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?
Replies
Jo, Terri-Anne, it has been a while. What a surprise---a pleasant surprise.
Thank you so much for your gracious words, both about my health and about my contributions to your long-ago site. I still remember how you corrected me in stating that it was Supergirl---not Saturn Girl---who implanted the post-hypnotic "forget what he learns about his future life" command in Superboy's mind. And I recall it fondly every time I see someone else post the same mistake on line.
I'm glad to see you two are still in there fighting the good fight of life. You will see how it pays off when you reach the stage of the Good Mrs. Benson and myself. Despite all the snags of health, we are content and prosperous and the passions of our love for each other has not died. It is the fate of the elders to be considered Cassandras in their advice to the young. We try to pass on what we've learnt, but each succeeding generation, since man first walked dragging his knuckles on the Earth, believes it's different for them. Technology will change, society will change, but human nature doesn't.
You are now where I was then, and you will find the same truth, that the advice you give to the generation behind you will be mostly disregarded. It is the way of the world. I'm so glad that you two have survived and thrived. And I take your observations very kindly.
Fair winds and following seas, my friends.
Wow, just catching up with this. Good luck, Commander! It sounds like you have a good attitude and a good plan. I have had a similar surprise recently: chronic pain in my left leg was diagnosed as venous insufficiency. I have since had vascular surgery in both of my legs–that may be the end of those procedures, but I have a follow-up visit next week. During the investigation, it was discovered that I have arthritis in both knees. Only the left has been bothering me, probably due to the vein problems. So now I am doing physical therapy to strengthen the atrophied muscles in my left leg above the knee. Which should help with the pain and restricted movement: fingers crossed!
Good luck, Commander! It sounds like you have a good attitude and a good plan.
Thank you for your kind wishes, sir. The somewhat left-handed consequence of my situation is that, now, I pay more attention to the least little ache or pain, and I wonder, "Is this it? The first symptom?" Yesterday, spent the whole day feeling a lack of energy. Not enervation, but short of the vitality with which I usually spend the day. I felt bad enough to turn in at 1900 last night, feeling either too hot or too cold. It could've been just one of those things, perhaps a lack of sleep. Or---I had to consider, was the tumour finally having taking a physical toll? Yet, I awoke in the wee hours feeling completely fine and energetic. And I still do. I imagine I'll be living with that uncertainty for quite a while.
During the investigation, it was discovered that I have arthritis in both knees.
It's not my place to offer advice, but I will relate from my own experience with two arthritic knees: getting total knee replacements was the best thing I ever did. One never realises the sheer pleasure in being able to stride across a room, or a store, or a sidewalk, with one's shoulders back, erect, until he's gone without the ability to do so for as long as I did.
The one thing I will say about TKR's: the key to success lies in the rehab. The few folks I heard complain about the failure of their TKR's were the ones who blew off the rehab as being too painful or a waste of time. I threw myself into it, two hours a day, three days a week, and the result of all that sweat was I have more than normal flexibility on my knees. (Now, if I would just stop being lazy and get back into a regular exercise regimen, heh.)
I wish you all the good fortune with your knees, my friend.
Both of my knees needed total replacement due to osteoarthritris; I had one done in 2007 and the other a year later. I was told that I was a relatively young patient for the procedure and was warned that thee implants were only expected to last ten years, plus or m,inus a few. However, my now 18-19 year old knees are in good shape, I probably should have worked a bit harder on the original rehab, but I have been working out regularly for many years now. My advice is to have no fear of the procedure.
I appreciate the advice and well-wishes for my knees. I should emphasize that although knee replacement might eventually be necessary, it won't be in the near term. The PT is the first approach; after that, there would probably be cortisone shots.
I know several people who have had knee replacements over the years. They are constantly improving the preocess, so in this case being able to wait is a positive.
UPDATE TWO:
Modern medicine is amazing.
I'm an old school guy. I follow the dress standards of seventy years ago. I follow the cultural and etiquette rules from then, as well. (I corrected my radiologist to-day when he addressed me by my first name; I thought I did it pretty nicely, but knowing me, probably not.) If logic tells me that something needed to change, then I'm fine changing with it. But many of the societal changes of the last sixty or seventy years didn't need to. However, as far as medicine goes, I can't push it into the future hard enough. What I've seen of it now still astounds me. Eight years ago, I had cornea surgery to eliminate the cataracts in both eyes---and was left with perfect vision. When I was a boy, the only treatment for cataract sufferers was eyeglasses with thicker lenses. I walk straight and tall on legs with knees constructed out of plastic and metal, and I can't tell any difference from when I had my organic knees before the arthritis.
And then, there's what I found out this afternoon . . .
To-day was the meeting with the radiologist who's going to oversee my directed-radiation treatments. The Good Mrs. Benson and I were both there. The doctor first iterated the results of the mapping procedure from last week. Then he described the process and technique of the directed-radiation treatments. I will undergo radiation treatments every other day. He told us that I was being scheduled for five sessions. "We might have to go to as many as eight," he said, "but that should do it."
The GMB and I looked at each other. Then she asked him, "Five to eight radiation treatments to . . . ?"
"Get a curative result," replied the doctor.
Aye, we heard him right---he's expecting it will take only five-to-eight radiation treatments to destroy the tumour. Now, to be sure, there are a lot of "well, maybes" attached to that, which is always the case with cancer. Even when the tumour appears to be completely eradicated, there might be some infinitesimal speck of it that finds some place to hide, or that may migrate to some other near-by organ. So, even after the tumour is gone, I'll be undergoing months and months of MRI's and PET scans. As with Cheryl's cancer, five years is the benchmark.
But I thought the treatments would be take months, maybe even to the end of the year. Instead, I discovered that I'll be done before tax day. The department will work out my schedule and notify me of it by the end of the week, and I should get my first treatment Monday. After the discussion with the doctor, I was shown the machine that will work its radioactive wizardry. I underwent a session in it designed to map the areas to be targeted. As I type this, my torso is covered with indelible-ink "X's" and waterproof patches. From what I'm told, the only side-effects of the radiation treatment may be some mild nausea and some general weakness. Both will pass.
I'm stunned. In fact, I'm having to force myself from being over-confident. I know I don't have a guarantee. Cancer is damnedably persistant. But the early detection and the so-far mild effects of the tumour are working in my favour, and, for the first time, I've been officially told that my chances are damnedably good to lick this. The GMB has looked ten years older ever since the presence of the tumour was confirmed, and now she looks like herself, again.
One impact that my cancer has had was that it forced us to cancel an upcoming cruise (in fact, right now, we were supposed to be in our luxury suite somewhere in the Bahamas, sending our butler for another round of free cocktails). Being a last-minute cancellation meant nearly all the fare was not refunded. But I purchased travel insurance, and we're just waiting for the insurer to honour our claim. I don't see how it can turn down a man who has cancer, but who knows? However, if and when they do send me that cheque, it will come in handy---I may be having that suit tailored sooner than I expected.
And my regular physician will be getting one hell of a Christmas present from me this year.
Glad to hear that it's going well. I remember how much quicker and simpler cataract treatment was for my father than it was for his father. It gives me hope that if/when my turn comes, it will be simpler still.
Wow! That is good news. Keeping you in our prayers.
Fantastic news! Morden medicine is amazing. I hope all goes well, and you'll be getting measured for that suit soon!
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