Sunday, December 14, 2014

Metal Nipple Tags

How's that for a title?

Wow, it's been almost three months since my last post! I have really meant to post more. I have a list of a dozen topics I want to write about. But life just keeps getting in the way. That's a good thing. I'm back to my busy self.

On November 17 I went for my most recent surveillance checkup with Doctor Rad at Dana-Farber. It was a little more than a year since treatment. At that point they order a chest x-ray to check for any metastases in the lungs, which is the most common site.

Before the x-ray the technician had me stick those little band-aids in the photo to my nipples. Doctor Rad told me later that sometimes the nipple is not clearly identifiable in an x-ray and can be mistaken for an abnormality. So they have the patient wear these markers. Notice the metal beads in the center. Those show up the x-ray and inform the radiologist of the nipple locations.

My result?

All clear, of course. Had it not been you would have heard about it hear long before now!

I forgot to remove the nipple markers until the next morning in the locker room at work, after I had been walking around shirtless for a few minutes.

I mentioned to Doctor Rad that I was now past the halfway point to two years since treatment. At some point along the way I had heard (I thought from one of my doctors but perhaps not) that my particular kind of cancer, if it is going to recur, almost always does so within two years.

Doctor Rad told me that their main concern at these visits is not recurrence. They don't expect that to happen. Their main concern is the long-term side effects of treatment such as dental problems from high radiation doses to the mouth. It damages the bone regeneration capacity in the jaw and teeth and can lead to serious dental problems. It also means I may never again be a candidate for a dental implant.

[Something I learned in my work: bone is not just a dead rigid material like many of us envision it. Bone is constantly being "remodeled". Bone cells called osteoclasts are constantly tearing down bone and other cells called osteoblasts are constantly forming new bone. That wikipedia article says about 10% of the adult skeleton is replaced in this fashion every year. Some osteoporosis drugs work by blocking the activity of osteoclasts and thus slowing bone recycling.]

My surveillance appointments continue to get wider spacing. My next appointment is not until March and the next one after that is July. Wonderful Wife and I actually miss them! Doctor Rad and Doctor Chemo feel a little bit like family and we always love to see them.

I continue to be amazed how much "cancer survivorship" remains on my mind. I still think of it many times every day. As I've written before, I'm reminded every time I eat and don't have enough saliva. I still panic just a little when I find myself in an eating situation where I don't have access to plenty of fluid, although I'm learning that I can make it, depending on the moisture content of the food and my patience.

Saliva and taste still haven't recovered much if at all over the situation a year ago. I still can barely taste sweetness and that particular taste goes away quickly after the first bite or two. Salty and savory things taste good enough but are still greatly diminished compared to pre-treatment. Saliva is still greatly diminished and is not stimulated by eating. As I wrote back in September I tried Pilocarpine, a drug that stimulates saliva in some people. It did nothing for me. I took it for three weeks and stopped.

I'm mostly accustomed to those side effects now. Although I keep eating sweet things and hoping they'll taste good!

I also think of cancer every time I put on my new slimmer wardrobe. Like I've said before, I like that aspect.