One Step at a Time

That is how we are going to beat this thing. The cure for me comes in four steps. Here is the game plan.

1) Six weeks of daily chemo and radiation to shrink the tumor. That's 28 treatments with weekends off.

Radiation every afternoon at 3:05 (minus the blanket).

Xeloda—chemo in a pill!
I take four of the large ones after breakfast and three more large ones after dinner.

2) Surgery in November to remove whatever is left of the tumor plus all of the surrounding lymph nodes (basically the whole rectum).

Who needs a rectum anyway?

I will also have a temporary ileostomy to divert bowel traffic while things heal.

Ileostomy—draining from the small intestines so the resected large intestines can heal.

3) Four to six months of additional chemo on the chance that some rogue cancer cell wants to try and kill me later.

Cancer cell—Rogue Leader

4) Surgery to reverse the ileostomy followed by a lifetime of learning how to use the new plumbing.

Don't worry, be happy!

The whole process will take until May or June of next year. So... one step at a time. As of today I am in week five of step one. This afternoon I received radiation treatment 22 of 28. Only six more to go!

And Then Reality Set In

There is nothing fun about cancer.

Bend Over

The first time I heard "bend over" was during a physical when I was entering the Navy. But nobody touched anything. It would be years later before I experienced a prostate exam. Still starts the same. Bend over. I've spent the better part of 48 years thinking my digestive tract was a one way street. You just shouldn't put things in at the bottom. It ain't natural. Fortunately I was asleep for my colonoscopy. I was wide awake for what came next.

Did you know they make a special table for rectal exams? They do. And I got to ride on one. That's right, I said ride. Assuming I'm already bare bottomed it works like this. Bend over.

I am kneeling on the little step at the foot of the exam table and leaning lengthwise across the table towards the pillow end. At first I think it's an ordinary exam table. But wait, there's more! Next thing I know the pillow end starts lowering, dropping my head towards the floor. This continues until I form an inverted V with my gluteus maximus at the apex. And just to make the ride more fun, the entire table lifts me up into the air so the doctor and my tumor can see eye to eye. What I always thought of as an exit is now an entrance. And the doctor is ready to go in.

I should mention at this point that the doctor (let's call him Brad) was assisted by his nurse (Nancy) and a technician (Maria). I can't tell you what part they each played in the exam because they were all behind me. My sweet wife remained in front of me, if only to rub my shoulders and watch my facial expressions. But I digress.

According to my wife they put instruments in there that we never knew existed. She was really impressed. Of course, I didn't exactly get to see them. I do remember thinking, "You can do that?" And I did get a complement from Brad. During one of several digital intrusions (a.k.a. finger) I was asked to squeeze tightly. No surprise to me, he said I had a strong muscle. Doctor certified! I won't mention all the times he had to ask me to relax.

The point here (yes, that's a pun) is that following a CT scan, a rectal ultrasound, and the taking of several other measurements, the famous Colon and Rectal Surgeon, Doctor Bradford Sklow, was ready with my prognosis. And so, without any further ado...

It turns out I have Stage II rectal cancer with an 80% chance of survival. The cancer has not spread anywhere else in my body, nor has it gotten into my lymph nodes so far as can be detected. The tumor did manage to get through the rectal wall and into the fatty tissue on the other side. But it appears to be locally contained and highly treatable. So yeah, I'll bend over for that!

Waiting

and waiting, and waiting.
You tell me I have colorectal cancer and then I have to wait three weeks to see a doctor? Aaaaaah! The only thing I knew was that I had rectal cancer. So I started searching the internet for all things rectal cancer. I scared myself to death. So I stopped searching the internet for all things rectal cancer. Instead, as the shock of the diagnosis wore off, I started taking more walks through our neighborhood with my wife—trying to talk out what having cancer means to me, to her, and to our family. The only thing we knew for sure was that change was coming. Heck, it was already here. I hate change. Always have. But the more I understand something the better I can deal with it. I just didn't like my first lesson from cancer being patience.

So how did I miss the warning signs?

Oops!

Well you ask. The truth is I missed all the clues my body was giving me. Of the six leading signs of rectal cancer I had four. I figured the periodic blood in my stool was probably from hemorrhoids. If I had bothered to look up what hemorrhoids really were I would have known better. As for occasional diarrhea, that can be explained by any of a number of different things. I am always tired, so nothing new there. Except that after two years of night school I had taken the summer off and still found myself tired. I think the one sign I should have noticed was the increase in bowel movements and the narrower, odd shaped stools. But again, I wasn't really paying attention. Any of these signs in isolation was just a nuisance. I wasn't looking for rectal cancer. After reading some literature from the National Cancer Institute, I learned that it is very common for patients to not connect the dots pointing to their cancer. But from the moment of diagnosis there is suddenly complete clarity. Amen to that, brother. I can see clearly now!

Scout Camp

That's how I found out about my tumor. I went to scout camp with my two youngest boys. I had to get a physical to spend the week with them. BSA requirement. Since I hadn't had one in three years my wife called my doctor and told him to give me the works. In hind sight (yep, the puns are everywhere), the prostate exam proved providential. It lead to a Fecal Occult Blood Test which showed positive. My PA, astute man that he is, didn't like the results. He decided that 48 was close enough to 50 and strongly encouraged me to get a colonoscopy to find out what was going on. Now in case you missed the concerning news, the FOBT showed that I had blood in my stool. Nasty tumor! Three weeks later (including a gorgeous week in the mountains with my sons) I went in for my first ever colonoscopy. I say first because with a diagnosis of rectal cancer it will be far from my last colonoscopy.

Get yours today!

You Have Cancer

That's what I was told when I woke up from anesthesia following my colonoscopy. The official report reads, "A polypoid non-obstructing large mass was found in the distal rectum." Yeah, I had to look up distal too. It means the furthest part, or in my case down near the bottom of the poop shoot, the end of the line. OK. So I have a malignant, two-inch tumor in my butt. That makes me a rectal cancer survivor since my diagnosis on Friday morning, July 30, 2010.

Steve's Tumor (the pink part)

Does this tumor make my butt look big?