What I Learned Today

Deb and I had an appointment with my E/N/T doc today so that he could size up my squamous cell carcinoma in preparation for tomorrow's operation and give us a chance to ask questions.

He seemed to like the way the carcinoma was looking -- as if it should be an easy operation tomorrow. He had expressed some concern about it being too close to a branch of the facial nerve, but seems confident now that he has room to spare between the extent of the excision and the nerve. Yay!!

I asked him about how and why, after the recent bouts of chemo and radiation, a tumor could show up so quickly. He explained that the therapeutic radiation beam is now so carefully aimed, that it probably didn't affect that area that much -- and I know that the radiation doc was working hard to keep the radiation beam away from my right parotid salivary gland (since the function of the left parotid was going to be inevatably lost because of its proximity to the location of the primary tumor). He (the radiation doc) felt this would not interfere with the overall efficacy treatment, since the flow of metastatic particles should be down and away from that area. So my neck got clobbered, but my chin got a fairly light dosage.

And I know that that particular area of my right chin got a light dosage, since it's still growing some hair.

So all that makes sense about the radiation.

As far as the chemo goes, my E/N/T guy explained that the different forms of chemo (and there are well over a hundred, if I recall correctly) attack cancer cells in a number of different ways. Some of them disrupt the DNA chains, so that the cancer cell functions "normally" until it goes to reproduce, at which time both daughter cells die. Other treatment options disrupt the external cell membrane and kill the cell then and there.

The point being that chemo for a salivary gland duct cancer might attack cells in a totally different way from chemo for a squamous skin cell cancer.

And the doc also pointed out that most people carry latent patches of cancer cells that simply need a trigger to begin growing and misbehaving. And disrupting the body's immune surveillance system (which my treatment has certainly done!) can be one of those triggers. And goodness knows, the amount of sunburn my face endured when I was a blue-eyed, blond-haired kid (decades before the term "sunblock" entered the common vocabulary), there could easily be such patches lurking beneath my visage.

So that's what I've been told. And it all makes sense.

Whew.