Tag Archive | biopsy

Skin Cancer Too? Really?!

Photo Credit: nation.com.pk

So the week before last I had some biopsies done.  I had postponed this followup visit to the dermatologist for, oh, about a year and a half.  Yep, I know.  But I’m sure you get it.

The previous two visits had ended with biopsies, some rather large and deep.  The results were mixed — some of my sacrificed moles were fine, others had pre-cancerous cells.

When my first 6-month followup came around, I canceled because, well, I was tired.  I had just finished radiation and was getting weekly infusions of Herceptin that my body wasn’t reacting well to.  And I was spending plenty of time at the hospital and Cancer Center. I just couldn’t deal with one more thing.  Then I just never bothered to reschedule.

So last month I finally picked up the phone and called.  Fast forward to my appointment.  They did a quick once-over, saw some areas of concern, and then scheduled me to come in for biopsies the following week.  I reluctantly but dutifully returned and got a bit nervous when there were two doctors, a nurse, and a tray of scalpels in the room.

It was less involved than it had been on previous occasions.  I was on my side when they took the mole that was on the fringe of my chest radiation field.  After cutting it out, the doctor stitched it up quickly, but I could feel the blood dripping down my back.  They scrambled to get it cleaned up as I mentioned that I was on aspirin therapy so I was a bleeder.

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Photo Credit: dermnetnz.org

They then moved to the lesion on my forehead.  This was the one that had concerned me for months.  It didn’t look like much, but every time I washed my face, even gently, it bled.  I thought this was odd and it was really what had inspired me to schedule the appointment.  The three doctors I saw the first week agreed and mumbled something to each other about act-something keratosis turning into cancer.  And then the two new doctors on biopsy day were mumbling the same thing to each other after looking at it with their special little scope-y things.  The the one turned to me and said it was likely actinic keratosis that became cancer, but I didn’t pay much attention.  I couldn’t have skin cancer, too.

When they got to my head, the numbing needles didn’t really do their job.  Thankfully it didn’t take too long.  But they couldn’t stop the bleeding.  Pressure wasn’t working, so the nurse passed aluminum nitrate (I thought they used to use silver nitrate?) to the doctors and they were finally able to stop it.  They taped me up and sent me home with an appointment card to have my stitches removed and receive my results in a week (last week).

I returned last week and was told that the area on my head is skin cancer.  They said that I would need to schedule my surgery with the Mohs or chemosurgeon at the hospital.  They asked me to head over there to schedule it in person.  Since I had the biopsies done at the hospital, this meant walking across the hall to the Mohs surgery department and the sole surgeon in our area who is trained to perform this type of surgery.

But that was still too long a walk for me at that moment, so I skipped out and went home.  I still haven’t scheduled the surgery.

I try to avoid feeling sorry for myself or dwelling on things that I can’t change.  But, really?  I mean it sounds like this one isn’t that big a deal, especially in comparison to the breast cancer, but I was a bit incredulous when they first told me.

I began wondering about statistics.  “What are the chances of having been diagnosed with two distinct types of cancer before the age of 37?”  I consulted the internet and still don’t know because I was sidetracked by the search results.  Turns out that it is not really understood why someone in this age bracket would develop one cancer, let alone two.

Well, I’ll just have to do my best to avoid a third.

P.S. Please do something for me.  Schedule a skin cancer screening — it’s quick and easy.  And you aren’t too young!

*** I am very sorry to say that a couple of months after I wrote this post, my little sister was diagnosed with MELANOMA, the deadliest form of skin cancer.  So I’d like to reiterate the “p.s.” above.  If you notice something that isn’t normal for you, be it a breast change, an odd-looking mole, or some other concerning symptom, please get it checked out.  It’s important, you are important, and you are not too young for cancer.

About My Brain

brain lesion cancer breast metastasis

So I fell down the stairs again today.  I hit my head pretty hard.  And I managed to land on a section of my back that was already hurting quite a bit.

