7/16/06 Dann's Health

Dear Family,

Some of you have already heard that last Monday I went in for an x-ray due to recurrent back pain, and found that I have a spot on my lung. The x-ray was ordered by a chiropractor, who was concerned that the back pain wasn’t going away after continued treatment. I’m very fortunate that this was picked up on an X-ray, or I may not have become aware of any problems in my lung until much further down the road.

That X-ray bought me a quick ticket to the hospital for a CT scan last Wednesday. Genevieve and I met with pulmonologist Dr. Michael Lafor today to review the results and implications of the CT scan, and to plan the next step.

Dr. Lafor said that the mass is about 2 cm X 3 cm, or slightly smaller than a golf ball, and is located in the upper portion of my left lung. He cannot imagine what else it would be other than cancer due to the characteristics that he can determine from the CT scan. However, this may not be all bad. Based on the CT scan, he thinks that it is most likely to be either an adnocarcinoma or a carcinoid carcinoma, in that order. He believes it is unlikely to be small-cell carcinoma, which is another category of cancer, and it’s not worth going down that road of discussion unless we hear otherwise.

If it is a carcinoid carcinoma it is very likely to be benign, but should be removed anyway, as they can become malignant if left for a very long period of time. If it is an adnocarcinoma, the five year survival rate is about 70% for Stage 1 cancer and 40% for Stage 2 cancer. “Staging” is basically categorizing how fast it grows and how fast it spreads. Based on size and shape, and the fact that the CT scan did not reveal signs of any other masses in other parts of my abdomen (heart, liver etc.), he would expect it to be Stage 1 or 2 if it is an adnocarcinoma.

As with most good doctors I have ever met, Dr. Lafor qualified everything I have described above, beginning with, “The first rule of cancer is that there are no rules.” Therefore, we can’t count on any of the above until we get hard data. That brings us to the next step.

On Wednesday afternoon I will have an outpatient bronchoscope, where a narrow flexible cable with a camera and a pincher on the end will be guided into my lung. A sample of the mass will be taken for a biopsy. By Friday we should have results of the biopsy, but it could be Monday. Also, he said that about 20% of the time they can’t get a good sample, and will have to either try a needle biopsy through a puncture in my back, or surgery. This is another road we won’t go down until we know if it is necessary.

Two more steps will take place throughout this ongoing process. First, I will have a pulmonary function test on Monday, which will be needed as a baseline in the event that I have the mass removed from my lung. Next, a PET scan is being ordered. That will take another 7-10 days because it requires pre-authorization from the insurance company and a note from God. (Son Mike, put in a good word for me.) The PET scan involves sending a few radioactive sugar molecules into my system. They “light up” in areas where there is metabolic activity, such as the lymph nodes, which is an indicator of cancer. That will tell if the cancer has spread.

All of this sounds much further down the road than we may actually need to be. We may have just tuned in to the worst case scenario and gone too far and too fast. Hopefully we’ll have a more realistic picture Friday or Monday.

One of the first things I started wondering was how I got this mass to begin with. The doctor dismissed out of hand the possibility that this is related to my having smoked for a few years ending in 1981. He said that he considers me the equivalent of a non-smoker because the length of time and amount that I smoked were insignificant. Further, only small-cell lung cancers are related to smoking. His only explanation is genetics and bad luck.

As soon as we have an update we will email you. I find it hard to share this info without getting too choked up if I try to tell the story verbally. I’m happy to hear from you, but it’s easier to share the hard stuff this way, particularly when it means telling many different people.

There are a few people we wanted to email, but all the contact info is on Gen’s computer. Of course, it is now at the computer hospital, so we’re both getting our diagnostics run. Bad timing for the computer. Bad timing for me too – I think about January 2051 would be a better time.

Love to all, and we welcome all prayers.


Dann and Genevieve