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
I would tell you to stay strong but you're stronger than the rest of us, definitely than me!
But I will send you good thoughts and well wishes, just to be on the safe side!
I'm sorry to hear this. I'm sure that you'll handle it with your usual practicality and determnation.
Here is hoping for the best in your present and future path, Commander.
Tracy is going to be devastated to hear this.
Keep that optimistic outlook. I know we will.
What's new? Not much. I....
I just want to echo what others have said. We're all offering our best wishes for this situation.
In addition to your positive attitude, Adam, a few other things are working in your favor. The cancer not having spread is a very big deal. The liver is remarkable in that however much of it can be saved after radiation will usually work as well as the original organ. Your liver is working very well even with the tumor. The other thing is that as old as you are (and I am) we are lucky that we are in 2026 and not 1956. Options exist that just weren’t there in the past.
Also, I agree with your feeling of family with the Captain Comics Round Table.
. . . As old as you are (and I am) we are lucky that we are in 2026 and not 1956. Options exist that just weren’t there in the past.
Eric noted the same thing below, my friend---and you're both right. While I decry many of the social changes that have occurred in the last seventy years, one element for which I am so grateful is the medical advancements. Even up to the 1980's, the only available radiation treatment was a "war of attrition", as it were. Both the healthy and the cancerous cells would be bombarded by radiation, with the expectation that both the good and bad cells exposed would die, but also with the hope that enough healthy cells remained for the patient to recover. It was a haggard, miserable cure.
Now we have things like the linear accelerator, with computers that enable the killing radiation to focus only on the cancerous cells and leave the healthy ones to thrive. And this even newer radiation-bead treatment, which permits even more precision in targeting the cancerous tissues. For once, I'm very glad that I live in the twenty-first century.
Commander Benson said:
Back when I was considering my options about prostate cancer, a decade ago, I didn't need to read every bit of research before me to conclude I didn't want to do radiation, specifically because it was so imprecise. It seemed to me like using a firehose to wash the dishes.
That was then; thank God things have improved.
The opinion I have formed of your character from reading your contributions to this site leads me to be convinced this is something you will fight and win.
I can only add my thoughts and best wishes to previous comments.
I am devastated. Knowing my friends have to go through this journey makes me sad. I know that you will handle everything with strength. Our love to you both. We will be keeping you in our thoughts.
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