This Ain't Gonna Be Fun

Friday was one hell of a day. We arrived at Anderson at 8:30 for the first of 5 appointments. It was Patient Education and Instructions. There were 10 patients and their spouses or significant other in the mini class which was conducted in a hallway. Gary, the nurse who ran the program was very good in a very non-traditional way. He really said it the way it is. If one didn't want to hear reality, this was not the place to be. I remember Dr Beadle saying this was the program that would scare the hell out of you and she was right on the money. Yesterday's information sheet with the side effects was merely a precis of what was covered today. I'm not going to go into all that was covered but suffice it to say this treatment is really going to be rough, the side effects are going to be nasty, there will be pain which will be managed and for 4 of the 6 weeks I will be miserable. He also said the side effects do take time to disappear, sometimes up to a year and in many cases they don't entirely do this.  Unfortunately I am not a stoic. However I have convinced myself that I will endure this, I will do all that is asked of me and I will triumph. I know this sounds good but I hope I still have the same conviction as the therapy progresses.

Next on the agenda was a meeting with the entire Radiology team. Six doctors crowded into my little examination room and scoped my throat, probed around and discussed it. This little team consists the best of the best and they exuded confidence. I  was given my radiation schedule which starts on the 21st. That day will be a dry run to make sure my position on the table is correct and the mask is properly marked and they are ready to go. The first actual treatment will be on the 22nd and I will have 33 of them. I am not pleased with the time of these treatments as it is 3:45 PM. It's the perfect time to hit the school traffic coming and the rush traffic going. I will see if I can get it changed to a morning hour.

My last apppointment was with Dr. Anita Sabichi who is a medical oncologist with Dr William. Our appointment was scheduled for 1:00 PM but she was running late and at 3:15 she showed up. The major highlight of this meeting was a discussion of Erbitux and whether or not I should have it. To say that this threw me would be an understatement. I was feeling so good about making the decision to have Erbitux instead of Zactima. You are not allowed to become complacent. I learned that Erbitux has it's own side effects that I had been previously unaware of and which she made perfectly clear.

She went over my non-finalized pathology report and told me they knew the location of the primary site, that I had squamous cell carcinoma, that the tumor was very small as was the tumor in the node. (We knew this) She said that they recently found that there are a group of people with  head and neck tumors that didn't have the major risk factors, (smoking & alcohol use), who had tumors that were positive with the  HPV virus. (human papilloma  virus) She said that as kids we were all exposed to this virus but for some reason some people don't anhiliate the virus from their body and it gets harbored in the back of the throat and the lymph tissue there. If it is there for a long period of time it can cause a tumor. They are not at the point in time when they can treat this tumor differently. However, looking backward they see that people who have HPV in their tumor do a whole lot better than those who don't. Patients who have HPV have a better prognosis, less chance of a reoccurrence and less chance of metastasis.  She said that regardless, she feels I will do well because I have a little tumor and a little lymph node. The results of the HPV test done on me are not back yet.

So, the choice of whether to have the Erbitux or not, is up to me. All I want is some doctor to tell me what to do but it doesn't seem to be happening. So, the choices as I see them are as follows: Behind door number 1 we have Radiation by itself. Behind door number 2 we have Radiation and Erbitux and behind door number 3 we have, perhaps HPV virus in my tumor which would allow me to bypass door number 2 and select door number 1. If this is the case, I have opted to take door number 1.

Dr Sabichi went on to say they don't like to overtreat their patients and that all involved in my case would feel comfortable with either decision. She said that I had to be comfortable with my decision. My comfort level would increase dramatically if someone else was to make that decision.

After a brief trip to Dental Oncology to drop off my radiation schedule and hear about the fluoride treatment I will have to self administer, we left the hospital. It was now 4:30 and time to go home. Did I mention the bloodwork? Yeah, I had that too squeezed in between Dr. Sabichi and Dental Oncology. What a fun day!

Ending on a high note, I was told that I should eat anything I wanted this coming week and to gain weight. I believe this was the first time in my life I have ever heard those words.