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Lakeshore - [cancer] Now is the summer of our discontent
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Jay Lake
Date: 2010-07-21 05:21
Subject: [cancer] Now is the summer of our discontent
Security: Public
Tags:books, calendula, cancer, endurance, health, personal, travel, writing
Well, the PET scan result yesterday was confusing. On Monday, when we met with the oncologist, she was quite convinced this was a metastasis. My oncologist is not an excitable person, she always hedges. This time she didn't. Then the PET on Tuesday showed the growth in my liver failing to exhibit the high level of metabolic activity associated with tumors.

A few things I know, or reasonably assume here.
  • This is not the same place as last year's liver anomaly (several people have asked me that). The old (and still existing anomaly) is buried in the right lobe. The suspected metastasis is in the left lobe.

  • The liver is in the metastatic pathway for colon cancer, along with lungs and the lymphatic system.

  • The logical assumption is this is a metastasis, and CT scan was highly indicative of this. So the PET scan is a puzzler.

  • It would be one heck of a coincidence if I had spontaneously developed a cyst or other liver issue in this timeframe. A welcome coincidence, but very weird.

Once I get a consult with the liver surgeon, I'll know more, but my current understanding is that we'll go ahead with the surgery, then rely on the biopsy to guide what comes next. I find it improbable this is not a metastasis, but the evidence is showing mixed.

Weirdly, in some ways this new ambiguity is more upsetting to me than simply being on the path to another round of surgery and chemo has been. That says a lot more about the quirks of my psychology than it does about medical science.

calendula_witch and I spent quite a bit of time yesterday discussing the implications of all this. I am feeling very vulnerable, all too aware of my own mortality. If this proves out to be a met (which is still my belief), my survival odds have taken another nose dive. They're already pretty spooky, but I do understand the difference between statistics and prognosis.

My fear — and here I am talking about emotional reactions, not logic or sound medical judgment on anyone's part, least of all mine — is that this cancer will continue to be aggressive, and throw mets faster than we can treat them with surgery and chemo; that I'll spend the next few years grinding myself to pieces trying to catch up to something that's killing me slightly faster then we can cure it; that I'll become too sick to work, too sick to write, and within a few years, too sick to go on living.

I recognize I've had all of this news less than forty-eight hours, and mental/emotional whiplash twice already, once with the Monday consult and again with the PET result. This is no time for me to be drawing firm conclusions or making major decisions. Yet the New Zealand/Australia trip impends, Endurance is due, my life hurtles onward, and everything is inflected by this problem.

Ugly mysteries, life and death stakes, colliding schedules and commitments. If I were a character in a book, this would be fascinating. Living through it, not so much...

Good thing I'm seeing my therapist today. Gee, I wonder if we'll have enough to talk about?

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Jay Lake
User: jaylake
Date: 2010-07-21 13:13 (UTC)
Subject: (no subject)
It seems like a false positive would be exactly the type of thing the PET scan would be intended to reveal.

Well, yes, and that may be where we are right now.
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