Soooo....I Have Cancer

I met with my radiation oncologist this morning. As much as I didn't want to be there I really enjoyed meeting with him. He is a very straight shooter, easy going, and has a personality and sense of humor that I can easily see myself getting along with. He had an opportunity to review my case with both my surgeon and a radiation oncologist at the hospital. All three of them agreed that this is a tricky situation. All of the margins of the tumor showed good, clean, healthy tissue (Stage 0). All of my lymph nodes were clean (Stage 0). The only reason they even considered recommending radiation treatment is because the tumor only slightly started to make its way into what they call the extrinsic muscles of my tongue (Stage 4). Had the tumor stayed in the intrinsic muscles of my tongue we would be having a different discussion. He said there are definitely "no brain-er" patients...those that have positive lymph node results or imperfect margins in the excised tumor. I do not fall into that category. But after a lengthy discussion with him we decided that it would be best to undergo radiation treatment. And so I signed the consent form.

The next steps:

- Continue to let my neck and arm wounds heal. These are doing remarkably well all things considered.

- Continue to let my tongue heal and get the swelling under control over the next couple weeks. My chewing and swallowing continue to get better but it is still challenging at times. I am also able to talk a bit more each day but it is very tiresome and frustrating when I cannot get the sounds to come out right.

- Get fitted by my dentist for a guard for my lower teeth in an effort to prevent electrons "bouncing" off the fillings in my teeth and creating sores on my tongue.

- Get fitted for a plastic mesh head/neck/shoulder mask that I will wear during each treatment in order to keep me in the exact same position every time. I'm nervous about this but my oncologist said he could give me a "chill pill" before each treatment. If I am at ease, he is at ease...and he said I will be easier to treat if I am not all worked about about the mask.

- Have a scan of my head and neck performed so they can "superimpose" my MRI scan (from June) with the scan from their machine. This will allow them to be able to tell their machine exactly where and how "deep" they need to administer the radiation.

- Go in for a "dry run" to make sure the mask fits properly and aligns correctly with the machine delivering the radiation.

- Have a feeding tube placed directly into my stomach through my abdomen in the event that swallowing becomes too painful or difficult. They cannot afford to have me lose weight because I cannot swallow, have the mask become loose on my face, and have my head wobble around as a result. He rarely gives his patients and option when it comes to the feeding tube but did say that there have been cases where the patient could swallow and eat during treatment and did not need to use it. Whatever...with all I've been through surgery-wise thus far I think I can handle this. I'm still nervous about it but I know it will be okay.

- Begin treatment. This probably won't start for at least 2 or 3 more weeks because of insurance paperwork and various appointments that I need to go to. It is likely that I will receive anywhere from 30 to 35 treatments over a period of 6 to 7 weeks. Radiation will be administered once daily (Monday through Friday) for approximately 15 to 20 minutes each day. I was given the worst case scenarios as far as side effects are concerned and I genuinely appreciated everyone not sugar-coating anything. It could be downright awful and miserable but everyone reacts differently. Time and time again I have been told that I have my age and my general health in my corner and that I am ahead of the curve with everything so far. Maybe there is some glimmer of hope that I will be on the less severe end of the side effects but only time will tell.

- Begin recovery. I was told that I will likely start to feel "better" approximately 2 weeks after my final treatment. Approximately 4 to 6 weeks after the final treatment is when most patients start to "feel like themselves" again. Again, these are just generic timelines. Could be longer, could be shorter.

From the sounds of it this could end up being a far cry from a walk in the park and honestly I think I am more scared of this than I was for my surgery. The first half of treatment is usually much easier on patients than the second half. Side effects include sore throat, sore tongue, hair loss, dry mouth, thick saliva, skin irriation on my neck/head, fatigue, and loss of taste. Some of these (like taste, for example) can take longer to reverse but over time they should come back although I was advised that some foods might never taste the same again.

I wish I could snap my fingers, make all of this go away, and get back to normal. But life doesn't always care what we want and will throw us a curveball from time to time. I have an outstanding support system and a never-give-up attitude. There is absolutely 0 doubt in my mind that I will make it through this no matter how difficult it will be.

Thanks for Reading and Take Care,
Josh