Well, it’s been a while. To my vast coterie of followers — all 13 or 14 of you — apologies. Best laid plans and all exploded when I received an early Christmas present, a diagnosis of perianal malignant melanoma. I’ll skip the details and let the name tip you to the salient facts. My friend Bob’s response upon hearing was, “So, you’ve got ass cancer.” And there you have it. Shit happens.
If I had to share something with Farrah Fawcett, I would have preferred the hair. It was a surprise find during a routine surgery for (polite cough here) hemorrhoids. Unlike the melanoma we all know — skin cancer — this particular delight accounts for only 0.2% – 0.3% of the disease. Thanks, but I’d rather win the lottery. Being an internet whore, as soon I my surgeon called with the news I jumped online and read every mention of the disease I could find. And the internet, being a bit of a whore herself, generously served up both the possibility of complete cure and a “Ho, ho, ho — you have three months to live” super-size value meal. Merry Last Christmas. God bless us, every one.
Now I’m your basic dreamer/pragmatist, so of course after a day of anger and desperate panic, I immediately began eating a healthy, anti-cancer diet. Yeah, I know. I stopped dairy and red meat. I bought tons of fruits and vegetables and no longer let them just rot in my produce drawer. I started each morning with a fruit and veggie smoothie (finally putting that $300 Montel Williams juicer to use.) Gluten didn’t pass my lips. I vitaminized, mineralized and visualized. In two months I lost 50 pounds (Ed. Note: There’s plenty where that came from, so not as drastic as it sounds.) The phrase ‘eat to live’ became more than just the title of Joel Furhman’s very informative bestseller. It was my new directive. And guess what — pretty quickly I began to feel like a million bucks.
Luckily this wasn’t an instance of that famous last gulp of life before kicking off. I’m still here and, as of my last PET scan, technically disease-free. Apparently, this is what it feels like to eat well and take care of yourself. Guess some of us just need a bigger foot in the butt to pay attention. (Had my mother, the dietician, not been cremated, she’d be turning in her grave…)
Now back to the villain (or hero?) of this piece — perianal melanoma. The logistical reason this was even discovered (because there are virtually no symptoms until it’s usually well on its nasty way) was because I was unhappy with my healthcare situation and wanted to return to my previous physician. That required changing my health insurance, which as a freelancer was actually up to me since I pay out of pocket. (Ed. Note: This would still be on my to do list had there not been SERIOUS effort on my friend, Annette’s part. She would not stop bugging me until I did the paperwork. Lesson here: It’s always Nike time. )
Once on my new plan, even though I’d had one only 4 months prior, as a pro forma gesture I went in for a physical. Dr. Painter, being the thorough physician she is, noticed a few things, sent me to a few specialists who ultimately discovered my early Christmas present thus securing the truth that my decision to change back to Dr. Painter was one of the best of my life. [Ed. Note: See image above.]
Okay, we have the pathology report — what next? Dr. Nandakumar, my colorectal surgeon had never run across this particular melanoma. My brand new oncologist (and who doesn’t thrill to speak those words?) was in the same boat. So they presented my case to the surgical review team at Weill Cornell, seeking opinions on a treatment protocol.
The group decision: a second surgery (when they used the words ‘wider’ and ‘deeper’ I was ever more grateful to the inventors of general anesthesia) followed by weekly interferon shots — for up to 5 years.
Flashback here to my initial oncology visit with Dr. Popa (a delightfully intelligent woman with great experience and a generous sense of humor.) She gave me the lowdown on standard treatments for melanoma – one of which was interferon. As she outlined the nasty side effects (suicidal ideations, anyone?) she promised it would be prescribed only as a last resort.
Returning to the land of happy treatment news, I looked across at my friend, Eric who’d been a brick, attending every doc visit with me since the diagnosis. He was masking the same “Oh, shit” expression on his face as I had on mine. “But,” Dr. Popa chirped, “It’s the fancy interferon!” Well — I don’t usually go in for labels, but as long as it’s tasteful…
She explained that my prescribed treatment, Sylatron, was pretty new having just been approved by the FDA in April of 2011. Developed by Merck, it is a pegalated (coated) version of the traditional drug. Interferon is the general label for naturally occurring proteins which are released in response to pathogens, such as viruses, bacteria or tumors. So strictly speaking the method of action for Sylatron is to boost my immune system so that my body would target cancer cells and eradicate them. Faster, pussycat, kill, kill!!
I’d like to take a moment for a little life irony here and point out that my freelance job for the past several years has been developing training for pharmaceutical companies. What this meant was suddenly I was uniquely qualified to read and understand the Prescribing Information for my own cancer drug (you know, that multi-folded piece of thin white paper with the tiny, tiny print that you get inside every prescription box. Yes, Virginia, I actually read mine.) Ain’t life a kick!
I chose Friday as my weekly injection day, so I would have the weekend to deal with the promised side effects (fever, chills, nausea — the usual cocktail crowd.) As I was the first patient to receive this treatment at Weill Cornell, they wanted to observe me at the infusion center for the first 10 or so weeks. Pat, my regular infusion nurse, was the personification of experience, humor and grounded intelligence and would make anyone feel safe. So I happily offered up my arm week after week for my Sylatron dose.
Upon receiving the shots, there was an immediate reaction. First, a noticeable band of pressure developed around my head. Then, according to Eric who was always there to watch, I would sprout a pair of red “Spock” eyebrows while a flush traveled down my face, sometimes ending as a scarlet goatee. My blood pressure would spike and I definitely felt strange. Within 10-15 minutes, the reaction would lessen and once my blood pressure returned to normal, Pat would send me on my way.
I won’t lie. That first night, with a fever of nearly 104 degrees, as I hugged a huge surgical ice pack and struggled to lower my temperature while attempting to keep the top of my head from flying off, I wondered if I could handle this treatment. Luckily a combination of the cold embrace and a Bob Newhart rerun (“Life is a Hamburger,” the one where Carol announces her engagement to Don Fezler, an unemployed would-be poet) at least got me to sleep. When I awoke in the morning, things were much more manageable.
After the first eight weeks, the dose was cut in half. The benefit was some of the side-effects lessened. By week twelve I’d graduated to shooting up at home. Giving myself the needle was the easy part (it’s just like a sub-Q insulin shot) but mixing the drug properly required really paying attention! Luckily it all comes in a sweet little package with instructions and syringes so now it’s just what I do on a hot Friday night.
Well, that’s it. I’ve got cancer? I’ve survived cancer? I’m living with cancer? I’m not sure what my label of choice — if any — will be. What I do know is that a little sense of urgency can be very effective at driving the dramatic structure. So RIPE and I are back on the boards. Countdown to opening night.
So I invite you to stay in touch, and perhaps raise your glass in community each Friday evening as I’m having cocktails for one (on the advice of the manufacturer, not shaken. Just gently turned.) Hear that, Mr. Bond?