Sunday, February 21, 2010

BIG C little C, what begins with C?

Anyone who is ANYONE with a child knows the answer to that--

Camel on the celing, C, C, C! We know that Dr Seuss book by heart--both the full version and the abbreviated diaper bag one. After this week, "little c" has a new meaning in our house. It's what we call Eric's cancer. Fitting given his nickname for some time was "little e." It's not that we are afraid of saying the word, although, it certainly doesn't roll off the tongue. Ouch. That pun wasn't intended...We just are calling it as we see it.

So, here's the update on little c. It is pretty little--about 2cm. It's still ugly, and I have the pictures to prove it (if you are adept at finding out my Picasa web albums, you'll run into it. BE WARNED.). Eric and I were commenting how it is a strange feeling to be able to actually see the cancer. Even with many other solid tumors, they are internal and you never really "see" them. Every couple of nights for the past month or so I have asked to see his tongue, but now that we know it is cancer, it just looks "different." There is still some patches of cancer left after the biopsy, but those will soon be gone because...

We are gearing up for surgery! Here is how Friday went down:

After the MRI on Thursday, Eric had a joint CT/PET scan Friday morning. The prep for the imaging studies was slightly longer than Thursday's and came with more surly technicians. I still cringe every time Eric has to tell someone "I had a biopsy, and then a few days later it came back positive for oral cancer." Shudder...

The tech put in a line in his arm and filled it with some sort of radioactive kryptonite (okay, not the actual medium, but I like to call it kryptonite) that required him to stay far away from me for an hour as it coursed through his veins. We were told that for the next 90 days we shouldn't consider expanding our family--that we would be playing with wounded soldiers due to radiation. Um...you think there is much more playing outside of peek-a-boo in our house? I just had a baby 7 weeks ago. According to my doctor, I still need a few more weeks of healing from Mr. McFeely's speedy delivery. (TMI? Folks who are new to the blog on account of peeping to hear about Eric--this journal is HONEST. Strap in and hold tight.) With Felix's colic (oh yes, he's got it...and he's got it bad. Three hours a night of fussing bad. Of course he does--none of the Heintz boys wants to feel left out of the struggle), Eric sleeps in another room. And then there is that whole cancer thing. Not sure anyone really feels compelled to start a family at the time of diagnosis. Maybe I am wrong. But I think the only addition to our family we would consider right now is a weekly maid, night wet nurse or aloe plant.

Back to the kryptonite. Eric had to sit still for 1 hour while I read and re-read magazines and tried not to make jokes or incite any movement of his face. We attempted sign language for a bit, but we were reduced to ASL of the baby variety. "More" "All Done" "Bath" and "Diaper" didn't get us very far.

After the hour, Eric went in to get the scans while I left to get him some lunch for afterward. As I walked out of the hospital, it hit me again: my husband has cancer. As I walked into Chipotle by Emory and our old stomping grounds during grad school, I remembered getting a discount for being a student. I wondered if any place gave cancer discounts. I think they should.

After Eric's scans, we went home to kiss Felix, visit Miles and then headed back to Emory for our appointment with the ENT surgeon ( Dr Wadsworth). Again we were met with a depressing waiting room outfitted with the poorest reading selection. Free Atlanta themed magazines from October 2008 just weren't keeping my attention. We finally got into a room and one of Dr Wadsworth's fellows came in with an Emory med student and went through the whole question game: "how did you discover this?" "what do you do?" "can I look at your tongue?" "can I feel your neck?"

And then she pulled out the Afrin on steroids.

There was a hidden tank she turned on, and the room errupted with some sort of loud motor reminding me of the archaic machinery we (unsafely) managed in middle school industrial arts class. She injected his nose with "super Afrin" to numb the entire passageway from nare to throat. Next she pulled out the Trinitron monitor and a device that had a long tube with camera attached.

"Do you want to come over and watch?"

Who, moi? YES!! I love this stuff. I'm telling you--I missed my calling.

