...and so it begins again...

Unfortunately, the time has come again that I will be utilizing the blog post to attempt to keep my sanity about everything and try to keep everyone who has any interest up to date as to what is going on and how everything is going.  I definitely found this to be rather therapeutic during chemo and radiation the last time, and so as I launch into the next round of resections and recoveries and controlled poisonings and Chernobylesque levels of radiation exposure, I hope to continue this as a means of release and a source of information.
Slightly over 2 months ago, I had a CT scan of the head and neck as a normal follow up procedure and, at that point in time, my images were unremarkable and all seemed right with me and the world.  Fast forward to last Monday, April 14th when I was at my ENT surgeons office complaining of a lump at the base of my neck that was starting to concern me.  Maybe it was there in some form or fashion for a month, but I can't be sure of the date that I first noticed it.  He was rather concerned and did his obligatory through the nose throat scoping but then also performed an ultrasound guided needle biopsy (sounds way more glamorous than it actually is) to assess the cells that made up the mass.  For anyone unfamiliar with this procedure, imagine taking a needle and inserting it slowly into some part of the body, say the front of the neck, then wildly jamming it in and out and back and forth for 15 seconds before removing said needle and repeating a couple more times for good measure.  Put lightly, it is not my favorite diagnostic procedure.  I leave his office and find out later that he is concerned enough that he called my doctor at MD Anderson and recommended I have yet another surgery pronto even before any results came back.  Thus began the current iteration, the outcome of which is very indeterminate and the road ahead is filled with great uncertainty.  Everything this round will be done through MD Anderson.

Needle biopsy supplies

Now for some details on the current plan to go about treating it this time.  The first step happens this morning and is a two drug chemotherapy concoction that I will be getting in hopes that the tumor responds by slowing its rapid growth or hopefully shrinking some prior to surgery.  The two chemo agents are CARBOPLATIN and DOCETAXEL.  This will be followed by a shot at least 24 hours later that I believe is for nausea, but I must say I don't quite remember.  I will have yet another surgery on May 13th.  I have two tumors at the base of my neck, one growing around the thyroid and pressing against my trachea and the other is just behind my right collar bone.  The surgery will remove my thyroid, the tumors and anything else they determine needs to come out.  They will also be taking a "palm-sized' portion of my skin in the affected area and a plastic surgeon will be part of the surgical team to reconstruct anything in my neck that will need it and to graft skin from another part of my body to my neck.  Once surgery is complete I will be allowed to recover for a bit and then they will again administer daily radiation to my neck in combination with chemotherapy.  For the type of cancer I have, the radiation is the primary treatment and the chemo is systematic and more a secondary treatment to work with the radiation.  This cancer does not respond very well to chemo alone so the radiation is the best treatment for what I have.  It is a very risky proposition from what I understand re-radiating an already radiated part of the body and the risks are great for very debilitating and permanent damage to all of the soft tissues involved.  To that end, I am pretty sure that MD Anderson is one of the few places around that would even attempt to do what they are about to, so I am at least fortune in that regard.  They are still treating this a localized recurrence since it is still contained in my head and neck region and as such they feel they have some chance to actually get it this time.  Chances are very high, however, that this will return and the fear would be it showing up somewhere else in my body (lungs are the ultimate destination for this type of cancer).  If it progresses to that point, there is very little that even they can do or attempt to do for me.  I can only hope that the third time is the charm and that we can miraculously get this out of my body once and for all and that my overall quality of life after this round of treatments is not so impacted that things become tremendously difficult.
In the coming days I will try to update as to all the life changes that have occurred since my last round of posting as much good had been happening prior to this most recent diagnosis.  I got a new (awesome) job that I am enjoying immensely, we spent Christmas in San Francisco, we were about to sell our house in Katy and buy one on the shores of Lake Travis northwest of Austin...much was happening but now we revert to a holding pattern until I can get this health business under control.