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February 16, 2010

Day 0 - Prologue

PLEASE NOTE: The posts may be delayed by a day or two because the chemo has me knackered. For your calendars just know that treatment started on Ash Wednesday and will end on Good Friday. Make what you want of that. I'm expecting to have similar *metaphorical* results to the Jesus myth, in that I will rise from my Jefferson Street cave on that day free of disease.

Howdy folks. Here I start again on this blog that has been fairly bland and regurgitates often what we find at popurls or the beeb or elsewhere, but today we set sail on a new course where I am at the front lines of a battle. If you're interested please follow along. I cannot promise this will be easy, but know that it will help me in the process of dealing with this dangerous illness.

Ok, for the uninitiated here's what happened. On 18 December a lovely pathologist named Dr Britt Ljueng from UCSF did a fine needle aspiration (FNA) on an enlarged lymph gland just under my right ear in what is known as the jugular basin. As I lay there and Claire sat near by biting her nails up to her shoulders, Britt focused her microscope on the tissue she just removed and said, "Yes, I see squamous cells here."

What that means in other words is, "Mr Morris you have cancer." She went on to describe the type of cell as poorly differentiated and slow growing which as I learned somewhat later is not the best of news treatment and prognostic-wise. She wrote on her card 'preliminary impression - nasopharyngeal carcinoma'. What that means is that somewhere in my mucosa, possibly the nasopharynx, malignant cells had grown then metastasized to the right jugular lymph chain. There was not, and remains un-found, a primary tumor.

We left the building and I called Pat, my brother. He's a scientist and is great in these need-a-direct-and-unequivocal-opinion scenarios and he was perfect, is still perfect, and I am so grateful for him in my life. He's got his own cancer story to tell, so I wont divulge more than that here. Just say he was my first best friend forever and remains so.

Yet, it was in talking to Pat I started to descend to the bottom. This was real. I paced outside the deli at Divisidero and Bush across from the UCSF Med Center and wept into my mobile phone. I recall saying, "Pat, I'm kinda scared," and he replied, "I know." That was the beginning of my new life.

We then started the process of what to do and treatment options. We met with a wonderful surgeon at Kaiser Oakland, Dr Deepak Gurushanthiaia who, if he was not a worldly man and of deep erudition, you would think he was a 12-year-old Dude. It turns out I was in the best hands. The Oakland facility is a teaching hospital, so with his team of Residents there to train with the best, on January 15 I underwent a 5.5 hour procedure to 1) remove the gross disease from my neck, and 2) to do random biopsies of my mucosa to try and find the primary tumor.

Objective 1 went as well as can be. They removed about 50 nodes from my neck and 7 had disease. The good news is that there was no adhesion to any other structure and that there was focal extracapsular extension in a couple. This microscopic outgrowth of tumor from the lymph capsule meant I was headed for chemo and radiation.

Objective 2 was a failure. Either the primary is microscopic or is gone. Either way radiation and chemo are what will be done. The problem with not finding the primary is that the target volume must increase and my entire mucosa will get, in the parlance of our times, "cooked". This will suck. A lot.

But as our hero in Galaxy Quest says "Never give up, never surrender"! That is now our motto.

Posted by Michael at February 16, 2010 03:18 PM