Inanna and I are sitting in a small exam room and the three doctors walk in. It is instantly obvious who the surgeon is … older, bow-tie, exuding self-confidence. The radiologist is probably in his mid-thirties and looks like any of the guys I grew up with. The hematologist/oncologist, she was different. Quiet, petite, mid-thirties as well. I did little research on the doctors at this point, but they are all very impressive. The surgeon is considered top notch, the oncologist is incredibly well educated and has an extensive curriculum vitae, the radiologist is less well known but I heard good things.
The surgeon does most of the talking (all quotes in this post really were said):
The biopsy and scans confirm rectal cancer. We’ll do a digital exam today to confirm the exact location, I want to make sure I have room for my stapler.
There are forty fingers in this room, do I get to pick?
And that is how the meeting started. Seriously.
I asked why he was referring to it as “rectal” cancer when others have said “colon.” He explained that the location is actually on the border between the colon and rectum so it actually is colorectal cancer. There is a difference in how each is cancer is dealt with, mine will be dealt with as rectal cancer.
The discussion continues as to what the plan will be. I will have 5 ½ weeks of chemotherapy, 24 hours a day, 7 days a week. During this time I will have radiation every weekday. After this, I will have 8–10 weeks of rest, no therapy of any kind. This will be followed by surgery, and then most likely 4 months of chemotherapy. The operation will leave me with a temporary ostomy that will be removed at the end of the chemotherapy.
What are the odds I am going to live until surgery?
How can you say that? You’ve been doing this 24 years.
And I have never lost a patient before surgery. I cannot make any promises as to what happens after.
Ok. Maybe I should stop asking question. But of course I don’t.
What stage is the cancer?
You have to be careful with staging this type of cancer. Yours is early stage 3, but that is not 3 times worse than stage 1, it really does not mean much. Your lungs and liver are clear, it is in the first lymph nodes.
At that point it is all sinking in. I found my self keeping my eyes closed a good amount while listening, it helps me concentrate. Every time I opened my eyes, they met the eyes of the oncologist. She has these deep brown eyes and she was looking right into mine. For whatever reason, it was very comforting. There was something about her. And yes, I found her to be very cute and as I said, impressively intelligent and experienced. I knew she would help me.
During all the treatment before surgery, will I be foggy? Will my mind be clear?
The cancer is in your butt, not your head!
Well I have been told before that my head is up my ass.
This is a lot to take in. I have colon and rectal cancer. I will have radiation and chemotherapy at the same time before surgery and then more chemo is possible. I will have an ostomy. Fuck.
Do I have any options?
No. There is no plan B.
The oncologist jumped in at this point. She explained that they discussed one on-going trial as a possibility for me. That trial is the same as above but without the radiation.
Why would I choose the trial? What are the side effects of the radiation?
There may be some skin irritation. You may lose fertility.
(laughing) You can just take them as well, that does not matter.
We don’t do that, sorry. And you may lose your pubic hair.
(turning to Inanna) Well, it will make me look bigger.
Ok, I don’t want the trial. Are there any other decisions?
Because you currently have neuropathy, we will have to carefully consider the chemotherapy after surgery, but we will deal with that later.
And there we were. I have my doctors, I have my plan, I have my stage 3 colorectal cancer, and I my lungs and liver are clear. I had one more question.
Any of you have a Jewish mother?
(Radiologist) I have two, my wife and my mom.
(Sugeon) Does Italian count?
How do I tell mine?
The surgeon then does a check as to how far in the tumor is. Yes, he can feel it with his finger in my butt. And yes, I can feel his finger in my butt (I am so glad this blog is anonymous). If it is far enough in, the ostomy will be temporary.
Great! There is plenty of room for my stapler.
The highlight of the meeting came with the surgeon’s finger up my ass.