Thursday, January 18, 2007


What do you have? What's the story? How big is it?
I have a primary squamous cell carcinoma of the upper aero-digestive tract. For those less medically inclined, let me explain each part. It is a carcinoma, generally known as cancer - a malignant tumour measuring 3.5 by 3.0 by 2.5 cm in size (or at least it did on 4th December. Hopefully it has already begun to shrink with treatment).

How many growths are there?
It is a primary tumour, which means that this growth is the original one. Left unchecked, it would spread to my lymph nodes and then to other parts of my body through a process called metastasis. Fortunately, we seem to have found it before this deadly self-reproduction had really got underway. However, in late December before I started treatment, my oncologist did find some a small tender lump in one of my neck lymph nodes. This seems have disappeared with chemotherapy. Similarly, a PET scan in mid-December discovered a few other possible secondary growths, though these were inconclusive and too small to treat with radiotherapy. The hope is that chemotherapy will have mopped them up.

What kind of cancer?
It is a squamous cell carcinoma, which refers to the kind of body cell in which the growth originated. Cancerous growths are normal body cells gone wrong, which start to reproduce themselves much faster than they ought and without reference to surrounding tissue. If this happens in or near a vital organ, it will eventually be fatal as that organ is taken over or crushed by the new growth. Malignant growths are those that also send out more cells into the rest of the body and begin to reproduce themselves elsewhere. By definition 'cancer' means malignant. Some tumours are 'benign', and just stay in one place (this can still be dangerous or deadly in some locations), but they are not generally called cancerous. Squamous cells are the cells that form linings inside the body, particularly in the oesophagus (food pipe) and trachea (wind pipe).

Where is it?
It is in my upper aero-digestive tract. This is a deliberately ambiguous classification since they are still not sure if the tumour began in my oesophagus (more common, but less likely in my case, given biospy results) or trachea (rare for a 28 year old non-smoker). The growth is located between these two tubes and grows into the base of my trachea, in my left bronchial tube (connecting the trachea with my left lung), partially obstructing it (this had been making breathing difficult until recently). It is a few inches above my heart. If you draw a horizontal line between my armpits, it is located on the left side about a third of the way across my chest. Please note: despite my voice being affected (and how we first discovered the growth), it is not a throat cancer, nor is it a lung cancer.

Can they operate?
No. Or at least not for now. Not only does it presently impinge upon two vital tubes already mentioned, worst of all, it is snuggled under a loop of the aorta (main artery exiting the heart). It is also hiding behind a rip, blocking clear access from my back. There may be some chance of surgery once it has shrunk from the combined chemo-radiation that forms the core of my medical treatment.

How serious is it?
Very serious. The rapid onset of symptoms seemed to indicate that it has not been around for long and was acting very aggressively. The speed with which I was given treatment indicated the pressing need for action. The possibility that it was already spreading (see above) also shows that it meant business. No one has given me a definite prognosis, as the rarity of my age and condition means that statistics are too scarce to make even an estimate. We just live each day as a gift, with hope in the God who raises the dead - and who also sometimes heals the sick.
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