BCCA and Me

[Originally written on December 26, 2014]

Here’s a little update and background to some recent developments in my life…

In the late spring of 2014 I noticed a small lump developing on my lower left leg (I mean the lower part of my left leg—both my legs are already set as low as they can go), just above the ankle. I didn’t think much of it because I had had three similar looking objects removed from my scalp over a period of a few years, at least ten years ago. They all turned out to contain nothing but harmless bits of gristle (similar to the nearby contents, I’m sure). 

In August I had my family doctor look at this lump on my leg and he recommended that I should have it removed by a plastic surgeon. (“…because those things can bleed,” he said. Okay. I agreed. Bleeding is not a good thing from my perspective.) So by the time I was able to get an appointment with Dr. Brown, the “plastic surgeon” (he’s not actually plastic, so I’m not sure why he gets that title) it was the end of October and the lump had grown rapidly over the preceding month or six weeks.

I had this “minor” (or “miner”—either one is accurate) day surgery on December 2^nd and the surgeon removed the offending object. As is normal practice, he sent it to the pathologist for testing. A few days later I was called into Dr. Brown’s office to receive the news that what he had taken out of my leg was a malignant tumor and furthermore, he was not able to remove it all.

I was immediately scheduled for an appointment with a Radiation Oncologist, Dr. Bahl, on December 23^rd at the BC Cancer Agency here in Abbotsford (“BCCA” in case you hadn’t figured that out already, or perhaps thought the title of this essay was misspelled and what I had really meant was “BCAA” which stands for the British Columbia Automobile Association). 

We had told a few of our close friends, the staff at my office and my prayer warrior friends in India that this was going to take place and I was grateful for their prayers. The evidence of them was significant. I was calm. Not worried at all. My brain was just feeling a bit numb. So, in other words, quite normal. (Sharyn came with me, of course, in order to take copious notes as is her way of functioning, and to be able to hear what Dr. Bahl would tell us with more than just my ears. I’m glad she has her own, because they work so much better than mine.) So this little report to you comes out of that meeting.

Of course there are still many unanswered questions, but at least we’re on a track of positive action now. The first thing that is needed is more surgery on my leg. The initial excision did not remove the whole tumor despite the fact that what the surgeon did remove was more than 2 cm in diameter. (Incidentally, that’s almost the size of a golf ball and quite appropriately, what’s left to show for it now is a good sized divot in my lower left leg. Hmmm… I love golf!) 

So this additional surgery will attempt to remove whatever is left (of the tumor, that is, not my leg!). We’re hoping that the surgery can be scheduled for some time within the first few weeks of January. (Dr. Brown gave me the heartening news that when they’ve finished with my leg, what’s left will bear a scar that looks like a shark bite. But, he told me, it will make for a great story. Especially coming from a guy that doesn’t even swim! And then a friend of mine informed me that after his sister-in-law had this same surgery she was able to walk normally in no time at all—just two or three months! Then she died of breast cancer a few years later. Hmmm. I just love these messages filled with hope and reassurance.)

Before the surgery, Dr. Bahl will have the excised tumor examined again, this time by the pathologist at the BC Cancer Agency to get more specific information about its dimensions and appearance in order to give the surgeon a better picture of how far to dig. (I fully support that concept—informed digging. Especially when it’s in my body.)

Since the surgery will be done under general anaesthetic (of me that is, not the surgeon, I hope) they will at the same time inject some kind of radioactive liquid into me that will indicate which particular lymph node services that part of my leg. Then they will remove that lymph node, which is most likely near the back of my knee and it will be tested for cancer.  If it is cancerous, their next course of action will be to explore lymph nodes further up the body looking for the extent of the spread.

About the same time as this surgery is scheduled I will be sent to Vancouver for a PET scan. (I’m not sure why they feel they must do this, because I don’t have any pets—certainly not in my body. Maybe later, when they discover this fact, they will then do a more focused kind of PET scan called a “CAT scan” just to be sure. One never knows, I suppose, just where they might find a cat. Maybe I should just loan them my book entitled 101 Uses for Dead Cats and avoid all the testing?)

Anyways, a PET scan is a nuclear medicine imaging test that will determine the stage (i.e. find out how far the cancer has spread and if it is present in other organs and tissues). It will detect cancerous cells anywhere in my body. Except my brain, Dr. Bahl said. (Although he didn’t specifically state this, I suspect that’s because nothing could penetrate through this thick skull of mine. Nothing!) He did say that if there’s cancer anywhere else in my body those parts will light up brightly. (I wish they could have done this before Christmas because it might have just added an interesting dimension to our Christmas trees. I could have just stood there and people could have thrown decorations on me. Can you envision that? Okay, don’t try.)

So, surgery and a PET scan. Then they are also setting up an appointment for me with a cancer dermatologist who will check out my whole body for other signs of melanoma. One of the questions they have right now comes out of the fact that the initial pathologist’s report indicated that this excised tumor seems to give evidence that it is from a recurrent tumor or one that has metastasized. This is interesting because I’ve never had any other symptoms of this before, and certainly not in that area of my leg. So they’re going to look all over me. (One thing they will not find, for sure, are CATS or any other kinds of PETS.)

Surgery, PET scan, cancer dermatologist. All these will be scheduled as soon as all the doctors’ and surgeons’ offices open back up after the Christmas break. The surgery is the most urgent of these procedures so I’m grateful that the surgeon (I hope he’s not plastic either) which Dr. Bahl thought would be the best one to do it… well, his office is open the soonest of all—December 30^th. On that date Dr. Bahl’s office at the BCCA will call the surgeon’s office to schedule the surgery. The others open back up after New Year’s Day. (He actually called three or four surgeons’ offices, himself, from the hospital while we waited, to try to get me in somewhere. I was impressed with that.)

After all these tests and things are done, we will meet again with Dr. Bahl to discuss next steps for treatment. Thankfully, that appointment has already been set up for February 12^th. So that’s the outside limit of the time frame for us knowing what kind of treatment will be planned. Obviously it will be in the exploratory mode for some time because the extent of the spread of cancer is still unknown. I guess they’ll keep digging and testing until they don’t find anything. (That should end when they reach the brain cavity because I’m pretty sure there’s nothing there. Or if there is, it’s already dead.)

Dr. Bahl has assured us that all his communication with the other specialists and the setting up of the appointments will be done with his message of urgency. Evidence of this is that later on the same day that we saw Dr. Bahl, the cancer dermatologist’s office called to say that they had already scheduled an appointment for me on January 2^nd. Marvelous! This begins a new era of making friends with the nice folks at the BC Cancer Agency. I’m looking forward to that.

In the meantime, we wait. Patiently and yet with a great sense of peace and calmness (at least in my own mind). This does mean that my trip to India has had to be canceled. I was supposed to leave on December 31^st. I know that is a disappointment for the folks there, as it is for me.

Sharyn and I have officially dubbed this Christmas as the “weird Christmas,” but we’re very grateful that our whole family could be with us. Thank you for your care and concern for me. I appreciate your prayers and support. Many blessings on you.