Last year, as the thoracic surgeon explained to my brother and I the pathology of the cancer that my father had been diagnosed with, non-small squeamous cell lung cancer, he offered a confusing statement which at the time did not seem as important as hearing the prognosis for our father. But in retrospect, I almost wish I had paid more attention. Of course, I wish perhaps the surgeon would have been more assertive in his diagnostic concern.
While he claimed to have gotten all of the cancerous tumor, the surgeon expressed concern that it was unusual for the tumor to have been located where it was (almost adjacent to the heart). My brother and I had been asked if our father had any other cancer such as a brain cancer. Of course he had not, and I responded no.
The simplest way to explain what he was trying to get at, the cancer cells that created this tumor, had to have come from somewhere else. Yet imaging studies and other tests had not revealed any other location of cancer. And so my father underwent four cycles of chemotherapy and thirty treatments of radiation therapy.
After developing a fluid build-up in his chest cavity, some exploratory surgery revealed the cause, cancerous tumors in the lining of the portion of the lung not removed during the surgery. Which leads to several “what if’s” scenarios. First, the surgeon opted not to remove the entire lung, because as a smoker of fifty years, my father’s lungs had become so riddled with emphasema, and felt it would be too difficult for him to breath with only the one lung. This left the remaining portion of the lung, which now I suspect probably had the cancer in it, remaining in my father. What I cannot explain is how my father responded to the chemo, but during radiation the cancer chose to react with the fluid build up. But in the end, scenario two, if the surgeon had opted to remove the entire lung, as many people do live without, then the cancer that may just have been hiding in the lining at that time, would have been removed, and my father would not be at the crossroad that he is at today.
This is not the first time I have had to rehash the woulda-coulda-shoulda scenario. My grandmother who battled and beat breast cancer, only to lose her life to ovarian cancer more than a decade later had a similar crossroad. My grandmother had undergone a hysterectomy. But due to her age, the surgeon left her ovaries in place. So again, I ask, had the doctors removed her ovaries when they did the hysterectomy, would my grandmother have passed away from ovarian cancer?
And the scenarios go on and on. What if I do not choose to go through a particular treatment? What if I opt to extend a treatment? Would a clinical trial be a better solution, or perhaps a complimentary or alternative treatment?
The truth is we do not know. Because of the urgency and timeliness of treating cancer, we often do not have the time to consider all the possibilities. The truth is that you have more certain results rolling dice on a craps table in Las Vegas than deciding what is your best option to dealing with your cancer. At least when the dice settle, you have your result. After being declared a winner, the dice will not all of a sudden turn on another side changing the result, like cancer can.
Yes, dealing with cancer is a crap shoot. Sometimes you roll “snake eyes”, but sometimes your roll “sevens.”
Paul's Heart 