The "Good" Cancer

Papillary Thyroid carcinoma. That's what I got, friends. Known to many as the "good" cancer.

And if I ever hear anyone say that out loud to me, be very careful, because I might very well punch you in the mouth.

While I am one of the first to recognize that I could have it worse -- much, much worse (trust me -- while sitting in the waiting room at UCSF cancer center, I was absolutely counting my blessings) -- all cancers are insipid, including thyroid.

Here's what throws people off about most thyroid cancer: it's highly curable (anaplastic excluded. Sadly, anaplastic -- which is what Justice Renquist sufffered from - is a guaranteed death sentence. But it's also the least common form of thyroid cancer).

Thyroid cancer has one of, if not THE lowest mortality rate, of any cancer. Depending on the study, upwards of 98% of patients suffering from follicular, or papillary, are ultimately cured. So ... I've got that going for me. And trust me, I'm holding on to that statistic in a pretty big way.

At the same time, the treatment protocols are proven, and fairly straight-forward. There's plenty to contemplate, plenty to learn, but for most of us, upon diagnosis, the move forward plan is pretty darn cut and dried. Without getting too granular, it goes something like this:

- complete thyroidectomy (removal of the thyroid gland), followed by recovery followed by a period in which you are slowly weaned off your synthetic thyroid replacement medications, which for most of us is synthroid. This phase of the treatment is commonly referred to as "going hypo"-- remember this phrase 'cause you're going to see it a lot more in future posts.

Going hypo -- which last about 20 days -- is miserable. The thyroid, in essence, provides your forward thrust. It's what drives your metabolism. Without it, you become listless, fuzzy headed, and completely without energy. And those are the good parts! In a nutshell, it sucks beyond belief. And it's compounded by the fact that it MUST be accompanied by The Diet From Hell.

The Diet From Hell is enormously critical to the treatment. The protocol works much like a reverse notion of what carbo loading does for marathon training. The idea is that you want to completely and totally deprive and deplete your body of iodine. After a period of 20 days or so of doing such (by which time yo're pretty much holding on for dear life. Ok - that's an exaggeration. But trust me -- you are completely spent by the end of this period), patients are administered a small "scan" does of i-131 radioactive iodine isotope, which is immediately absorbed by remaining "bad" thyroid tissues that are hungry for iodine. 72 hours after you are administered the scan dose, you are CT scanned, and based on "uptake" (absorption) doctors are able to ascertain the extent of your disease.

As an example, my original scan revealed that there was "uptake" in what appeared to be two areas in my neck (not terribly uncommon, especially as I had six bad nodes removed during surgery) and my hip (unbelieveably uncommon; we'll hold on to this for another day).

Based on this analysis, doctors quickly - within hours, administer a big whooping therapeutic dose: usually somewhere between 100-200 milicures (sp?). I was right in the middle at 150. Once you are administered your dose, you need to run for the hills for a few days and go into complete isolation, because you are lit up like a Christmas tree (we'll hold off on this too for another day). You cool down, resume your life, and six months later go back in for yet another scan (which necessitates going hypo/diet yet again).

And in 75% percent of cases, that's it. The protocol is considered HIGHLY effective. Most people get a clean scan and they are done. Sure, that's a bit cavalier: thyroid cancer has a high rate of return, and you must undergo frequent blood work, but for most people, the story ends there. A shitty year for most, full of unpleasantries, but 12 months and out.

This past Monday, April 30th, was my scan. And for me, the above scenario wasn't meant to be. If it was, you probably would not be reading these words. Which brings me to where I am now. At a crossroad. Damn.

More later.