Removing the Asterisk

I had my procedure this morning, or at least attempted to.  Gastro-Guy got in there, poked around a bit, did an endoscopic ultrasound, and then packed up his tools and high-tailed it out of my esophagus.  Why?  Because it’s not cancer with an asterisk but plain old invasive cancer.

The good news (if I may stretch the definition of that phrase to its breaking point) is that it has been caught about as early as it could possibly be caught.  Okay, well, that’s not totally true – the asterisk version is the earliest but this runs a close second.  It’s Stage 1B and the survival rate on this is in the 90-95% range.

The bad news is that the way you survive it is to have a pretty awful surgery.  They chop out the offending portion of the esophagus and stomach (my tumor is right at the gastric junction of the two) and then pull up what is left of the stomach and attach it to what is left of the esophagus.  Part of it can be done with a minimally invasive, laparoscopic process and the rest with an incision below the rib cage so there will be no cracking of chests as there used to be with this.

Unfortunately even with the new technique, recovery time is long – 7-10 days in the hospital, and many weeks at home after that.  And it is a pretty significant lifestyle change as the type, amount, and (in my opinion) quality of food you can eat afterwards is severely limited.  I’m going to miss cheeseburgers.

Gastro-Guy has referred me to a surgeon he describes as “the person I’d want to do this surgery if I had to have it” but said surgeon is on vacation so I can’t get in to see him until July 9.  After that it’s tests and pre-op procedures and scheduling, which will probably mean that the soonest the surgery will happen is the week of the 23rd.

I’ll keep you posted.

It Should be in the Employee Manual

I told my boss today, “When one finds out one has cancer, one gets the rest of the day off.”  I believe that rule it should be in the employee manual.

I’ll write some background all this at some point, but the short version is that 7 years ago I was diagnosed with a condition called Barrett’s Esophagus, wherein the lining of the esophagus begins to undergo a cellular change after being splashed with too much stomach acid due to acid reflux.  There is a good chance that Barrett’s will eventually become esophageal cancer so regular endoscopies (camera down the throat, biopsies taken) are performed to monitor the progress.

I had my regular endoscopy last week – well, sort of regular – that’s part of the background I’ll write at some point.  And today the word came back from my gastroenterologist (whom I lovingly refer to as Gastro-Guy, but not to his face): cancer.

The good news is that it is sort of barely cancer – cancer with an asterisk.  The official term is carcinoma in situ, which is latin for cancer with an asterisk.  Or maybe cancer in place – I forget.  Anyway, it basically means that the cancer is just sitting there on the surface of the esophagus not doing any real damage yet – like one of those bad moles you get removed only mine is on the inside of my body.  Gastro-Guy will be able to go in with another endoscopy and remove it with a few snips of the tissue in a procedure called Endoscopic Mucosal Resection (yes, it sounds gross, but really isn’t that big of a deal and certainly less horrifying than the alternatives).

The only asterisk to the asterisk is that when he gets down there he’ll look around some more, do an endoscopic ultrasound, and then make sure that it really is just on the surface and hasn’t gone any deeper.  If it has, well… then things start to get really interesting.

The procedure is scheduled for June 26th.  Fingers crossed for an asterisk.