Cancer

I was diagnosed with lymphoma a few weeks ago. Lymphoma is a cancer of the lymphatic system.

Let me stop right here and mention that the prognosis is excellent. I will probably be cured in 6 weeks or so. I have a very rare, very special case, and it's very minor. Let me reiterate, I will probably be cured in 6 weeks. I am fine. I'm not dying any faster than the rest of you... So, take a deep breath, relax, and let me tell you this ridiculous story...

In July of 2003, I wrote a blog entry about a weird, red, puffy lump on my arm. In January of 2005 I finally had it diagnosed. It was a rare form of cutaneous lupus. It was only on my skin, not systemic, and it didn't pose any threat, so I just ignored it. I had a few other similar red, puffy lumps, and I assumed they were the same thing, so I ignored them too. That was a mistake...

The original lump on my arm disappeared on its own, but I still had a lump on my left thigh. I was always kind of annoyed at having "lupus" on my permanent medical record, because it's one of those things that insurance companies like to hassle you about. So, I decided to go get this other lump checked out to see if really was lupus - remember, I assumed that it was the same as the lump on my arm, so I assumed it was lupus. I was thinking that maybe I was misdiagnosed the first time around.

On April 12th, 2011, I went to a dermatologist, and had her take a biopsy of the lump on my thigh. Around a week later, she scheduled me to come back to her office to discuss the results. She looked very concerned as she sat me down, and then she told me about the lymphoma...

I like to call it "dill buckle" - that's how I remember its name, "Diffuse Large B-Cell Lymphoma (DLBCL)", or, to be exact, "Primary Cutaneous Diffuse Large B-Cell Lymphoma, other". The extra bits at the beginning and end are very important. If you search the Internet for "DLBCL", you will not see comforting results, and you will not see my affliction. Like I said earlier, I have a rare, cutaneous form of lymphoma. It's just on that one spot. And that ", other" at the end is good too - that means I don't have the ", leg type", which is nastier. Really, all I have is a little, red, occasionally itchy lump on my thigh with a very alarming name...

At this point I've endured a few miserable tests to confirm all of this crap. I've had a bone marrow aspiration and biopsy, which is basically where they hand-drill a very large needle into your hip, then suck out the bone juice, then drill more, and get a chunk of the marrow itself. ...Sorry, I should have warned you before describing that probably... It's as unpleasant as it sounds. I made the mistake of watching a YouTube video of it before getting it done. I highly recommend that you don't watch it. The anticipation was almost, but not quite, as bad as the pain. And the pain was pretty intense for a few moments - not dissimilar to breaking a bone, actually.

I've also had a combination PET and CT scan. These involved drinking 2 and a half cups of barium, which wasn't bad at all. Then I had to get injected with fludeoxyglucose, which is a form of radioactive sugar. That one almost made me pass out - I hate needles, and I have a particularly strong psychosomatic reaction to things being injected into me. I had to lay still for 45 minutes, then lay perfectly still for another 30 or so while they scanned me. It's surprisingly hard to lay perfectly still... Then they brought me inside, and I did a CT scan which is basically a series of x-rays of my guts. For that one, they had to hook me up to another IV - this time with iodine.

The technology behind these scans are amazing, by the way. Just mind-blowing! The PET scan in particular is fascinating! So, P.E.T. is Positron Emission Tomography. The way it works is that they inject you with this radioactive sugar, it congregates in areas of "activity" such as the brain, lungs, heart, and anywhere that is fighting an infection of some sort (eg. a tumor). What happens next is the amazing part! This radioactive sugar shoots out positrons, which are electrons with a positive charge, then those positrons encounter electrons in your body and they annihilate each other, causing matter to convert directly into energy - in this case, the energy is in the form of gamma rays. Then the scanner detects the gamma rays... Anyway, read more about it here. The science is fascinating!

...and yet, as fascinating as it is, I was also enraged by how backwards and stupid it all seemed... So, it's a known fact that ionizing radiation causes cancer. That is, radiation that's strong enough to knock electrons off of molecules is a carcinogen, a cancer-causing agent. X-rays and gamma rays are both forms of ionizing radiation. So, in an effort to see if I had cancer anywhere else in my body, I was subjected to carcinogenic radiation. I couldn't hug my pregnant wife for a day after getting the PET scan, because I was radioactive! This guy has an interesting video about being radioactive. I was exposed to around 24mSv of radiation from these scans. The average background radiation a normal person is exposed to in a year is about 2.4mSv - so I got about 10 years worth of background radiation in one day... It's an interesting coincidence that I was irradiated at the same time as Japan's nuclear disaster. All the media attention has prompted people to generate lots of interesting info on radiation - my favorite is this neat chart on XKCD. Anyway, it does seem pretty backwards to be subjecting a person with cancer to all of this radiation, right? It's like going to the hospital with a severe burn, and having the doctor come out with a blowtorch to burn off the burn... it's ridiculous!

All the tests came back negative, by the way. The cancer seems to be just on this one spot on my thigh. Since lymphoma reacts so strongly to radiation, they are recommending that I get focused radiation treatment on the spot, and on a small around around it. No chemotherapy has been recommended at this point, which is good, because, ironically, chemo also causes cancer, heh.

The biggest downside to all of this was the timing. For a couple of weeks, I was so upset by all of these health issues that I was barely thinking about my soon-to-be-born son. I got tunnel vision where all I could see was cancer. It was terrible... Thankfully, that time has passed. We're over the major hurdles. No more oncologist visits. No more worrying about this tiny, slightly itchy spot on my thigh. I'll probably be starting radiation therapy in a week or two, and it lasts about five weeks. Before I'm done, I'll have a baby boy! Despite being so close, it's still impossible to think of myself as a father. It's just one of those things. It took me a while to get used to being called "husband" too. I'm so excited about the future! I can wait to teach this kid about rocks and bugs and science and fire and everything. Watch him turn out to be a jock. Perhaps instead I'll finally have to learn about soccer and baseball and football! It doesn't really matter. I'm just ready to meet this little dude!