Cancer realities
By Bernie Krewski
On January 13, Dr. Daniel O’Connell, my follow-up surgeon for the last 10 years, determined there was a recurrence of cancer symptoms in my mouth, and ordered a PET-scan for January 31.
In our discussion February 24, reviewing the results (with Pat’s presence), he described three possible options: no treatment, referral to the Cross Cancer Institute, and surgery.
No treatment would result in a slow but prolonged pathway to eventual death. The Cross might offer some type of chemotherapy in combination with targeted doses of radiation. However, such remedies would only be palliative and provide temporary relief.
Surgery, I agreed, was the best and only option. The presence of this cancer, he said, is not directly connected to the onset of cancer that I experienced and for which I was treated in 2004-2005. The time span is far too long. Rather, in layman’s terms, my body is susceptible to oral cancer because I have had it in this area before. This is described in these medical concepts – “condemned mucosa” and “field cancerization.”
I found two research papers that describe this phenomenon: “Danely P. Slaughter’s Field Cancerization Concept of Carcinogenesis: The Path Forward to Early Cancer Detection and Chemoprevention,” Cell & Developmental Biology” (2015) and “Tumor Microenvironment in Head and Neck Squamous Cell Carcinoma,” Seminars in Oncology (2014).
Eight to 10 hours of surgery will be necessary. It will involve the reconstruction process known as the “flap” – taking vessels/tissues/muscles from my right arm and possibly my leg and connecting them to the wound that needs repair. I experienced this same process, utilizing my left arm, when I had my laryngectomy in 2005.
My ability to speak and swallow will be furthered diminished. The first 72 hours after surgery, he noted, are the most critical.
Surgery will likely occur sometime in March and for certain by the end of April. Dr. O’Connell said I will need to see him every three months for after care during the next two years.
He prescribed an oral rinse to manage the “burning” sensation in my mouth.
The demeanor in this meeting was exactly what most cancer patients want, as I have read in the clinical literature – clear, straightforward, informative, calm, and honest.
Immediately after, we met with Jessica, Dr. O’Connell’s “assistant.” Anticipating this would likely happen, she had “reserved” a time slot already – surgery will be on March 11.
She outlined the next steps, supplemented by calls in the days following: paperwork/consent; physical examination by family doctor; lab work (blood and ECG); biopsy by Dr. O’Connell’s Fellow Feb. 28 (Dr. Andrew Bysice – studying for another year after his residency); Teaching Clinic March 4 (2 hours); Diagnostic Imaging (of arm and leg) March 7; Pre-Admission Clinic (no date).
I am resuming exercising sessions Feb. 28, March 3, 6 and 10. On Sunday March 9, I will be meeting with the two first-year medical students who I have been mentoring for this academic year.
Besides Pat’s support, these three resources will help me face these forthcoming challenges: my years of experience as a cancer patient, knowledge of this chronic disease, and understanding its impact on daily living.