Wednesday, September 24, 2008

The partial pathology report

Dr. W, the nice radiologist, called later today with a partial pathology report confirming the cancer. Still to be done is the estrogen receptor status and the HER-2 stuff (human epithelial growth factor). I insisted that he read me the report as he was being very vague and finally reluctantly told me that it was a grade 3 tumor, the worse in terms of aggressiveness. He really does have a problem delivering bad news. I was trying to get from him, did this mean it was growing extra fast but he said it meant the cells were undifferentiated, which probably will mean that they are estrogen negative so they will be harder to stop. As cancer progresses, the cells become less and less like the cells they came from and are much harder to kill. I want this thing out now and stressed the need for surgery ASAP. He said he would do what he could and I soon got another call scheduling me Monday for most of the day. I will spend about 3 hours with my newly diagnosed cohorts learning about cancer and the options, meeting with a social worker and setting up support groups. While this is going on, each of our cancers is discussed before a 'tumor review board' with various experts giving their opinion on what should be done and finally I get to meet with a surgeon who tells me what they came up with. The scheduler told me surgery is usually scheduled between 2 to 4 weeks later. I said since I seem to have an aggressive cancer, this is too long. She said they will take that into account and maybe it will be sooner. I am really trying not to shoot the messenger. I am scheduled to be there 7 hours.

The Wall Street Journal recently had a discussion on whether is it really necessary that physicians know organic chemistry. Shouldn't they take some classes in bedside manner instead. My opinion is that they should know the chemistry and they should know basic cellular biology. Bedside manner would be nice too though I don't think it could be taught. I started questioning my nice radiologist about how many of my cancer cells were in "S" phase (an indication of how fast they are growing) and he hemmed and hawed saying 'gee that is an excellent question, I'd love to sit in during your consult, you seem to know so much.'

Argh. Maybe I know too much. Maybe this is my punishment for correcting my Italian teacher's grammar and spelling. Noone likes a know-it-all.

So things seem bleaker than before. Maybe I should have the whole thing cut off. But I am trying to distance myself from the reality. THIS CAN NOT BE HAPPENING TO ME. I really haven't grasped it. It is a problem and annoying and part of me wished I didn't open this door to look in but it would have only gotten worse. I cancelled my colonoscopy. Enough stuff already.

Right after the UM calls, my long time friend J called. We went raspberry picking, which I haven't done in a while. The owner is a nice 81 year old man making jokes about his age. It struck me that I won't probably be that old. Lots of raspberries this year.

Tomorrow I go to Happy Hour with a former co-worker. His wife  went through all this 2 years ago. I need details, what to expect, etc. I think she had a more scary diagnosis than me plus she had to work throughout it and my friend had been let go byour former employer on top of it all. She has e-mailed me some saying the worse part was what I am doing now-waiting for biopsies and more information. She did radiation for 7 weeks but got to know the guys going in for prostrate treatments at the same time. I want light at the end of the tunnel. The nice radiologist still insists I have a good prognosis but talk is cheap and he really has a hard time giving bad news. He identified with me too much having kids the same age and being the same age.

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