So I got to watch as she went down Eric's nose and all the way to his vocal cords (which showed some wear and tear from teaching/coaching). Eric gagged a few times, but handled the intrusive procedure well--especially given we had no warning this was going to happen. The Dr said she didn't see anything too concerning upon initial inspection.

Dr W finally came in and sat down to give us the real 411 on the situation. He said he had the MRI results, but not the CT/PET scan. The MRI looked "beautiful." I have no idea what that means, exactly, but we'll take it? It's not like when the ultrasound tech tells you that your baby is exceptionally beautiful (because lets be honest, they tell all expecting parents that). There was some asymmetrical swelling on his neck nodes, but it could be due to the biopsy. We will have to wait for the PET/CT full results before we know what the true story is.

But, from the looks of it, the cancer is small, and the hope is limited node involvement. We were quoted that Eric is a "lucky man" in that it appears we caught this early. So early, that the 90% cure rate statistic was thrown at us! Not only that, he said he is pretty sure we are going "to kick this." I would prefer he told us we were going to take it, slash it in the face, throw acid in the bleeding facial wounds, and blend it to a pulp, burn the remnants, and then compost them (I'm trying to be a steward of the planet, people, ha ha), but I'll take "kick this," too. (Surgeons aren't known for their eloquency.) Head and neck cancers make up about 5% of all cancers, and Eric's case, which is exceedingly rare, is only a sliver of those. But, what that also means is that he doesn't fit the typical profile nor the typical prognosis (which for oral cancer is BAD). The hope is that we don't even need to utter the words chemotherapy. After all is said and done, Eric will need to follow up with the doctors every 6 weeks for quite some time, and then in a few years, he can go less and less frequently, but will need to be watched, well, forever. He'll also get yearly chest exams via x-ray or CT scan to make sure the cancer has not spread. He is now at an increased risk for additional cancers.

So here is where we are today:

Eric needs a 3 part surgery (to be scheduled to take place within 2-3 weeks):

1. Partial glossectomy. He'll have about 15% of his tongue removed. During surgery, they'll send the removed portion to the pathology lab to make sure they got clean margins (i.e. they took out all of the cancer and a good portion of healthy tissue surrounding).

2. Partial to full neck dissection. They'll remove some if not all of the nodes on the side of his neck through an incission from his ear to his clavical. Those will be sent to the path lab, but results won't be available for a few days.

3. Pan endoscopy. Dr W will pull a Dora the Explorer and look around Eric's mouth/neck anatomy to see if there is other cancer, which many times is the case.

Depending on the node situation (if there is malignancy), we'll have the radiation discussion. But we are not going to cross that bridge until we come to it. And we haven't come to it.

Surgery will be 4 hours and result in about 2 days in the hospital. Eric will be out of work for 2 weeks and we'll have to wait and see about the extent of speech therapy required. Within a few years, no one will be able to tell there was any surgery on his tongue and the neck scar will be barely visible. (But what guy DOESN'T want a neck scar?)

We high fived on the way home. It feels strange to high five over cancer. And Eric finally broke a smile in his "daily cancer mug shot."
From Cancer Licks



We were told that we need to make it to 5 years before we can start throwing around the word "cure." I'm not sure I'll have a restful night sleep for a good 5 years.

5 comments:

  1. I like the sound of 90%!! So glad you have a plan and know where you're going. Keep us posted on dates and let us know what we can do to help! LGM

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  2. Great news. 90% is wonderful. 5 years will be here before you know it.

    Thinking of you all!
    Sara

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  3. It is good to have the actual medical update "on paper". Even though you described it all to us, the details still elude me.
    Hopefully, everyone in your household will be able to sleep better and better as time and healing goes on. Do you hear that Felix?!
    Love you all so much

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  4. Ahh, yes, the big high 5 over cancer. We just did that today when Bob's bone marrow biopsy results were read back to him as completely normal. Absolutely, unequivocally normal. Just like the average joe, or eric (so to be).

    You can certain high 5 over cancer! You guys can conquer this.
    hugs,
    Karen

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