“Im in denial,” I said,
“No, you’re not,” he said. “You don’t like it and that’s understandable.”
I was in the Outpatients Clinic at Auckland on Tuesday and to my disappointment, my surgeon thought my inner cheek on which I had an operation in March, looked red and blotchy, a possible sign of cancer or pre-cancer in my case.
I had intimated to him that I didn’t want a biopsy although I don’t know if I said those words. I was in a busy week of a lovely busy life and I didn’t want to have the biopsy and wait the two weeks for the results. Irrational, but it was how I felt after about 8 HNC surgeries big and small.
“You’ve had a field change,” he said, trying to make me take it seriously. This means that a large area of cells around the last actual cancer are abnormal and at risk of mutating into cancer. And the last surgery, while it didn’t show a full cancer, showed “carcinoma-in-situ” in one biopsy and “double thickness dysplasia” in another.
My surgeon was unhappy about this (as well as concern for me, he has a professional pride in his work) but decided to keep me under close watch. When I went back to him on Tuesday I was feeling well, the prosthodontist had been doing a lot of work on me and hadn’t sounded any alarm and I’d had no symptoms like bleeding, pain or a lump.
I want to make it clear that I am not a typical patient; only some of us have a field change to the extent I have had. Or the repeated primaries I’ve had. This won’t happen to many HNC patients.
My heart sank when he went very quiet after looking into my mouth with his magnifying glasses. I’m a cancer vet so I could handle it and discuss the situation with him bluntly but I WAS disappointed. I yearned for a clear inner cheek.
I had forgotten that the last surgery had been low down in the inner cheek from my lower lip and along a little bit, quite close to the lower jaw on which I have a screwed-down dental plate. His decision, after pondering for a bit and lecturing me about the reality of my situation, was to see me in two months with the prosthodontist, unscrew the plate and take some biopsies of the whole area, “So I know what I’m looking at.”
This was a good outcome for me although I can’t see the prosthodontist having time for that. (Just my impression.) I had a repreive from the awful “biopsy and waiting for the results” thing.
When I wended my long, rainsoaked way home though and told others about it, it sounded as if I had been silly and had refused a biopsy when I should have had one. After all, if a biopsy DID come back positive, it wouldn’t be a big cancer and all I’d need was another little op.
I don’t think it was like that. a. If the surgeon had been worried he would have biopsied me or booked me in for a biopsy sooner down the track. b. we had a full and frank discussion. c. his decision to look at the tissue under the bottom plate at the same time is probably a outcome preferable to both of us.
Whatever happens, my gut instinct right now is that I’m okay but I had to write the story down to see it clearly.