Todd Two-face
The results of the biopsies are in, and apparently I'm an overachiever.
I have two different forms of cancer.
Thanks, Todd.
The MRI that we had taken earlier only showed my thoracic and lumbar spine areas. So, they saw the mass in my kidney and the mass wrapped around my spine. The next order of business was to get a PET scan. I go in, they feed me some radioactive sugar water, lightly flavored of lemon and despair. After a bit of a wait, they put me in the machine.
The results made for a pretty picture but also a really scary one. I was lit up like a Christmas tree. Basically, the way the scan works is that it shows what areas are really sucking down the sugar. Since cancer tends to be pretty metabolically active, the areas that are affected end up being all sorts of beautiful colors. My colors were in my neck, under my arm, on my lung, around my spine... The only one that didn't light up was the mass in my kidney. More on that in a bit.
So... lots of cancer. Definitely metastasized. Probably renal cell carcinoma (because of the mass in the kidney), which is super hard to treat, especially if it has spread. Which this had.
Biopsy time. I go in, the guy doing the biopsy hears that there's cancer in my lymph node under my arm and decides to do the biopsy there instead of in the kidney, like they'd ordered. I mean, it was easier to get to, so why not, right?
The biopsy comes back as Hodgkin's lymphoma. And the specific kind of lymphoma that is the most treatable form. For a solid three or four hours, we're sacrificing animals and virgins on an altar in gratitude. Then we go see the radiation oncologist, who rather brusquely informs us that he thinks it's actually two different kinds of cancer. Good information to have. Not the best way to get it. I think he might be Todd's uncle or something.
See, Hodgkin's lymphoma doesn't typically show up in the kidney. It happens in maybe 1-3% of patients with that form of cancer. All the other masses can be explained by the lymphoma, but that one's weird. Also, they're not sure if the mass in my spine is renal or lymphoma.
More biopsy time. They do one of the bone marrow in my hip (to stage the lymphoma--spoiler alert, it's stage 4), the mass in the kidney and my spine. That last one was at our insistence. We didn't want to end up finding out that the kidney was renal and then not know what the thing on my spine was. More on that in a bit. I say that a lot, don't I? It's a suspense-building tool. Authors, take note.
So, what's the big deal about two cancers? Well, these two don't play well together. Lymphoma typically responds really well to chemo, but RCC (renal cell carcinoma) doesn't. At all. The treatments for RCC are immunotherapy and radiation. A small percentage of people respond well to the immunotherapy (they're called super responders). They don't get sick, and the cancer clears right up. That's not the norm.
Right now, from what we can tell from the MRI, the mass in the kidney is contained. So, if everything else is lymphoma, we can just go through chemo, they can take my kidney, and I'm good to go. But if the mass in the spine is RCC, that's a much different story.
Back to the first "more on that later." The biopsies came back. The kidney mass is indeed RCC. No lymphoma in the marrow. Biopsy of the spine--inconclusive.
What???
They didn't tell me that was an option. The tissue they took from my spine was necrotic (dead), so they couldn't tell what kind of cancer it might be. Even though we made a stink and pushed for the biopsy, we got no information back.
Which brings us back to the second "more on this later." We ended up exactly where we didn't want to be.
The plan is to do two rounds of chemo (four treatments), take another PET scan and see what the mass in my back is doing. If it has shrunk, that means it's lymphoma, and we just move forward with treatment. If it hasn't, it's RCC. They'll pause the chemo for a hot second and radiate my back. Then we go back to chemo.
Have I mentioned that Todd is a total $#!+?
-------------
In our next episode, we go into all of the reasons why there is no good response to someone telling you that they have cancer.
Next post.
I have two different forms of cancer.
Thanks, Todd.
 |
| Now imagine him with a flat-brimmed cap. |
The results made for a pretty picture but also a really scary one. I was lit up like a Christmas tree. Basically, the way the scan works is that it shows what areas are really sucking down the sugar. Since cancer tends to be pretty metabolically active, the areas that are affected end up being all sorts of beautiful colors. My colors were in my neck, under my arm, on my lung, around my spine... The only one that didn't light up was the mass in my kidney. More on that in a bit.
So... lots of cancer. Definitely metastasized. Probably renal cell carcinoma (because of the mass in the kidney), which is super hard to treat, especially if it has spread. Which this had.
Biopsy time. I go in, the guy doing the biopsy hears that there's cancer in my lymph node under my arm and decides to do the biopsy there instead of in the kidney, like they'd ordered. I mean, it was easier to get to, so why not, right?
The biopsy comes back as Hodgkin's lymphoma. And the specific kind of lymphoma that is the most treatable form. For a solid three or four hours, we're sacrificing animals and virgins on an altar in gratitude. Then we go see the radiation oncologist, who rather brusquely informs us that he thinks it's actually two different kinds of cancer. Good information to have. Not the best way to get it. I think he might be Todd's uncle or something.
See, Hodgkin's lymphoma doesn't typically show up in the kidney. It happens in maybe 1-3% of patients with that form of cancer. All the other masses can be explained by the lymphoma, but that one's weird. Also, they're not sure if the mass in my spine is renal or lymphoma.
More biopsy time. They do one of the bone marrow in my hip (to stage the lymphoma--spoiler alert, it's stage 4), the mass in the kidney and my spine. That last one was at our insistence. We didn't want to end up finding out that the kidney was renal and then not know what the thing on my spine was. More on that in a bit. I say that a lot, don't I? It's a suspense-building tool. Authors, take note.
So, what's the big deal about two cancers? Well, these two don't play well together. Lymphoma typically responds really well to chemo, but RCC (renal cell carcinoma) doesn't. At all. The treatments for RCC are immunotherapy and radiation. A small percentage of people respond well to the immunotherapy (they're called super responders). They don't get sick, and the cancer clears right up. That's not the norm.
Right now, from what we can tell from the MRI, the mass in the kidney is contained. So, if everything else is lymphoma, we can just go through chemo, they can take my kidney, and I'm good to go. But if the mass in the spine is RCC, that's a much different story.
Back to the first "more on that later." The biopsies came back. The kidney mass is indeed RCC. No lymphoma in the marrow. Biopsy of the spine--inconclusive.
What???
They didn't tell me that was an option. The tissue they took from my spine was necrotic (dead), so they couldn't tell what kind of cancer it might be. Even though we made a stink and pushed for the biopsy, we got no information back.
Which brings us back to the second "more on this later." We ended up exactly where we didn't want to be.
The plan is to do two rounds of chemo (four treatments), take another PET scan and see what the mass in my back is doing. If it has shrunk, that means it's lymphoma, and we just move forward with treatment. If it hasn't, it's RCC. They'll pause the chemo for a hot second and radiate my back. Then we go back to chemo.
Have I mentioned that Todd is a total $#!+?
-------------
In our next episode, we go into all of the reasons why there is no good response to someone telling you that they have cancer.
Next post.
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