Proloque

My journey began just over a year ago when they incidentally discovered a tumour on my kidney while doing a CAT scan of my abdomen to check on a previous problem. Reading the literature, I have discovered that this is how most renal cancer is discovered. They find it incidentally while looking at something else. I had no observable symptoms, no pain, no loss of appetite or weight, although I am for forever trying to shed the poundage, no tiredness, although I frequently try to power nap in the afternoon--something I have done all my life-- in short no symptoms. As far as I was concerned I was a healthy, overweight, hunk of a man!

In many respects the discovery was serendipitous in that I would never had known I had the cancer if it were not for the CAT scan until it may have been too late to do anything. As it was, I was referred to Dr. Roberts, a urologist, and Dr. Cagiannos, a specialist in urologic surgical oncology. With the two doctors, Pegs and I  discussed whether to remove the kidney entirely or try and do a partial nephrectomy to remove only the tumour and that part of the kidney affected by it. We went for the partial nephrectomy (I don’t like to give too much of myself away). Dr. Cagiannos performed the operation in February of 2010, in time for me to join the family reunion in Mexico at March break. If one has to relax and recuperate, I could not have had a better venue and company.

We believed the operation to be successful. I recovered quickly, did not suffer undue pain while doing so. I got back to my walking 5 to 10 kilometres five out of seven days a week and took off on trip to the west to hike with Jane, my sister and her husband, Russ in Utah. The rest of 2010 and 2011 was a busy and healthy year. In fact, I still am.

However, this month I was shocked to find that maybe I was not as healthy as I thought I was. My follow up CAT scans on the anniversary of my operation revealed lesions on my lungs. Dr. Cagiannos referred me for a biopsy, to an oncologist, and a thoracic surgeon at the Cancer Centre of the Ottawa Hospital General Campus. To my amazement I had appointments scheduled within days for all three. For once it appeared it was not a problem of them fitting me in but of me freeing up my schedule.

I had my biopsy done a week ago. I had my date with the oncologist, Dr Reaume two days ago. I still have to meet with the thoracic surgeon next week to hear his comments.

The doctor who took the biopsy, did tell me at the time that it would be difficult to obtain a sufficient sample to be able to have confidence in any negative result. The lesion was small and difficult to reach to obtain sufficient tissue sample. While the biopsy came back negative, Dr. Reaume stated that I had T3a, M+ (grade 3) renal carcinoma. He actually said that he does not normally recommend biopsies when lesions appear so soon after kidney surgery. We had asked the oncologist whether or not they would try and obtain a biopsy through open sugary. He said no, not needed. His comment which he repeated a couple of times was “if it walks like a duck, quacks like a duck ....”. (I think this is one of his favourite sayings.)

I am now to under go a battery of tests which include more X-rays of my lungs, MRI, and CAT scans (I'll be glowing soon.) of my brain, heart, bones, and just about everything else to see whether the cancer has matastised any place else. Once these are all completed (about 4 to 6 weeks from now), I'll meet with Dr. Reaume and his senior fellow to whose clinic I am being assigned, to map out a plan of action. It appears that initially I may be placed on a drug called SUNITINIB, (trade name Sutent) which has proven effective in many cases of slowing the progression of the matastisis and could prolong my life a few years. However, the drug comes with a five page list of side effects that are awesome bad! And another two pages of not likely “but could occur” which are insufferable. Looks like I may be in for one happy time. Unfortunately there is no cure for my cancer.

He/She (his senior fellow is a long haired blonde with an accent to which I must listen carefully) do not plan to start me on this drug until all tests are in and my symptoms have progressed. At the moment I feel perfectly healthy and could possibly accuse them of putting one over on me for some ulterior motive (increasing their pay cheque?) . I doubt that though.

I asked about keeping my appointment with the surgeon if the cancer was inoperable. Dr. Reaume encourage me to do so. While he thought that surgery would not be an option since I had a number of lesions on both lungs, he felt it would be too traumatic for the lung to be punctured many times, and besides by the time they were finished there might not be much lung left. Anyway it could be an option and he felt it would be worth my while to talk to Dr Samji, the surgeon. He said the two would be consulting with each other on what is best for me.

I must admit I am very pleased with the friendliness of staff, from the receptionist, the PA, the nurse to the Doctor. They were are welcoming and encouraging. I felt I was being heard and they were ready to assist in any way possible. They took time with me. They have hooked me into Kidney Cancer Canada which is a patient led registered charity offering support to renal cancer patients, their families and caregivers. They are also a strong advocacy for research and the raising of funds. If you want to know more, their web site is www.kidneycancercanada.ca. 

I am of course anxious about how all this is going to come about, but for now I feel good and it is hard to imagine what's ahead. At the moment I am trying to learn as much about the disease as I can, as well as talking it out with Pegs, my siblings and children. Needless to say I am being a little more serious about starting to get things in order. Pegs gives the appearance of handling all the news well, but every now and then I see cracks. 

I am also volunteering for any trials that may be coming available and for which I might be a good candidate. While I hope that these may help my condition, I also feel that maybe there can be some purpose to my getting the disease. Maybe by being in the trials my case will help to advance cancer research to the benefit of others. This I hope will make some sense of this misfortune, or "bad luck" as Pegs would say.

I awoke early this morning thinking I should keep a log of my journey. This prologue is the first entry. Today is March 1, 2012 and I am taking the first of many steps which I hope will be make a long journey. I paraphrase a line by Dylan Thomas  “I will not go gentle into the dying night.”