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Chemotherapy

My Semicolon Life: Good news on the cancer front

USATODAY
  • Music critic compares his CT, pathology reports
  • Chemo's off the table for now
USA TODAY music critic Brian Mansfield, left, and singer George Strait at the Country Music Hall of Fame.

When USA TODAY's Nashville music critic Brian Mansfield was diagnosed with colon cancer at age 48, he figured that a lifetime of Southern-fried foods, extra-large sodas and stress eating on deadline had brought it on. Turned out he had a genetic syndrome that gave him an 80% chance of developing colon cancer. He'll chronicle his life with the disease -- and with only a small part of his colon -- in a series of weekly installments.

I thought by now I would have seen an oncologist.

It's the weirdest thing: When I got diagnosed with colon cancer back in June, every doctor I saw told me about these great oncologists they could send me to. Then, after the surgery, they just quit talking about them. Nobody ever told me not to see an oncologist, they just stopped bringing up the subject.

When my surgeon visited me in my hospital room after the operation, he said that I might not have to undergo chemotherapy. But I figured I'd at least consult with an oncologist. After all, I had a doctor -- my gastroenterologist -- in charge of finding the cancer. I had another -- the surgeon -- in charge of removing it. Surely it was a good idea to have a doctor in charge of the cancer itself. That only made sense, right?

Now, I have a natural inclination to want to avoid people who can pump poisons into my body, even if those poisons might help me in the long run. But oncologists were on my mind last week after I finally thought to ask for a copy of my post-surgery pathology report. I had gotten great pictures, some of which would make wonderful Halloween avatars for my Facebook page, but for some reason it had never occurred to me to look at the report about what my surgeon had found when he cut me open.

The report from my CT scan and my pathology report sound like they're talking about two different cases.

My stomach sank after I saw my CT report. It talked of enlarged lymph nodes and suggested my tumor might have extended beyond the bowel wall. Based on that report, my surgeon anticipated at least a Stage II cancer. I would have considered myself fortunate to get Stage IIIA, where the cancer's either in the muscle layers of the colon and one to three lymph nodes or it's in four to six lymph nodes but not in the muscle. The more I read the report, the more I steeled myself for worse news.

The pathology report, by contrast, read like the next best thing to "happily ever after." The tumor didn't get beyond the wall. It didn't get into any of the 36 lymph nodes removed and tested. It didn't get into the blood vessels. There were no signs of cancer in the surgical margins.

Basically, it was just a big ol' tumor that hadn't gone anywhere. No wonder I had friends tell me my surgeon came into the waiting room practically skipping.

The only thing in the pathology report that threw up a red flag was a separate polyp that my colonoscopy hadn't caught. But my surgeon had taken that out along with my tumor, my appendix and most of my colon, so it wasn't going to be creating any problems in the future.

At my two-month post-surgery checkup, I asked my surgeon if he planned to send me to an oncologist. He shrugged off the idea. He'd send me to one if it eased my mind, but he'd be perfectly happy to handle all the necessary future screenings in his office.

As for treatment, "there's some debate about whether Stage II patients should have chemotherapy," he says. "Nobody thinks Stage I patients should."

Well, OK, then.

Until cancer decides to pop back up inside my body -- and that could be a year from now, or 15, or 40, or never -- I'm done with treatment.

We'll keep a vigilant eye out for potential trouble, and we'll start with the findings of that first CT report. My right kidney has a nice-sized cyst on it, but that's probably no big deal. More worrisome is the "nodular focus" near the base of my right lung. "A metastatic focus cannot be excluded," the report states. In other words, might be nothing, might be cancer.

In three months, I'll get another CT scan to take a second look at my lung. Six months after that, I'll be coming up on my one-year cancer anniversary, which we'll celebrate with two big jugs of Gatorade and another colonoscopy.

Those things are months away, though, and I can't do a thing about either of them right now. I can, however, help a 10-year-old plan her long-awaited and once-delayed trip to New York.

We leave next Saturday.

Music that makes me want to live

Cancer has changed the way I hear music, more than any other life event except marriage. Songs I once appreciated only on a surface level now strike deep at the core of my soul. Some inspire me; some terrify me. Others that I might have liked before I've got no use for now. I've also got more time to listen, whether it's during my morning exercise time or while lying in a hospital bed. These songs form part of the soundtrack to my cancer story.

1. Thankful N' Thoughtful, Bettye LaVette

2. Founding Fathers, Will Hoge

3. Every Road Leads Back to You, Richie Sambora

4. Live in This City, Dragonette

5. Lover of the Light, Mumford and Sons

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