#2 Dr selection

Bring on the doctors

Through a referral I started in San Diego meeting with a doctor who performed a pandoscopy (a what?) by using a general anesthetic he snipped small pieces of skin in my nasal, base of tongue, and throat in search of a “primary” cancer site. It’s all new to me so you are likely learning the terms as I have: one by one rapid fire. His analysis was “no known primary” which calls for infusion chemo: 3 different type chemo’s infused 2 to 4 times, then carpet bomb my throat with radiation to catch any possible cancer cells in the typical areas. Just like cops, round up the usual suspects.

Time for a second opinion.

Met with the Stanford folks where they had an impressive “tumor board” review of many doctors and interns poking and prodding in order of rank. Their analysis was the original Pandoscopy was not complete enough and it was time to try again to identify a primary. Through my readings it was clear that head and neck cancer regularly hides in the tonsils so I instructed my doctor to be certain to eliminate that possibility and remove anything that was doubtful. During surgery he determined that my right tonsil was irregular and upon doing a biopsy on it determined it was the primary or source. Whoopee!

A third opinion?

In the meantime I had an appointment previously scheduled for an opinion at UC San Francisco, a highly recommended treatment center. Upon meeting the ENT (ear nose and throat) specialist, Dr Wang, and meeting Sue Wong, the radiation oncologist I felt a connection and liked their team approach to treating me. Beside, I always wanted to hang out in San Francisco which is one of the top ten cancer centers in the US and home of the Rice a Roni trolley car. Hey, may as well have some fun while they torture you with chemo and radiation eh?

With that decision made I meet with the medical oncologist, Sarita Dubey, AKA the Chemo lady. After much discussion I settled on a drug regiment similar to chemo called Erbitux, a drug that was made famous due to Martha Stewart trading the ImClone made drug. There were several nasty long term side effect tradeoffs that I was avoiding. One being permanent swallowing issues and the other was to save my hearing which is already damaged from motorcycles, nail guns, guns, with a pinch of genetics. Huh?

Last second news

The ultimate cure is the radiation that is intended to kill the cancer cells which also kills healthy cells but the healthy ones should regenerate successfully. I guess that’s why doctors get the big bucks to figure this stuff out. A mask was formed around my head, neck, and shoulders to prevent any movement on my part while the radiation was to be delivered. Yep, they bolt you to the table to remove any movement. Time for one last PET scan: a CT scan that identifies heavy concentrations of glucose, a need for hungry cancer cells. The scan revealed a “lit up” left tonsil. My radiation doctor, Sue Yom, told me that she wouldn’t treat me with an inconclusive diagnosis. The choice was to treat both sides of the neck or prove the left tonsil was clean. I returned for a 3rd surgery to remove the left tonsil which revealed cancer in that side too. Now we’re having fun.