Friday, December 02, 2005

An Unwanted Journey: Day 0008 - Otherwise Healthy

“…he is a pleasant, otherwise healthy looking well nourished man.”

Hmmm, how appearances can deceive. The operative report from my gastroenterologist gives some clinical descriptions and then launches into a travelogue of the gastrointestinal tract viewed through the Olympus video colonoscope. Here’s the part that’s most pertinent:

“In the rectosigmoid between 16 to 17 cm to about 10 cm there was a large mass noted that extended over a distance of about 6 to 7 cm and involved about ½ of the circumference of the colonic lumen. It was a friable mass with areas of ulceration in the center. The distal end of the tumor seemed to be about 10 cm from the anal opening.”

“…This young man’s colonoscopy unfortunately shows a large rectosigmoid mass. He is quite a young man to have cancer at an early age.”

I think so too!

On the other hand, the first pathology report says “the biopsies show superficial fragments coming from a tubulovillous adenoma with low grade dysplasia. No invasive carcinoma is identified. However, the biopsies are superficial and sampling bias cannot be excluded.”

So, no cancer yet, but not necessarily no cancer!

Some things are becoming clearer to me now just 10 days from my colonoscopy.

  • I will probably be treated for rectal cancer.

  • I will probably have a special kind of MRI geared toward preoperative staging of the cancer.

  • I will probably be enrolled in a clinical trial of a chemoradiotherapy protocol aimed at reducing the size of the mass in order to facilitate surgery and improve quality of life for me subsequent to surgery.

  • I will probably not have full staging information for about 3 to 3.5 months from now until after the surgery is done and the postoperative pathology report is complete.

  • I am (tongue in cheek) “young, healthy looking, pleasant” and spoiling for a fight with this damned cancer!

  • If I qualify, I would seriously consider any clinical trials associated with preoperative chemoradiation for rectal cancer.

And now for something completely different…

If you enjoy the comedy routines of Bowser & Blue during the holiday season, you might enjoy the lyrics to their Working Where the Sun Don’t Shine in praise of the colorectal surgeon:

"Working Where The Sun Don't Shine" (The Colorectal Surgeon's Song)

We praise the colorectal surgeon
Misunderstood and much maligned
Slaving away in the heart of darkness
Working where the sun don't shine

Respect the colorectal surgeon
It's a calling few would crave
Lift up your hands and join us
Let's all do the finger wave

When it comes to spreading joy
There are many techniques
Some spread joy to the world
And others just spread cheeks

Some may think the cardiologist
Is their best friend
But the colorectal surgeon knows...
He'll get you in the end!

Why be a colorectal surgeon?
It's one of those mysterious things.
Is it because in that profession
There are always openings?

When I first met a colorectal surgeon
He did not quite understand;
I said, "Hey nice to meet you
But do you mind? We don't shake hands."

He sailed right through medical school
Because he was a whiz
Oh but he never thought of psychology
Though he read passages.

A doctor he wanted to be
For golf he loved to play,
But this is not quite what he meant...
By eighteen holes a day!

Praise the colorectal surgeon
Misunderstood and much maligned
Slaving away in the heart of darkness
Working where the sun don't shine!

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