of thirty-three years. Financial security. Good health. Matinée-idol good looks. (O.K., maybe not that, heh.) I've been particularly smug over my good health. SInce I got my arthritic knees replaced, I've been pain-free and more active than I've been in years. I feel absolutely great. And I blithely assumed that I would be that way always.
That was hubris.
You see, gang, I just had it confirmed . . . I've got liver cancer.
The thing of it is . . . I still feel absolutely great. It was through a stroke of luck---and my regular physician of thirty years---that I discovered that I had a problem. For decades, I've gotten a check-up every three months and my annual physical every December. The numbers have always been in the green. I do have essential hypertension, but that's been under control for decades. Every three months, I've gotten lab work done, and every three months, I've gotten a clean bill of health. Including my liver functions, which always showed normal.
And that's how the numbers came out at my last physical this past December. In fact, my doctor joked, saying maybe on my visits, he should just bring a six-pack, and we sit around and swap war stories for thirty minutes. Then, at the end of the session, he mentioned that there is a new test, a blood test that checks one's DNA for cancer markers. He asked if I was interested in taking it. "Sure," I said. "Why not?" With TRICARE, it wasn't going to cost me anything, and I didn't expect it to find anything significant.
Again, hubris. The test came back at the end of the month, indicating that I had a 60% chance of having some form of liver cancer. My doctor ordered an MRI for me. The MRI results indicated a suspicious lesion on my liver. After giving me the news, my doctor picked up the phone and called the head oncologist at the city's leading clinic for oncology, and said, "I have a friend in trouble . . . "
The next day, I'm having a consultation with this oncologist. He ordered a PET scan for me, and the results confirmed the MRI's indications: I have a large malignant tumour across the breadth of my liver. Things have moved fast after that. In the past week, I've spoken with my oncologist again, and with a surgeon who specialises in both liver surgery and oncology surgery, and with a oncology radiolgist, and I consult with the leading radiologist in the area in a couple of days.
Now, before you folks get all weepy-eyed, there's significant good news with this diagnosis.
One, I am completely asymptomatic. I still feel great. My numbers are still within normal range. If all of this hadn't happened, I'd never know I had a problem. Two, the tumour, while large, shows very little activity. It's mild---that's why my liver functions are still completely normal. (In fact, there's a 5% chance still that it isn't malignant, at all. But I told my doctors to go with the odds and not waste time with a biopsy; they agreed.) Three, and most important, the cancer hasn't spread; it's localised to that tumour alone.
The only unfortunate aspect is the size and placement of the tumour. The liver is remarkable in that it can regenerate after a resection. The problem with my tumour is that it spreads across the very centre mass of my liver. Surgical resection is not practical---it would take 80% of my liver. Doable, but very radical. Only one slight step above a liver transplant.
Therefore, radiation is the most recommended approach to treatment. There's a technique in which radioactive beads can be inserted directly into the tumour which will shrink and ultimately, destroy the tumour. This is the preferred approach. After I see the radiologist next week, I'll be scheduled for a "mapping" operation, which will determine the precise locations where the Y-90 beads should be inserted. The one concern is if the tumour has spread across too many different segments of my liver. If so, then the radioactive beads are out, and they'll use computer-directed bursts of radiation to kill the tumour. I'm hoping the beads are useable; statistically, 70% of patients who undergo the bead technique see total destruction of the liver tumour.
But, even if we have to go with the computer-directed radiation approach, my odds are still excellent. Because the tumour is showing so little activity, because it hasn't spread, and because my overall health is strong and vital enough to endure a harsher approach.
The time line is, sometime next week, I'll undergo the mapping procudure, then have the actual radiation treatment within the next three weeks.
Aye, it sounds like I've had a bad break. But I don't view it that way. At my advanced age, something was bound to hit me, sooner or later. I'm lucky: I have a physician who is thorough to the Nth degree. If he hadn't mentioned, "by the way", that DNA test for cancer markers, a year from now we would've been having a much grimmer conversation. Because we caught it now, the doctors are able to deal with a cancer that is only mildly active and hasn't spread. If one has to have liver cancer, I've got it under just about the best conditions possible.
Cheryl and I waited until yesterday to inform our family of the news. I wanted to wait until I had a definite diagnosis and a plan for attack. To-day, I am giving you folks the news, for you are as much a family to me as my blood relations are. The thing to keep in mind is that I'm confident in my chances. Not in some cheerleading-type "Rah rah!" sense. But in the knowledge that the odds are strong on my side. It's a calculated confidence.
So, what's new with you guys?
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Have the members of this board ever gotten together on a Zoom or Google and shared a drink? Because I think that's something that we should do at some point.
The drink need not be alcoholic.
We will likely all never be together, but that would be something, and I'm fairly certain none of us is growing any younger.
Commander, I'm so grateful that you and your doctor have caught this quickly, and that you're asymptomatic and in such good shape. And that the cancer doesn't seem to be spreading or progressing. And that we're living with the medical advances of the 21st century, not the 20th. All of that's in your favor... but even if it weren't, I'd still be betting on your fighting spirit and determination to see you through this and get you into that sharp-looking suit.
And I echo JD -- in this day of online meetups, why HAVEN'T we all gotten together to lift a glass? We need to make that happen.
I am just seeing this, and I am gobsmacked. I don't want to say "Welcome to the club" because it's not a club one wishes to join, although the membership is dismayingly large.
Richard is right; the advances in medical science mean more options and better outcomes than one might have had in years or decades past, and that is in your favor. You are also fortunate to be in good overall health and have benefited from early detection; some varieties don't get detected until they've gotten too advanced for treatment to do any good.
But we are in times in which a diagnosis of cancer is no longer an automatic death sentence. I've been a longtime reader of Men's Health magazine (which I highly recommend to all), and recall an article in which the author describes being diagnosed with cancer and told he had 18 months to live ... 14 years ago. He got treated, it went into remission, he got treated again, it went into remission again ... and the cycle repeated, several times. The rest of the article (which was excepted from his book) was about learning to live with such uncertainty.
I think people live with such uncertaintly because we have an abundance of hope; at least I know I do. And the love, well-wishes and prayers of family and dear friends is of incalculable benefit. Know, Commander, that you have all of those from me and my wife.
CK, I knew you'd pop up here with words of support from one who knows. In fact, when I sat down to make the intital announcement of my condition, your updates on your prostate cancer immediately leapt to mind. "Welcome to the club" may be black humour, but it's apt. Cheryl and I have certainly been going through all of the mental and emotional onslaughts that you and your wife experienced.
One thing you touched upon to which I haven't given much thought---I'm too busy working out the plan of attack right now---is the uncertainty of cancer. When Cheryl went through chemotherapy for her cancer twelve years ago, most often, she'd fall asleep and I'd chat with the relatives of the other patients. Some of their tales were daunting. I remember talking to one man who told me that this was his wife's fifth go-around against her cancer. Four previous times, they thought, or hoped, that they'd killed it dead, only for it to come back. The physical, emotional, and financial toll on that man and his wife is almost too staggering to contemplate.
We got lucky in Cheryl's case---the doctors did kill her cancer dead. She gets annual PET scans, and there's never been a hint of her cancer recurring. But I have to think about my own situation, now. Nearly all of the factors in my case are good for total recovery, but there are no guarantees in medicine. That's going to linger with me long after the treatments. Cancer is a peculiar Sword of Damocles.
You're still with us, CK---thank God---and if I have to be in the club, then I am in high company. (Though, I wish above all wishes that both you and I had been blackballed from such a confabulation.) Thank you so much for your prayers and words of encouragement.
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