19.) The “Good Cancer” Bus

I was recently told—by a medical technician no less—that, “Well, at least you’ve got the good cancer!”   Hummmmm…  I wasn’t sure whether to breath a little sigh of thankfulness for that, or to clobber her!  I mean, good cancer? Really???

You know, all this “waiting” has got to be one of the hardest parts! It has now been three months since I first discovered the lump in my throat and that initial doctor visit; and, since that day, my life has been pretty much turned on end. While I’m blessed to have a medical provider that jumps on things pretty quickly and keeps the ball rolling—I’ve never had to sit and wait for insurance approval—still, it sure seems like a lot has had to happen just to get to this juncture. I’ve been through a couple of ultrasounds, a five sample needle biopsy, more consultations—phone & clinic—than I can count, more lab tests and blood work than I can possibly keep track of, two surgeries—one requiring a five day hospital stay—and eight flights to and from the island of Oahu. And I just now, finally, have some preliminary inkling of the extent and staging of the cancer—maybe.

However, even now, both the ENT surgeon and my endocrinologist have warned that they can only offer a “preliminary” prognosis at this point because nothing will be known for sure—if it ever is—until after the WBS (whole body scan), which will occur one week following the internal radiation treatment, or RAI—radioactive iodine ablation—which is still more than a month away. And even then, more will be known only after months of testing and a second WBS, yet to be scheduled six months after the first one.

But, according to my doctors, the cancer is “currently” designated as T2N0M0 Stage II differentiated papillary carcinoma of the left thyroid. “T2″ means that the initial tumor was larger than 2 cm but not larger than 4 cm across—it was 3.5 cm—and that it did not appear to have grown outside the thyroid. “N0″ means that there appears to be no spread to the lymph nodes. “M0″ means that it doesn’t look—for now—like the cancer metastasized to any other organs of the body. In consultation with my endocrinologist following the second surgery, I was informed that the pathology report revealed a second tumor had been found in the right hemisphere of the thyroid—about .5 cm—but that did not change the current staging.

I guess age 45 is the “cut-off” date used to help determine general prognosis for those dealing with thyroid cancer. I’m 10 years beyond that cut-off—yikes!—meaning that, even though the cancer does not appear to have spread, I am automatically assigned a higher level of staging based upon my age. According to Columbia University Medical Center, using information “extrapolated from a number of sources including the American Cancer Society, the National Cancer Institute, and the National Comprehensive Cancer Network, among others,” for my age, stage, and type of cancer there is a 7% chance of recurrence, a 7% chance of distant recurrence, and an 89% survival rate at the 10 year mark (Columbia, 2011, para. 7). Other sources state:

While the prognosis for most people with thyroid cancer is very good, the rate of recurrence or persistence can be up to 30%, and recurrences can occur even decades after the initial treatment. Therefore, it is important that you have regular follow-up examinations to detect whether the cancer has recurred. Health monitoring should continue throughout your lifetime. (ThyCa, 2011)

What does all this mean? I don’t know for sure. I guess it means that, initially, for every 100 people over the age of 45 who are diagnosed with this particular cancer, 89 of us will still be here in 10 years, while 11 of us will have died from this disease. I’m not sure just how I should take that. Do I just relax, smile, and say, “Oh, well, that’s only 11 people out of every one hundred, or 110 out of every one thousand, or 1,100 out of every ten thousand of us; so, why be overly concerned?”

It’s kind of like being walked out into a huge parking lot and being shown a whole row of deadly buses destined to crash sooner or later. There’s the melanoma cancer bus, the breast cancer bus, the pancreatic cancer bus, the liver cancer bus, the leukemia bus, the lymphoma bus, etc., etc., on and on, and let’s not forget that damned ole Ewings sarcoma bus, chalked full of kiddos—very deadly. Oh, but then there is that bus way down near the end, one of the “good cancer” buses—the thyca (thyroid cancer) bus.

crashed school bus

Yes sir, if you’ve got to ride a bus, this is one of the buses you wanna ride! Sure, it will crash sooner or later and, yes, you’re going to get hurt, beat up, broken up, cut up, and poisoned. You’ll probably spend a few days or, perhaps, even weeks in the hospital by the time it’s all said and done. And, yes, your life will certainly be seriously disrupted, to say the least. But, hey, the good news—only a little more than 10% of you are gonna die from your injuries. Oh, and you should probably know that, once you’re on the bus, you’re always on the bus and, for every 100 of you that survive the initial crash, up to 30 of you may have to go through yet another crash somewhere on down the road…  “Hmmmmmm…. and that’s the ‘good cancer,’ hunh?”

Like most cancer patients, I’m often suspicious that I’m not being told the whole story. I feel like I’ve been put on a “need to know” status and my doctors are not going to tell me anything more than I really need to know at any given time; which, in my case, is probably a good thing because I can barely process what little I do know as it is carefully threaded out to me. Probably better to leave room for my imagination to run a little wild than to fuel my nightmares with the actual facts—ha!

Still, I find it amusing how that my doctors and technicians continually use “qualifiers” when discussing any results or prognosis with me; how they are always careful to “encourage” without “promising” anything.

When I went to my local doctor for the first time, she told me, “It’s ‘probably’ nothing serious, ‘but’…”

Then, before the first surgery, the ENT said, “It is ‘unlikely’ you will need a second surgery, ‘but’…”

Later, just before the second surgery, he said, “You ‘should’ come through this just fine and be on your way home tomorrow, ‘but’…”

Five days later, as they prepared to wheel me out of the hospital, he said, “I ‘doubt’ you’ll ever have to come back and see me, ‘but’…”

Now my endocrinologist is saying, “Everything ‘looks’ good at this point and I ‘think’ you’re going to do just fine, ‘but’ there is still that “minimal” chance that you may have to deal with more treatment beyond the initial radiation therapy.”

So, remembering my research, I asked her, “About a 30% chance of recurrence?”

She smiled, “Well, yes, about that!”

I just laughed and told her, “Well, with the way my luck has been running with all these percentages you guys keep throwing around, please make sure to keep me outta Vegas!”

For some reason, that didn’t seem to amuse her as much as it did me. Which, again, made me wonder, “What is she ‘not’ telling me?”

But, for now, I just keep waiting and trying to be a “patient patient,” enduring each new procedure and this crazy hormonal roller coaster they’ve got me on, while awaiting further analysis and trying to salvage the ragged pieces of my life following the bus crash. I also try to do what little I can to help other crash victims—some far more banged up than I—while playing the percentages and hoping the dice finally roll favorably in my direction.

Of course, I know that, for the child of God, life is a whole lot more than just a grand and glorious “crapshoot.” The Bible says: “The mind of man plans his way, but the Lord directs his steps” (Proverbs 16:9, NASB).

Oh, and by the way, people, there is no “good cancer.”