CoffeeBeer >> Warts & All >> Moon In Cancer

July-November 1992
Page 3

The Second Opinion

Friday Week 5:

This morning M went with me to an appointment with a Dr. D, a gynecological oncologist. We arrived at 10:15am and they gave me some forms to fill out. Then a woman cheerily asked me to come with her. I asked if M could come along and she said sure, although she seemed a little surprised.

She led me to the scales where she weighed me. (I weighed 111 pounds.) Then she led us into an examining room and took my blood pressure (120-ish over 70-ish—normal doctor's office pressure for me, although I was so nervous I was almost shaking). She said Dr D would probably come in and talk to us for a bit and then examine me. When I had called for the appointment—an appointment for a consultation—on Wednesday, I had the feeling the receptionist didn't quite get what I was talking about. Thursday somebody called me to remind me about my appointment and to tell me to bring my records. I told her Doctor H was supposed to send my records and lab results to Dr D. This woman today seemed confused and said she'd go see if Dr D had received anything.

M and I sat for fifteen or twenty minutes in the room. I realised that this was M's one and only opportunity to see what a gynecologist's examination room looked like, but M is pretty squeamish about medical equipment and doctors in general. I pointed out the colposcope and M immediately buried himself in magazines.

Dr D finally peeked in and told us he was looking for my records. Oh great, we thought. He's going to see the stuff for the first time, review it in sixty seconds, and then give us an expert opinion. He finally returned and sat down and started explaining everything in detail and drawing pictures. And he did not paint a very pretty picture.

Basically he told me what Doctor H had told me about the cone biopsy and D&C. He said there are two kinds of cervical cancer: the kind with squamous cells and the adenocarcinoma kind. The squamous variety is easier to see and easier to reach, being on the surface like skin cells. Adenocarcinomas are glandular cancers and are much more unpredictable and difficult to deal with. He said, like Doctor H had said, that these types of cancers tend to "jump" easily. One can look like it's in situ, or localised and not spreading, but it can jump over areas of tissue it leaves healthy and establish itself elsewhere. Doctor H had said this, but she acted as if they had found the carcinoma and there was probably nothing else. Dr D said that there is no way they could tell if they got it all, and that those carcinoma cells that would be left behind are the ones that could get deeper and deeper until they became invasive, invading other organs. At that point, he said, the prognosis for adenocarcinoma of the cervix is very bad: I would probably die. I would probably die.

He drew a little diagram to show me that I was right on the precipice of invasive cancer—way past dysplasia. He told me that the only option I had was to have my uterus taken out, and soon. He said that they always wait six weeks after surgery before doing another surgery, but after that six weeks I shouldn't wait any longer. My parents will be getting home from Europe in six weeks, which is seven weeks after my surgery. I phoned my mother and she's planning to fly up to Seattle after they get home. I have six weeks now to enjoy my uterus for the last time, a final period to look forward to, and six weeks to get used to the whole idea. Life sure changes fast.

More stuff we learned: Adenocarcinoma is a rare form of cervical cancer. It used to account for about 5 percent of cervical cancers (with squamous accounting for 95 percent), but it's starting to become more prevalent at 15-20 percent. After I have this hysterectomy I'll have to have frequent checkups and pap smears. The rest of my genital organs will be at much higher risk for cancer than the average person. But he said that my other bodily organs, including my breasts, will be at no higher risk than a normal not-at-risk person. This was a relief.

This is cancer. But when filling out medical insurance forms and whatnot, I don't have to call it that. I can call it a "precancerous condition" and they'll back me up on that. But it is cancer.

Dr D said that after my hysterectomy I'll probably still be able to feel my cycles. Most women do. Unfortunately that leaves the possibility that I may not. Hopefully I'm so in tune with the moon that I'll still feel it all.

(The full moon was completely clear last night.

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