2nd Radiation Oncologist - Jan 3, 2012

Today Julie and I drove to Santa Clara for an appointment with Dr Subir Nag, who according to his bio is "one of the world pioneers in brachytherapy and intraoperative radiation therapy."

I have consistently felt that I am getting excellent care at Kaiser - but from a subjective point of view this meeting was pretty depressing. I thought I was done with...discoveries about my condition, but apparently not. I have one more meeting tomorrow with the chemo guy...see what happens there.

In any case. Today. The point today was to find out about internal radiation which is going to be part of my treatment, in addition to external radiation and chemotherapy. I had been told that internal radiation is very simple. Turns out there are two kinds, and I'm not getting the simple kind. I'm getting the kind that is injected with needles, that you need spinal anesthesia for. Why? Because my tumor is big, it is deep. (If I knew how to draw a picture on my mac i would recreate the picture the doctor drew.) Because there is cancer not only in the pelvic bone near the tumor, but in my left hip joint (which must be why I got  on my bike yesterday, went OUCH, and got off. It hurt my bones.)

I've asked the oncologists about my chances of being alive in 5 years. They say it depends on how the tumor shrinks, which they cannot predict. Aside from issues of survival, for me, there are major issues to do with quality of life. In other words, what level of functionality my body will have at the end of all these toxic blasts? The doctor told me that there is a 'reasonable likelihood' that removal of the tumor will leave a hole, called a fistula, in the wall of the vagina, the bladder, or both. The nurse practitioner, Lee, said that radiation impairs the ability of healthy tissue to repair itself. At that point, surgery is risky, can cause more problems than it solves. So you have to wait many months to let the healthy tissue return to closer to normal and then see what is possible.

This is what happens after every exam and meeting with an oncologist - this was my 4th besides all the tests and scans - they give me what appears to be super depressing news. I think, Are you fricking kidding me? It sounds like a total nightmare, again. Then, strangely, I get used to whatever they said. As Shantideva says, If you can solve your problem, then why worry? If you cannot solve it, then why worry? That is pretty much my philosophy. To practice this philosophy, I have to live in the present, because I can't know what the future holds.


Here is a nice blog post a friend told me about that I enjoyed:
Cancer Broke All My Pencils