Week 1 in Review

So, week 1. Sucked. Diagnosis on Wednesday—quamous cell carcinoma at the base of the tongue. This is a cancer that is mostly caused by smoking and drinking. Vic does not smoke or drink. We are not amused. And I don't mean the royal "we." I mean Vic and me "we." (It can also be caused by reflux, which Vic did not know he had, and human papillomavirus [HPV], which is still being checked out.) The ear, nose and throat (ENT) doctor thinks we caught it early, and he does not think it will spread. He has ordered a PET/CT scan to find out what stage it's in and whether it has spread. He said there are two options: surgery, and chemo/radiation. The surgery is pretty brutal—they basically have to split your jaw open--and he said that they would only want to do this if the chemo/radiation didn't work.

Friday was a super fun day. Vic had his first consultation with the radiation people and the chemo people. Apparently, for those of you unschooled in the ways of cancer treatment, chemotherapy shrinks existing tumors and can provide a dose of poison to other cancers in the body, but it doesn't really "cure" you. Radiation is the heavy hitter, the one that takes the tumor out—the closer, if you will. So as much as it pains me to say it, radiation is like Jonathan Papelbon.

Now, here's the first snippet of conversation from the radiation consult.

Dr. Klish: If the cancer has spread, it's incurable. Blah blah blah. (She may have said more, I got stuck on "incurable.")
Patty: Hang on a sec—can we go back to that thing you said before? So are you saying that if the cancer has spread, it's incurable? (I don't know, maybe I thought if I put different emphasis on the same words, it would sound different. It really didn't.)
Dr. Klish: Ummmmmmm yes.
Patty: OK. Thanks. Great.

That said, she was quick to continue that no one thinks that the cancer has spread. Assuming it hasn't, Vic will get 35 treatments—that's one every day (M-F) for seven weeks. Radiation is not pleasant for where his cancer is. It's like getting a sunburn on the inside of his mouth. 35 times. In a row. As you can imagine, this will cause a significant amount of pain, probably starting around week 3. By week 6 or 7, he'll probably be on a narcotic-level drug like morphine. He does like morphine, but we both think the price is not really worth it.

Another significant side effect of the radiation is the problem it will cause with Vic's eating. Not only will he likely lose his taste, but his throat will be so sore that he won't be able to swallow well. Yet he needs to maintain his nutrition and his weight—because the radiation is delivered so precisely that even a small weight loss will require a readjustment of where the radiation goes. So....... yeah, he has to get a feeding tube. We're looking at it as an umbrella, though—if you carry it around, it won't rain.

This does bring up one of the good things about the treatment: because eating will be difficult, he needs to make every bite count. So he has been ordered—ORDERED—to eat butter, ice cream, cheese, meat, whole milk. None of that fat-free crap. Just lots and lots of protein. He is not supposed to get anywhere near a salad. We are *not* going to mention this to his heart doctor.

Other potential side effects include:

• Depression/anxiety (uh, I think he has that already)


• Damage to salivary glands (but on the bright side, no more drooling at night!)


• Dry mouth (we ordered a cool-mist humidifier to help with that)


• Hoarseness (but I like that sexy voice, so I don't mind this one so much)


• Thyroid issues (yes, Alice and Patty, they will monitor this given his existing thyroid issues!)


• Stiffening of the jaw and head area (he'll need to do exercises to keep them limber)


• Susceptibility to sunburn (so he has to stay out of the sun—he thought this would get him out of the yardwork, but I told him the trees can be watered at midnight as easily as they can be at noon!)


• Sunburn-like reaction to the treatment (he had to get an electric razor--apparently, you're not supposed to use blades on a sunburn!)


• Fatigue (he thinks this will get him out of the housework--ha!)


• Lymphedema (yeah, I don't know what that is either)


• Hearing impairment (selective, I'm sure: "Honey, can you take out the garbage?" "What?")


• Facial hair loss (fortunately, his beard is so patchy this will not be noticed)

Next stop: chemo consult. Awesome news here. And by "awesome," I mean "not so awesome."

There are two drugs he can take depending on whether his EGFR (which either stands for "Egyptian ghost fighting regime" or "epidermal growth factor receptor") is positive or negative.

• If it's negative, he takes a drug called Cisplatin. The oncologist said that this drug is hard on the kidneys. And as Vic is so fond of reminding anyone who will listen, he only has just the one.


• If it's positive, he gets to take a drug called Erbitux, which the doctor says is better for the kidneys, and it may not cause hair loss and nausea. Yea! But when I looked it up online, it says "may have an increased risk of cardiopulmonary arrest and/or sudden death." Boo! We've been that route before. We're not fond of it.

We will find out which one he has to take next week.

Emotional state, week 1: Up, down, sideways, positive, negative, angry, in denial, sad, scared, anxious, ready to get started, not ready to get started.

Song: Squamous River, sung to the tune of Swanee River. New lyrics by Victor Love.

Squamous, how I hate ya how I hate ya, my dear old squamous.
I'd give the world to see, a shrinking tongue and Waggy there for me I know that...
Pain is waitin' for me waitin' for me, 'cause of my squamous.
The folks at Hope will see me no more, when I can shut that squamous door.

Stay tuned for "Looking Ahead: Week 2"!