Brian's got a little c.....

 Hey Everyone, 

It's been awhile since I've done a solo post. Lucy is much better at these things and I'm usually happy to delegate that to her, but in this instance it's my story that needs to be told. So here goes nothing:

This winter I started to have a weird thing going on with my right tonsil. It wasn't too concerning but since I had a weird abscess in the same area last Halloween (or a bout of tonsillitis, we'll never know as it resolved in a couple of days) I thought I should get it checked out once we got back home. My primary care doctor agreed and sent me for a biopsy which came back positive for a P16+ oropharynx squamous cell cancer,  or in layman's terms, tonsil cancer. After some CT imaging it was confirmed I was only at Stage 1. There were a couple of hectic weeks during all of this initial testing that felt quite dramatic, crazy, and fearful. We consulted a local oncologist (Dr. Kusano) and he said everything is very treatable with a great prognosis which gave us much relief. He also encouraged us to get a second opinion at a high-volume cancer center to check on other treatment options. After another two week delay we finally completed a PET scan which confirmed the original CT.

We flew to Fred Hutch in Seattle for a 2nd opinion and to see if surgery was a possibility. There are no surgeons in Alaska that are able to perform the robotic assisted surgery (TORS) necessary for removal. Turns out the surgery was a crapshoot. A "tweaner" the surgeon called my tumor. Which was about what we expected based on our initial conversation with Dr. Kusano. The tumor was a bit too large to leave me unscathed from surgery. If I did the surgery they would remove surrounding tissue and it was unclear how much I would be left with, but what was known is if I consented to surgery there was no going back once they opened me up. I could end up with a large hole in my soft palate or worse. The long term deficits which I might be left with are unknown until after surgery. Oh yeah ,and radiation would still be required. That is what we were hoping to avoid. So option number one was off the table for us. Lucy and I discussed it and said, "nah, we're good with radiation and chemo". We learned the most during our visit from the speech language pathologist regarding what deficits I could be left with no matter the treatment path we chose. Ironically both of the Oncologists we spoke with at Fred Hutch did residency with our Anchorage radiation oncologist Dr. Kusano. We also determined that the available Proton Therapy at Fred Hutch was unlikely to provide that much of a positive change in outcome (maybe some slightly less long term effects) but would certainly complicate our insurance claim and would likely delay when we could start treatment.

We went back to Anchorage to consult with our local specialists and figure out the details of a  treatment plan. All that to say, I start Radiation and Chemotherapy on June 23rd. I will be having radiation 5 days a week for 6 1/2 weeks and 3 rounds of chemotherapy. 

Its has been an exciting couple of months during this process. We have learned many things about our healthcare system and specifically how painfully slow getting insurance authorizations for treatments is.  I am incredibly lucky I don't have a particularly aggressive or fast growing cancer as the delays would've been even more enraging. 

I do have a great prognosis. For my particular type of cancer there is a successful therapy available and the likelihood of recurrence is very low. Once I get past the first 2-3 years the odds are around 99% it won't come back. While anything can happen we feel good about where we stand, although it's been quite the ride getting here. I will have some significant short term things to deal with during treatment but I'll get through them. The long term things I'll be dealing with are negligible in the big picture as I see it.

So cancer sucks and I may have a few shitty months coming my way but I will survive and am incredibly lucky I can make my health my full time job. I don't know how other people deal with cancer while having a job, kids, pets, and everything else we have to deal with on a daily basis. I am so very fortunate even with this stupid cancer. 

So that's where I am at and will be this summer, early fall and even the next year as I recover. I am so blessed to have great friends and an AMAZING WIFE who helps me through all this murkiness we call healthcare in the US.

Much love,

Brian