The “Good” Cancer Still Sucks
I am not trolling for sympathy. Or prayers. Please don’t tell me I’m in your prayers, especially as the research suggests it makes no difference and, in some cases, can make things worse.
So I have cancer.
It’s Thyroid Cancer, the “good cancer.” And even among the types of thyroid cancers, it’s the “good one” (papillary).
Fuck the good cancer. It’s still cancer.
Lemme tell you a story. It begins in our sunroom on a milky March afternoon, me on the floor grading bad student news stories. I look up to answer a question and my voice fails. Okay, I stand and try again. Still no voice. It’s whispery, hoarse, a voice made for late-night phone calls (“Hi. Whatcha wearing?”) which while useful in a college town for entertainment purposes, also tends to land you in jail. Okay, I figure, maybe it’s laryngitis. I’m a prof after all. I talk for a living. It’ll pass.
Okay, you know the story. It didn’t pass.
My general doc, though, insists it’ll pass. A week later I break the news that, no, it hasn’t passed. He prescribes some antibiotics. No help. Finally I get referred to a Ear, Nose, and Throat guy who after various pokes and prods and scans, says a nodule on my thyroid is pressing against the nerve that controls one vocal cord. Ninety percent of the time it’s no biggie. Benign. Treat it and move on.
Okay, you know the story. It wasn’t benign.
So on July 3 a year ago they yank the thyroid. It’s a long surgery. There’s a lot of cancer to clean up, including the fact it’d wrapped itself around the nerve so well they had to take that as well. I’m stuck with this breathy “whatcha wearing” voice until later surgery uses Gore-Tex (no, really) to seal the gap and give me a passable voice with one working vocal cord.
Except it’s not over. Not at all. My lab numbers suggest there’s something still floating around in there. That means it’s time for a radioactive iodine treatment, often called RAI, or ablation. Basically you go off all meds, feel like crap for a few weeks, avoid all iodine, and walk into a hospital. A technician carries in a heavy lead container and scurries out of the cramped room. You open the container and swallow the very thing they’re scurrying away from. Thyroid cells (and cancer cells tied to the thyroid) love iodine, so the radioactive stuff heads straight there to (theoretically) kill off any remaining cells.
Plus there’s the possibility, if you’re bit by a spider, of getting a super power.
Unfortunately I have some stubborn labs, a measure of “thyroglobulin,” that suggests there’s still something in there, somewhere. Hiding, maybe crouched in my lymph nodes. A scan suggests as much, so my local guy sends me to a med college specialist for a biopsy. The specialist looks at the scan, frowns, does his own quick scan, and says there’s nothing to biopsy. “We’re just chasing lab numbers,” he says. Do another full radioactive scan to be sure.
Instead of just a scan we hit it again with I-131, and then we scan. Not a whole lot lights up, just traces here and there, which you’d think is damn good news except that, with cancer, apparently there’s rarely good news even with the good cancer.
Ya see, maybe I’m non-avid. Maybe my thyroid cancer won’t take up iodine. If that’s the case, I’m fucked. Not as fucked as I mighta been 10 years ago, but still kinda fucked. We won’t know, not till maybe March when I do some more blood work and have (yet again) another scan. If I’m non-avid there’s a few things to drag it out. Some experimental chemo meds that won’t kill the cancer but will slow its growth — and do all kinds of other nasty things to me. And there’s other stuff, but surgery in my case is difficult given I have only working vocal cord. If they nick the other nerve, I’ll be breathing out of a tube the rest of my life, with no voice at all unless I can find employment as a dirty late-night phone caller. In that case, a hobby could turn into a job.
But I don’t want any sympathy. It’s not as if I’m gonna keel over tomorrow. Or next year. I’m sick of being poked and prodded, I’m sick of people asking me, in concerned voices, how I’m doing. I’m sick of thinking about it. Hell, I have a sore throat right now, probably from a mild cold, but you can never escape your imagination going wild and picturing cancer running rampant through your throat, partying like crazy.
So fuck cancer. Even the good cancer.
Ultrasound found nothing. That’s the good news. My thyoglobulin keeps inching up. That’s the bad news (it’s a cancer marker). So this week I sit through a PET scan, which has nothing to do with dogs or cats or gerbils. Good news — it’ll find anything, wherever it’s hiding. The bad news — it’ll find anything, wherever it’s hiding.
It’s February 2 and I’ve returned from MD Anderson, the premier cancer center, as scans in Athens and at MDA confirm the thyroid cancer has metastasized to my lung. It’s not lung cancer, it’s thyroid cancer in the lung. That’s bad, as of course there is no cure. No chemo. The good part is the MDA docs are the best in the business and feel confident they can keep this a chronic illness, holding it back, as opposed to putting an expiration date on me. I’m unlikely to have a surgical approach and probably, eventually, will have to go on a nasty drug in a family of drugs called TKIs that inhibit the cancer cells from growing and can actually shrink the tumor. I say nasty because the side effects are not fun and they can eventually stop working. But there are new drugs coming down the line, all TKIs unfortunately, but still I can keep this thing at bay for a while.
I’ve written elsewhere about the clinical trial I’m presently in at MDAnderson. You can read my latest, very short, at: http://bit.ly/1IYyXNe