A Pain in the Neck

On Wednesday, I received the results of the biopsy of my pancreatic lesion that they took during my endoscopy last week. I haven’t had that much time to process the results, because I was dealing with the declining health of my 17-year-old cat, who died on Friday.

Remember that spot that kept showing up on my PET scans, the one that the lymphoma doctors said was probably a benign tumor but that we’d keep an eye on? The biopsy showed that it is a malignant tumor on my pancreas.

With Hodgkin’s lymphoma, you’re often told that you have the “good cancer.” I know that people with Hodgkin’s lymphoma don’t feel especially lucky, particularly those with refractory or relapsed Hodgkin’s lymphoma since we’re in the group that didn’t get better with the first round of treatment and had to follow up with more chemo, radiation and stem cell transplants.

No one tells you how lucky you are to have pancreatic cancer. In fact, the news is met mostly with silence. The statistics are grim. But, once again, I am in what’s considered to be a lucky group (so far). I have either a malignant neuroendocrine tumor or an acinar cell carcinoma, which is pretty rare. If it’s the former, the odds are good—as high as 50–70% for survival five years down the line after a complicated pancreas restructuring surgery called a Whipple procedure.

The next step is to meet with the surgeons to see if they would want to do more tests—either another endoscopy or a scan—to see what type of tumor it is before operating. My appointments are for next week.

I’m not going to lie—this isn’t good. Best case scenario: It’s the tumor with the better prognosis, the cancer hasn’t spread beyond the tumor and it can be removed with the surgery. Then once the months of recovery are over and if there are no complications, I can go back to a semblance of “normal.” (And then hope it doesn’t come back.) I’m not going to delve into the other possibilities right now until we know more. Right now, this is just conjecture.

I suppose the good in this is that there are really no known causes of this type of tumor—it’s an unlucky fluke. When I was dealing with the pancreatitis attacks, I spent a lot of time beating myself up, thinking that maybe I had caused them somehow, but at least I am absolved of that.

I realize that initially seems strange thing to say, but it makes sense. Right now I’m reading My Age of Anxiety, a book I recommend for anyone who, like myself, is prone to anxiety. The author, Scott Stossel, mentions a woman, a war correspondent, who suffers anxiety not when she’s being shelled, but after she submits a story and is waiting back for editor feedback. Stossel writes, “Freud observed that threats to our self-esteem or self-conception can often cause far more anxiety than threats to our physical well-being.” When I felt that this was something in my control, I felt really terrible—it kept me up at night and was an ever-present, gnawing feeling. I felt bad about myself. Now I just feel bad.

That’s not to say that I don’t wish I had insisted on getting a biopsy earlier. I’ve been through cancer before, and I know that something innocuous can eventually mean a cancer diagnosis. I should have known better. There was a spot on my PET scans lighting up. How could I dismiss that? I know the reasoning was that it had gotten smaller so we were just going to keep an eye on it. But, as happy as I am to have had this relatively “normal” year-and-a-half, I wish that someone—myself, my doctors—had decided on a biopsy before the pancreatitis attacks. In retrospect, it seems crazy to have ignored the spot on the scans, but I wanted so badly to be better.

That I’ve had it for so long and it hasn’t seemed to have spread from what they know so far could be a good thing—it could mean that it’s slow-growing and not aggressive. I am worried that it’s causing problems now, and, of course, now any bodily pang or twinge of discomfort worries me. I don’t know how to describe it, but lots of stuff just feels funny.

Part of me doesn’t feel like talking about this and needs to go on as normal. Another part wants to freak out. I don’t have many reflections to share. The name of this blog isn’t even accurate anymore. There really are no words for all of this.

Aside from cancer’s insistent intrusions, I still really do have a great life. I can attribute this directly to the people in it. For now, I’m enjoying the snowy weekend, relaxing and snuggling with the kittens before I re-enter the world of scans, doctor appointments, blood draws, tests and hospitals.