I had my first appointment with my oncologist – Dr. Wayne Cruse – this morning at “9am.” Sara, my friend and co-rhino keeper, picked me up at 8am. I showed her my newly painted apartment wall and we headed to get some breakfast. There was a little traffic, but we hit up Panera and headed to the Moffitt Cancer Center – just a few miles down the road from my apartment. They have valet parking – invaluable, as the place is enormous and busy. It felt like we were on the streets of Boston's medical district. I will bring a camera next time – it’s really quite beautiful. But, we were slightly late – supposed to be there 30 minutes before the appointment - so as soon as we entered the front door, I asked the receptionist where the cutaneous unit was. We had an escort show us the way there –though he didn’t quite give us the right directions, we were close. I signed in, filled out the paperwork 30 minutes later and was finally called to go in just before 10am. I guess it was a busy day.
He told me that my skin cancer is a nodular melanoma and it is 1.95mm deep – an “intermediate depth, not great news, but not the worst news.” I will be receiving a call from the surgery scheduler in the next few days to schedule my procedure. He will surgically remove the skin and underlying/surrounding tissue – about 1-2 cm in diameter – and also the sentinel lymph nodes (10-20 nodes). There will be a significant scar, but he is also a plastic surgeon, so that’s something. It’s kind of ironic that I got the mole removed because I didn’t like how it looked and now I may have a worse-looking scar – but I believe not having cancer is the better of those two evils. The removed
lymph nodes will be sent off for cancer screening. There is a 10-20% chance that they will have cancerous cells (i.e. the cancer has spread) and further surgery (remove all my lymph nodes) and treatment (TBD) will be needed. This also means that there is an 80-90% chance that the lymph nodes are clear and I will need no further treatment. For those of you that are like “What the hell are lymph nodes?” – I googled it for you and found this on Wikipedia.
A lymph node or lymph gland is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immunity cells. Lymph nodes act as filters or traps for foreign particles and are important in the proper functioning of the immune system. They are packed tightly with the white blood cells called lymphocytes and macrophages.
Lymph nodes also have clinical significance. They become inflamed or enlarged in various infections and diseases which may range from trivial, such as a throat infection, to life-threatening such as cancers. In the latter, the condition of lymph nodes is so significant that it is used for cancer staging, which decides the treatment to be employed, and for determining the prognosis. When swollen, inflamed or enlarged, lymph nodes can be hard, firm or tender.
Lymph nodes are not part of the body's system for handling illnesses stemming, for example, from environmental toxicity or personal injury— those tasks are handled by the liver and kidneys in the former and the muscular-skeletal system in the latter. The lymphatic system is structured to address biological infection by other organisms as well as biological breakdowns/ errors within the same body (i.e., cancer).
So….not sure how they’d remove all of them since they are throughout the body - that doesn't seem pleasant. It is also odd to find that lymph nodes help combat infections like cancer…but are also possible hosts for my cancerous cells. But, I don't write this stuff, so...? I’m not sure what would happen to my immune system if my lymph nodes were removed, but I can cross that bridge if I get there.
There are still a few “What if…”s, but on the whole, it is relatively good news. I will post an update when I have surgery scheduled. It should be just day surgery– in and out – and my parents are coming down for it. I had sinus surgery in 2011 (my 5th one) and they did not come down for that – mistake on my part (I told them they didn’t have to). I had to wait so long to go in for surgery – I had too much time to think about possible bad outcomes and my parents getting a terrible phone call. Long story slightly longer…I had a mini-breakdown though I was also drugged at the time, in a state of hyper-emotionality and hitting on the male nurses via the female nurses, so there’s that. I do think I look good in a hospital gown (pretty much like the image below - I'm in the next bed over) and those little socks they give you are wonderful.