I have been dreading the onset of chemo and radiation therapy.  I imagined the worst scenarios – my imagination tends to take me to some very dark places sometimes.  I am not afraid; I know the cancer can be cured, but I don’t cope well with not being in control.  I cannot fix this “touch of cancer” myself and I must rely on the doctors and technology to get me fixed up and back to my new normal – whatever that will be.  It’s been a struggle for me, but I’ve finally come to terms with it.

Back in July I was diagnosed with Stage 1 P16 (Human papillomavirus) oropharyngeal cancer.  All of my doctors have told me that if I had to get cancer (really, who has to get cancer?) this one was the one to get since it’s treatable, curable, and in 90% of the cases they’ve studied, it doesn’t come back.  Well, yay for that one.  I definitely feel better about that aspect, but the treatment part was what was putting up roadblocks for me.  I’ve never been sick; I’ve had nah-ne-nah surgeries in the past (three babies delivered, broken wrist, eyelid lift, cataracts removed).  Now I’m on a different kind of trek with trail signs leading everywhere.  I feel like my first time on the Camino de Santiago when Al and I traveled it on our own with a book we got from the tour company.  All it said was follow the yellow arrows and the scallop shells.  We did that and got lost one time, so I’m sure I’m gonna get lost here but at least this time I have plenty of guides and helping hands.  I need them.  I don’t know how to navigate this trail.

In early August I had surgery to remove the tumor.  Along with the tumor coming out, so did one lymph node, some of my soft palate, and my uvula (that little hangy-down thing you see vibrating in the cartoon characters when they open wide and scream).  The surgery took six hours.  My reaction to that when I inquired how long my surgery would take was “holy shit.”  The surgery went well, the cancer was removed, and I was out of the hospital in 3 days (went in on a Friday and came home on a Sunday).  I wasn’t prepared for the fact that I now speak differently (I was not told or maybe I just don’t remember that this would happen.  I was not aware that without the uvula, liquid pours out my nose if I drink too fast and a drinking fountain is out of the question.  That’s all improving though as my throat heals, but I will never be the same as before the surgery.)

But that wasn’t the end of the oropharyngeal story.  While the doctor got all the cancer removed and the margins were clear, they were too close for comfort.  I would now need radiation therapy.  I wasn’t going to do it – an 80% chance of it not coming back without the radiation sounded pretty good to me.  The surgeon did not tell me the exact measurements however.  When I went to see the radiation oncologist – a very lovely man who makes me feel safe and calm – I got a different story.  I got the exact measurements – good would be 5mm back from the wound site, mine was only 1mm back.  I hemmed and hawed a bit more, but finally decided to go for the treatment.  My thinking was that if the side effects weren’t much different than the surgery recovery, I could do it.  Thirty-five treatments (5 a week for seven weeks with time off for holidays, of course) sounded doable.  I made the decision to do the treatments.

The interesting thing about this oropharyngeal cancer is that I had only one little, puny symptom – a tickle in my throat.  That started in late April.  It felt like I had a little piece of paper or a hair stuck in my throat.  It wouldn’t go away.  Finally, I got annoyed and went to see the Ear, Nose and Throat (ENT) specialist in May.  He treated me for tonsillitis (yes, I am probably in the minority who at 74 still has or should I say had tonsils).  The treatment didn’t make the tickle disappear.  I went for a follow up.  In late June he did a biopsy.  The results were – you guessed it – positive for P16 cancer.  Did you know the virus that delivers this punch is sexually transmitted and almost every adult has it?  Check out this website:  HPV.  I had no clue!

So, Dear Reader, after all that digressing, back to the facts.  I decided to go for the radiation therapy.  In the meantime, I went for measurements, consultations, everything I needed to do to get ready for the treatments.  I even went to a maxillofacial prosthetic dentist to have impressions made for an item called an obdurator which, as the dentist described it, would be like a little diving board that would cover the opening made by the loss of the soft palate and uvula.  I would also have to use fluoride plates or carriers for the rest of my life due to the radiation taking place in my throat.  Why?  Because my saliva glands would change, my mouth would become dry, and without the saliva tooth decay is a real problem.  Sorry, but more digressing.

During my journey through this new topography, I figured I needed a topo map and began reading up on P16 and counted myself lucky that I had it in my throat.  Then the bottom dropped out – literally.  I discovered some anomalies in my bowel output (I don’t know a nice way to put this one).  My first reaction to a little blood in the stool wasn’t too much because who doesn’t get that occasionally?  However, when it did not go away I kind of suspected what was going on.  Another side note here – I had a PET scan in July and it came back clear for everything except my throat, so I suspect this tumor in my anal canal (doncha just love the fact that all I had to add was the “c” to anal) was way too little for the scan to discover.  So now to the colorectal specialist who did a biopsy in his office on the same day I went to see him.  I told the radiation oncologist what was going on, and he said we would have to treat both areas at the same time.  He also sent me to the medical oncologist to discuss chemotherapy.  Again, I wasn’t worried about the cancer but the treatments.  I remembered all the horror stories I’ve hear – well meaning friends were the first to proffer them to me.  Thanks, guys. The chemo may not be as bad as I suspected.  I have a four day regimen now and then another one the end of November.  I have a sweet new little bag that I carry around with a pump that infuses the medicine into my system through a PICC line (PICC Line Info).  So far, it’s been pretty easy except for my what ifs, etc.  I’ve been my own worst enemy.  My family and friends have been a big help.  People I barely know have offered to help.  The medical staff I’ve encountered have been kindness and compassion personified.  I couldn’t ask for better.  And, so I travel on.  Map in hand, hiking boots on, beginning one of the most difficult journeys I will make (well, perhaps the Inca Trail was more difficult).  I won’t know until the end just how difficult it will be because I’m only into Day 1 of this itinerary.  But the first day I’m still on the flats.  The uphill is coming up soon.  Like every trail if I follow the directions, I get to the end.  I always look back the way I came.  I learned that rule long ago.  It always comes in handy no matter what I’m doing.  And when it’s all over, despite the uphills, roots and rocks in the trail, and lovely distractions along the way, I won’t regret doing it.  I haven’t yet.  I suspect that outlook won’t change.  I’ll have bragging rights and I’ll be home free.  How good is that?