Author: shacker

“Cancer? But you look so healthy!”

That’s what the proprietor at the Thai restaurant said when I went to pick up our dinner the other night. I’ve started to realize what a common misperception this is – that cancer only affects people who are sick, or weak. But that’s because we think of it as a disease like other diseases, rather than a random outbreak of cell mutations. Cancer hits healthy people all the time. Cancer don’t care.

I watched a YouTube video the other day by a guy who got the same Squamous Cell Carcinoma throat cancer that I had. Everything about his diagnosis and treatment was identical, until we got halfway through, and he revealed that he was going to “treat it” with a vegan diet, juicing, and fasting. Wanted to get really healthy, too healthy for cancer. But it was such a profound misunderstanding, and he paid for it. As months went by, his visible tumor shrunk, and he thought he was on a good path. But when he went for his next scan, a whole string of lymph nodes was cancerous. The visible tumor had only shrunk because the cancer cells had consumed it, and moved on to other nodes. The only “health” happening there were the cancer cells themselves, who were flourishing as he left his cancer untreated.

Stay healthy, yep. But don’t think for a second that your health will protect you. Cancer don’t care.

Being healthy may help you survive it, and avoiding behaviors like smoking will prevent getting certain kinds of cancers, sure. But many cancers affect us pretty much at random – roll of the dice.

Two-appointment day.

Now that the dental work has had time to heal, it was finally time for my final CT mapping – the scan that will be used to precisely focus and target the radiation for maximum benefit and minimum side-effects. And to do that precisely, my head will need to be in exactly the same position on every treatment.

A few days ago, I had no idea there was such a thing as “Oncology audiologist” or “Oncology dentist.” But radiation treatment can have real impacts on both hearing and dentistry, and they need baseline measurements and preparatory conversations before getting started.

The audiology visit came first. They led me into a soundproof room with thick walls, and inserted a series of earbuds into my ears and played long series of clicks and tones at high and low tones, with progressive degrees of quietude. Also, tests where I was asked to repeat words back. My hearing is normal, with typical falloff at the high end correlated to my age. Potential effects of radiation would probably be either tinnitus or mild hearing loss. Possible future hearing aids if that does come to pass, but it’s rare. Not much to say here.

The Dental Oncology visit was more intense. I’ll definitely need fluoride trays, and to fluoridate nightly during treatment (loss of saliva during treatment means a much higher likelihood of cavities). But why is there less saliva? Because my salivary glands will be irradiated too, and damage to them could be permanent. I should expect a drier mouth for the rest of my life. Apparently, these days they are able to do a better job of targeting radiation so that it has minimal impact on salivary glands. And some people even have pre-surgery to move the glands! That prospect did not come up in my case.

The really scary/new information was that the radiation will also affect vascular flow in the jaw, which will make it impossible for it to heal in the future. That, in turn, means I will not be able to have teeth removed or implants done in years to come. So it’s important to get everything removed now that looks like it might be a problem down the line, and the doctor did find one tooth that seemed to have borderline future prospects. So, on top of everything else, I now have to have emergency dental surgery to have another molar removed, which means it’s going to get even harder to chew and swallow.

Not the news I wanted to hear, but I do appreciate the wisdom of it.

The next morning was to be my final CT scan – the “mapping and planning” one. Unfortunately, when I got there, they told me that we’d have to delay that because the tooth removal would change the structure of my mouth. So now I need to get the tooth extracted ASAP, give it 7-10 days to heal, and then do the final CT scan. Not great.

Hi everyone – 

Physically, I don’t feel that much different – I need a bit more sleep, my throat feels kind of “thick” with just a bit of difficulty talking sometimes. The hard part is yet to come. 

Emotionally, I’m coming to terms with what’s coming down the road. I’ve learned a ton in the past week, and all of the information has helped turned a big scary mystery into a big scary plan. But I no longer have “fear of the unknown.” I know it will be uncomfortable and then painful and I just have to be here for it. 

The number of appointments and scans involved in planning for cancer treatment is just ridiculous (but everything has a reason – no complaints). Trying to fit all of this into my work schedule has been a challenge, but work has been really supportive – no one is complaining that I’m missing half the time. I’m keeping a log of appointments I’ve had or that are coming: