April 10, 2024

Update on yesterday, after this recap of the story so far for those who missed it...

Have had a bump on the top of my head for about half a year that I thought was an infection that might go away. Then I noticed a knot on the back of my head behind my left ear in January. Had my doctor check them out, but she was stumped. After ultrasounds and biopsies, turns out I have melanoma on my scalp that has spread to a lymph node behind my left ear. PET scan showed I also have a nodule in my thyroid and two more in my lungs. Those may or may not be related to what's going on on my head. Had my first visit with an oncologist two weeks ago who says likely course of action is to remove the known lesions surgically and then follow up with targeted radiation, depending on what the thyroid and lung nodules turn out to be.

Monday I had an MRI on my brain because a PET scan reveals nothing about the brain. Also had an ultrasound on my thyroid.

Yesterday I had a visit with a pulmonary doctor to get started on what's going on in my lungs. He's ordered a CT scan to get more detail on the nodules there. After that, he wants to do a bronchoscopy so he can get samples of the nodules to biopsy and determine whether they're cancerous or not. If they are, he says they'll likely have spread from the melanoma rather than separate lung cancer. Apparently I quit smoking long enough ago and at a young enough age that I'm practically at the same risk as the average person for lung cancer.

Saw the oncologist again after that to go over the MRI and ultrasound results. Nothing out of the ordinary on the MRI. Ultrasound confirmed the nodule in my thyroid, plus one more that didn't show on the PET scan. Radiologist was unconcerned about both, but one doctor or another wants a biopsy to make certain it's not related to the melanoma.

Then I went on to a radiation oncologist for a chat about what we know so far, and potential treatment plans. The tricky part in my situation is that I've had a kidney transplant, so my immune system is suppressed. Usually, there is an immune therapy component to cancer treatment, but revving up my immune system obviously is the exact opposite of the suppression that keeps my immune system from attacking my transplanted kidney. She said she's having a conference with the oncologist and a surgeon I've also seen to talk strategy today. She thinks what will likely happen is surgery to remove the melanoma and the lump on the back of my head, followed by a 6 week regimen of targeted radiation. There is a possibility that the immune therapy may need to be brought in, and I discussed what that means for my transplanted kidney. There could be a point where I have to decide to sacrifice the kidney to deal with the cancer. I said I've already been thinking about that, and I will choose whichever option benefits me most in the long term. But that's a later on question.

This afternoon I go in for the CT scan, which will likely be followed up very soon with the bronchoscopy. Thyroid biopsy happens on May 1. After that, from what I gather, they should have the full picture and will know what to do from there.

I'm taking all of this pretty well, in a way that surprises me. I know if I hadn't already gone through the kidney process, I'd be having a harder time. I learned a lot about how to deal with my own emotions and what to focus on to keep fairly calm and rational about things. It's definitely scary, and it's a LOT to get my head around, but there's a process and a half dozen or more doctors all working in tandem on this, and that's very reassuring to me. My impression is that this has been caught somewhat early. It's been long enough to spread, but they all seem to think they can take care of their part in it.

More updates as they develop....