Cancer after Cancer? Biopsies, biopsies everywhere!

*I want to add a disclaimer – please know that the the following is my first-hand account with cancer and life ‘after’ cancer.  It is intended to shed light on the necessity to improve cancer treatment… I apologize to all that may be offended.*

 
The doctors tell me that I’m no longer at risk for relapsing.  That’s great news! Well yes… but in some ways no. I’m out of the woods for relapsing but I’ve entered a new world filled with the risk of secondary cancers (cancer that arises as a result of cancer treatment).  The reality is, cancer treatment sucks. 

I received a bunch of different treatments while attempting to destroy my AML: steroids, chemo therapies injected during lumbar punctures/spinal taps, chemo injected into blood vessels, oral chemo, more high dose chemo, total body irradiation, a bone marrow transplant… you get the idea. As I am here typing away today, obviously this concoction of toxins worked… HOWEVER, there’s a huge problem. These treatments create a LIFETIME of problems for cancer survivors – case in point… how many 30 year-old individuals do you know that have been biopsied and imaged 3 times in 6 months for 3 possible different cancers?  

Cancer Treatment Problems
So here’s the deal… there are a lot of different cancers and they all have their own recipe of treatments but most of the treatments stink. My personal least-favorite treatment is total body irradiation (known as TBI for short) – it can cook your ovaries, put you at a ridiculous risk for melanoma, give you cataracts, shut down your thyroid, and possibly hook you up with a little more bone marrow dysfunction (i.e. MDS or AML)… among other things. 

I know the idea of total body irradiation is a little hard to grasp so I wanted to help put this into perspective.  I received 12Gy/1200cGy (12Sv/1200mSv) of radiation for my transplant (see chart below). So maybe I shouldn’t be that surprised when they find problems with my mammogram, a peanut-sized nodule on my thyroid, and nodules in my lungs.  

http://onthatpage.files.wordpress.com/2011/03/radiation-chart.png

I look in the mirror and see a chunk of skin missing in my nose and two recovering scars on my chest thanks to cancer.  The scars on my chest have been healing for over 17 years. I am proud of my ‘battle scars’ (as we like to call them) but I’m also done with the charade. It’s downright scary every time I have to wait for a scan or a biopsy pathology report to come back.

    

Breast Cancer?
In May of this year I had yet another mammogram. After answering the same question four different times, I still responded in a cheery tone, “Yes, I know I’m young. I’m getting a mammogram at 29 because of my prior history of lots of chemo, total body irradiation, and a bone marrow transplant due to AML.” I smiled through the whole mammogram – “what’s a little pain… I’ve been through much worse!”  However, my smile faded when the radiation oncologist explained that my mammogram was concerning and that I needed to undergo a biopsy. “Do I have cancer… again?” I thought.
As I gowned up for the biopsy I wasn’t worried about the procedure… you lie face-down on a table, stick your boob through a hole, the docs clamp it off, they pull out some of the suspicious area, the docs verify that they got what they needed, and then you’re free to go. 


Unfortunately for me, the concerning area was very, very deep and after multiple attempts that involved contorting me into wildly uncomfortable positions, the surgical team almost gave up. They explained that we would likely have to head into full surgery to go at it a different way. “Let’s give it one more try!” said one of the nurses, “Do you think you can stick your arm in the hole too and shimmy down?” For once in my life, my lack of being well endowed paid off!  
On our last attempt, we were able to get me into position. The team asked me to take very shallow breaths so as to prevent me from moving out of position.  I was happy to comply since I had no desire to head into a full-blown surgery. That’s when the surgical team started running around the room, yelling commands at each other – it sounded like an episode from ER.  “I’m fairly certain I’m not bleeding to death,” I thought. If I didn’t feel like this was serious before, I certainly did now. The docs got a sample and after verifying that they had a good sample, I was un-clamped and free to head out.
About two hours after I arrived for my appointment, I was walking back down the hall with yet another scar… thanks to cancer. 
The interesting thing about leaving the breast biopsy area, is that you leave feeling more stressed than when you entered. It’s analogous to leaving the lecture hall after your organic chemistry final. You head out knowing that all you can do is wait for the results… did I pass? It’s funny to think about how things like O Chem exams hardly matter when you’re waiting to find out of the biopsy reveals cancer.
After two long days, I received good news. Not cancer!  
Nodule 1 and The Neck Biopsy

Then in late November, less than 7 months after my breast biopsy, I had that same familiar feeling in my gut. I went to the hospital for a routine thyroid ultrasound. Due to the amount of radiation that hit my thyroid, I am at a higher risk of getting thyroid cancer; thus, my endocrinologist just wanted to do a screening ultrasound.  However, the screening ultrasound revealed a 2 cm nodule.  Suddenly, the normal stressors – what to have for dinner, the work to-do list, cleaning the house – seemed… well… not stressful.  Although I probably should have learned my lesson from my traumatic breast biopsy, I was not worried about the actual procedure.  Getting a breast, thyroid, or bone marrow biopsy isn’t like going in for a bypass or other major surgery – the climactic part isn’t the surgery, it’s the results that come back later.  And, although it is usually only 2 to 5 days that you have to wait for results, it feels like an eternity.  Although Tom Petty was referring to something entirely different, waiting really is the hardest part.  The bandage or slight twinge of pain is a constant reminder that you had a procedure and that you might have cancer. 

Today, January 13th, I went in for my thyroid/neck biopsy, or more specifically a fine needle aspirate.  A ‘fine needle’ didn’t sound so bad… however, I will admit that pictures of the procedure did look a little more extreme than I had anticipated (thanks, Google image!).  

https://i2.wp.com/endocrinediseases.org/thyroid/img/pic_fna_nodule.jpg
The ultrasound wand helps the docs see where to biopsy.
https://i2.wp.com/i.ytimg.com/vi/CN5yFGaMDCs/0.jpg
See!  It’s not that bad – she’s smiling!!!

Keeping my fingers crossed pre-procedure!

Despite the procedure looking a little scary, everything went rather smoothly. Three separate syringes were inserted into my neck in a matter of 3 minutes.  Each syringe pulled out some of the nodule. The parts of the nodule that were extracted are now being examined by pathologists. I’m back to waiting.  So, now I am doing the only things you can do… I’m staying positive, keeping my fingers crossed, and eating chocolate while watching some hockey with my husband.

Stupid Cancer!!!

     

Advertisements