This reminded me that I never posted a “brain update” after my last oncologist entry earlier this month.  I guess I didn’t really forget to write about it, I just didn’t because I didn’t know what to say after my appointment with the neurologist the next day.

I’m still not really sure what to say.  When I arrived at the neurologist’s office, I took a seat in the waiting room with a double-sided questionnaire about my symptoms.  I pretended to fill it out, but I was just sitting there lost in thought.  I had just filled the same paper out a couple of weeks prior and my answers probably hadn’t changed, so I thought the time would be best spent staring off into the distance, clipboard on my lap and pen in my hand.

I only had a few minutes of quiet before my neurologist walked out into the big waiting room, purse on her arm.  She said ‘hi’ and said she’d be back for me as she walked out of the door.  The nurse came out moments later and took me back to the vitals station and proceeded to take my blood pressure, etc.  Before he finished, my doctor was back.  She said she’d take it from there.  She walked me back to the scale, took my purse and coat, and I stepped up to be weighed.  We then walked back to the room.  She carried my purse, her purse and my coat and chatted with me during our short walk.  She set our open purses down on her desk and I took a seat next to her.  She told me she was glad I came in because she wanted to show me my MRI so I could see “IT” for myself.

We chatted as though we were girlfriends out having a coffee date and as though we were discussing our husbands, kids, dogs, and the piles of laundry waiting for us at home.  The only difference was that the coffees were waters, the table was an exam table, and we weren’t talking about what we were making for dinner.  We were talking about the lesion in my brain.

She showed me my brain MRI.  There was the lesion.  And then the same area on my MRI from about 8 months ago.  No lesion.

Not really coffee shop conversation.

When I asked if it was a metastasis, she said that it may not be malignant.  She said that they typically see a lot of “mass effect” with malignant tumors.  (*Mass effect is damage to the brain due to the bulk of a tumor, the blockage of fluid, and/or excess accumulation of fluid within the skull.)  She said that this ‘mass effect’ was lacking on my MRI.  I asked, “Could the mass effect be lacking because it is such a new lesion?”  Maybe.  “But it could also be because it is something benign?”  Yes, definitely a possibility.  Looking at the lesion’s shape, I wondered, “Could it be because I swallowed a small grape and it went the wrong way and lodged in my brain?” But I figured that was pretty unlikely!

cancerinmythirties.wordpress.com brain cancer lesion thalamus breast cancer

The thalamus is the red area

The kicker (well, one of them!) is that it is deep in my brain — within the thalamus.  Not an easy place to access for biopsies, etc.  So no easy way to know for sure what it is.  My neurologist feels the best way to proceed is to wait a couple of months and repeat the MRI.  If it is malignant, we should expect changes.  If I have an increase of symptoms, it sounds like we can do it sooner.

Then there’s also that abnormal EEG that prompted the MRI.  So I don’t really know what to think.  On the one hand, I feel sick to my stomach because the cancer may have metastasized to my brain.  But on the other hand, I’m really hopeful that it hasn’t.  And at this point, I guess I should feel pretty grateful that it’s only a maybe and not a definite.

Cancer is the gift that keeps on giving…

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In case you were wondering what the thalamus does:

**”The thalamus has multiple functions. It may be thought of as a kind of switchboard of information. It is generally believed to act as a relay between a variety of subcortical areas and the cerebral cortex. In particular, every sensory system (with the exception of the olfactory system) includes a thalamic nucleus that receives sensory signals and sends them to the associated primary cortical area. The thalamus is believed to both process sensory information as well as relay it—each of the primary sensory relay areas receives strong “back projections” from the cerebral cortex.

The thalamus also plays an important role in regulating states of sleep and wakefulness.[9] Thalamic nuclei have strong reciprocal connections with the cerebral cortex, forming thalamo-cortico-thalamic circuits that are believed to be involved with consciousness. The thalamus plays a major role in regulating arousal, the level of awareness, and activity. Damage to the thalamus can lead to permanent coma.”

* Information from: http://www.mayfieldclinic.com/PE-BrainTumor.htm

** Information from: http://en.wikipedia.org/wiki/Thalamus