Wednesday, April 11, 2012

Feeling Lucky After a Tough Month

In his wonderful novel, The Goldbug Variations, Richard Powers observes that "the language of life is luck." The context was how DNA functions biologically, but I suspect Powers would not object to a broader interpretation beyond genetic inheritance. I've always said that I don't care about winning the lottery; I'm more concerned with avoiding losing in life's many negative lotteries, of which cancer is one. Well, I didn't manage to avoid that negative lottery completely, but I'm still feeling quite lucky. Having been diagnosed with melanoma (skin cancer) almost exactly one month ago, I am once again cancer-free.

Admittedly, I was unlucky to have melanoma in the first place - according to government statistics (see here), it afflicts fewer than 1 out of 100 males aged 50-70. On the other hand, I was very lucky to: (a) catch it reasonably early (at Stage IIb); (b) have a great support group of family, friends, and medical personnel; and (c) obtain the best possible test results following wider excision of the area around the mole and lymph node biopsy, which determined that the tumor was localized and completely removed by surgery, thereby avoiding the need for further tests and lengthier and less pleasant treatments.

Just to expand a bit on point (b): The mole was removed at the insistence of my orthopedist Dr. Joe Randolph, whom I was seeing about a flare up of arthritis in my SI joint; he noticed the mole on the other side of my back. My family doctor, Paige Huls, made room for me in her schedule and removed the mole the same day. After she called a week later with the bad news, she put me in touch with the Melanoma Clinic at the Simon Cancer Center at IU. It was at that point that my cycling buddies started getting involved. One of them, Dr. Dave Wilkes, got me in to see Dr. Theodore Logan, a leading melanoma specialist. Another cycling buddy, Dr. Larry Stevens (himself a surgeon) recommended the awesome Dr. Willliam Wooden to perform the wider excision and lymph node biopsy. A third cycling buddy, Dr. Tim Wozniak (not an MD, but a PhD in Chemistry), came with me and my wife to the consultations with all of my new doctors, including the dermatologist associated with the Melanoma Clinic, to take notes, ask good questions, and lend moral support. Additional advice and moral support came from yet another cycling buddy Dr. Jim Coughlin here in B-town. Finally, a close friend of ours in St. Louis, who is a pathologist, confirmed the final test results a couple of days before we received them from the doctors in Indy. Along the way, many other friends, colleagues, and extended family members sent messages of support.

The most difficult part of the entire experience for my family was the month-long wait for a final prognosis. Even though the doctors all agreed that, based on the initial pathology report, chances were about  80% that the cancer had not spread beyond the local area, uncertainty and accompanying anxiety inevitably took a toll. Hopefully, as cancer treatment improves (seemingly on an almost monthly basis) medical science will find ways to more quickly move from initial diagnosis to final prognosis and treatment.

Today I am cancer-free, albeit with an elevated risk of recurrence, which means that I have to take more precautions  - I now wear sunscreen whenever I go out, even when I don't plan on being outdoors for long periods of time, and I've bought a highly fashionable broad-brimmed hat - and I have to check in with the dermatologist regularly. These are all small enough prices to pay to be remain healthy. However unlucky I may have been to contract melanoma, I feel far more lucky to have come out the other side more or less unscathed (aside from a couple of incisions that will quickly heal).

I can't wait to get back on the bike (and, yes, I always wear sunscreen when I ride) and return to life's more literal road-bumps.

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