Hairpin Turns

I like the old way I thought
I was hanging in there
You held back the worst rain
From my shoulders then

What are we going through, you and me?
Every other house on the street is burning
What are we going through, wait and see
Days of brutalism and hairpin turns

Your nervous throat clicks
And my spirit swims right to the hook
You go quiet and leave me in the wake
Of a terrifying look

What are we going through, you and me?
What is it you want me be to be learning?
We’re always arguing about the same things
Days of brutalism and hairpin turns

Say it like I was right in the room there
And I’ll say it like your head was on my shoulder

And I’ll keep my eye open
And I’ll keep my eye open

The National, “Hairpin Turns”

“Overall, things are looking pretty stable. And that’s a good thing.”

Moments earlier, my phone had lit up with my doctor’s name and I braced for impact. My brain is already looking for patterns; for red or green lights to signal the news to come. He usually only calls when there is good news.

And, in fact, it was. Stable means no significant growth or shrinkage. Stable means no new metastasis. Stable means that I get to breathe again, to be the tiniest bit carefree. Until the next set of scans come in. My husband, listening to the other end of the phone call rises and I can hear the tension release from him as he sighs and embraces me.

For two days, the world is less heavy. The “what ifs?” start creeping in. What if I can stay stable on this line of chemo for a longer term? What if this roller coaster can convert itself to the scenic train ride that circles around the park for a while? We open our hearts to the “H” word, even though we should know better. We should know that with metastatic cancer there is always a hairpin turn just ahead that leads into a dark tunnel.

That hairpin turn came much sooner than we thought. For those who have read my posts titled, “How to Survive Stage IV Cancer” parts 1, 2 and 3, you will know that I always insist on getting a copy of the written report of your scans. Because there will almost always be parts of that report that your oncologist will not tell you about. Theae are things that don’t explicitly say CANCER (not yet, anyway), but which you will need to be aware of, keep your eyes on, ask about and monitor yourself.

Knowing this to be true, I drive out to the hospital on a Friday afternoon and play musical chairs in the hospital parking garage for 10-15 minutes so that I can pick up a copy of that written report and disk before the weekend. I fill out the form, sit back down, and then wait for my name to be called. I sit back down in one of the waiting room chairs to rip open the envelope. Black words on white paper arrange themselves into the standard report format and jargon:

RETROPERITONEUM/PERITONEUM/PELVIS: Interval resection of the large solid and cystic mass present within the pelvis on the comparison CT. However, there is an 8.9 x 3.3 x 5.6 cm lobular cystic mass at the left adnexa. IMPRESSION: A cystic neoplasm at this site is a possibility.

I stare at the words in disbelief. What.The.Fuck. What-the-ever-loving-fuck? I just had major surgery to remove a 16.9 cm mass in my right adnexa. Now you are telling me that there is a 8.9 cm mass in my left adnexa? Welcome to metastasic cancer, where there will always be something new to discover with each test and scan that ends up leaving you more questions than answers.

Is this part of the previous “giant glob” (as my surgeon described it) that was my previous mass and the surgeons didn’t get it all? Is my left ovary in that mass somewhere after all? The scans don’t specifically say that both ovaries are missing. Is this a new growth since since my last surgery?

I google cystic neoplasm: Cystic neoplasms include benign entities such as serous cystadenomas (SCAs), premalignant cysts such as intraductal papillary mucinous neoplasms (IPMNs), and cystic lesions with invasive carcinoma. So… basically this could be anything. Thanks a bunch, Dr. Google, for clearing that up.

Immediately I realize how silly we were to march out the “H” word so soon. Surgery is never clean with my cancer. Scans are never clear with my cancer. Why on earth did I expect this to be any different? Hairpin turns are built into the system. Metastatic cancer is considered to be incurable for a reason. It’s a giant game of whack-a-mole. Surgery, chemo, radiation, and trials are giant padded hammers. As soon as we furiously manage to bop one mole in the head, we turn to see that another has just popped up in another location.

My synopsis reads as follows: Woman goes in for combined HIPEC/Liver wedge resection. Tumor burden reduced significantly, but there is still cancer in both areas. And now there is a tumor rapidly growing on her right ovary causing damage. Woman goes in for surgery to remove THAT tumor, both ovaries and possibly her uterus. Unfortunately, her blood pressure keeps dropping and she requires additional units of blood, so they remove the “giant glob” and then close up and get out of there. The 16.9 cm tumor on the left is now replaced by a mystery “cystic mass” already 9 cm long in her “left adnexa.”

Of course, I know why my oncologist didn’t bring it up. Anything short of “suspicious for malignancy” doesn’t usually make the radar for things that he tends to decide to mention to me. And now I have a whole new set of “What ifs.” What if this mass in my “left adnexa” grows (or continues to grow)? What if I don’t find out again until I end up in the hospital with an infection or something worse because it is now encroaching on my left ureter or something else? AAARRRGGH!

I am a pro at this now. I can predict how the next week will go. I will ask the oncologist about it when I see him next Thursday. I have stuck with him because he has a good bedside manner and also the patience and willingness to listen to my concerns and questions. He will downplay this. He will explain why he thinks that it isn’t anything to worry about right now. He will then refer me back to the surgeon for further questions, before asking me to get up on the chair so that he can do his examination. And the surgeon? Well, I don’t see him again until early March.

So I am still riding the roller coaster. I am still navigating those hairpin turns. I am still arguing about the same things, and fighting the same fight on repeat. Maybe this is nothing at all. Maybe it will do nothing at all. But I know better. And I’m keeping my eyes wide open.

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