Wednesday, March 30, 2011

New bumps: part 2

Biopsy is scheduled for friday. One thing we were taught in medical school is; order tests only when the result would affect the 'management', aka treatment, of the patient.

Just so that people are on the same page in terms of the information this biopsy will provide, here's the deal: Given the size and character of these nodes and the fact that they're in my neck (I've have 80-ish lymph nodes plucked out over the course of 3 surgeries and around 60 of them have had cancer in them), it is highly likely (maybe 95-98% certainty) that these two 'new' nodes will have some kind of cancer. The diagnosis I've lived with for the past 6 years, is a thyroid cancer sub-type called papillary. There's a few things important with respect to that subtype; it is typically a disease of females or those exposed to radiation, i.e. Chernobyl. Papillary has an excellent prognosis, however the following features each worsens the prognosis: being male, extensive metastases, poor health, or certain mutations beyond the scope of this post. Unfortunately, we know I have mets in my bone, lungs, and neck. And of course, I'm male.

That all being said, my own hope for this biopsy is for it to come back saying 'well-differentiated papillary thyroid carcinoma'. The other possibilities are considerably less pleasant to think about and the worst would be 'poorly-differentiated thyroid carcinoma'...which carries a very poor prognosis. So, the differentiation status is very important. The other kinds of cancers aren't very likely, but again, I don't believe this biopsy is being performed to ask the question: "Is there cancer?", instead the question is "What kind of cancer is this?".

The last thing I want to say that I've tried to make exceedingly clear in other posts, but some friends still don't seem to pick-up on this: I have never been in remission form thryoid cancer. It has been inside of me since sometime before I was diagnosed in 2005. And honestly, given what has happened in the last year, new bone lesion and increasing blood tumor-marker, I've been waiting for this too happen. Again, the question isn't 'if?' but 'when?'.

In the meantime, today's Wednesday and I've logged 10hrs and 45min on the bike this week. I feel OK, but definitely have very limited race-type fitness as all of my activities have been base-miles, yoga/stretching, and lifting weights.


Sof the Froggy said...

Sending good thoughts your way my friend. I'll blow a bit of Red Rocks desert peace towards Columbia in the next few days.

Ariel said...

I don't know what else to say but we deeply love you.
Please let us know, what we can do to support you, Maggie and Cass. We are here for you in every way.

Callie said...

Thanks for the update. We continue thinking of you and your family and sending our best thoughts your way.

Andy said...

Dan, the care you take for all of us… The way you make an effort to provide comfort or at least reason to an unreasonable, scary situation is a monument to your character. Please keep us informed.

Lucas Miller said...

I love you, Dan, and hope that the news is as good as it can be. Whatever it is, please let us know if there's anything we can do for you. This is scary stuff and we will do anything we can to help you. When is a good time to plan a visit? Ariel and I were talking about when we can take some time off and where good places to meet might be.

Take care and keep the faith...