Recurrence

As I mentioned in my previous post, cancer an be a tricky bugger. My original surgery was in June of 2011 and everything came back positively enough, that myself and my wife were able to breathe a sigh of relief and hopefully put this all behind us and continue with our lives. As the oncologist explained to us, there was a chance of the cancer returning, but the odds were still good and in our favor. We chose to take the preventative maintenance route by watching my skin and getting routine testing done.

One year later I started noticing a lump under my skin near my groin. Because of my history of cancer, it bothered me a bit but I also wanted to stay positive in my thinking. A few things helped me get by. First, the results of my surgery were good enough to safely assume it might be something else. Also, it was developing right where my incision scar was when they performed the sentinel lymph node biopsy. I chalked it up to maybe a build up of scar tissue or possibly an infection. Lastly, I had the misconception that if my cancer recurred, it would show up in one of my vital organs. Since I was scheduled for another oncologist visit in a few weeks, I decided to hold out until then and have him take a look at it.

On the visit he mentioned it looked worrisome enough, given my history, to get tests scheduled to determine what it was. I saw a different surgeon nearby who did a fine needle aspiration, to determine whether or not the lump was caused by an enlarged lymph node (which is usually tied to some sort of infection), a cyst, or a cancer nodule. He also ordered me to get a PET scan.

To anyone that has ever had a CT scan, or knows how it works, a PET scan is pretty similar. The biggest difference is that PET scans are specifically designed to search for areas of your body which are metabolically active. This makes them uniquely qualified to find cancer. Essentially it makes a map of your body and using a special radioactive glucose isotope, will show hot spots of activity. Imagine your body as a weather map. Empty spots show no activity, while active areas will glow with different intensities. So imagine watching a weather report and seeing a bright red spot heading your way, you know something big is happening there, while areas of blue might be just a spot of light rain. When spots appear where they shouldn't be, it's an indication that cancer is developing.

After a week, we got the results. Both the biopsy as well as the PET scan concluded that the lump was in fact a melanoma tumor. The biopsy would have been conclusive enough, but we needed to make sure it hadn't spread anywhere else. The good news was the PET scan was clear otherwise, showing no other spots throughout my body. At this point my cancer stage was upgraded from Stage 2 to Stage 3. This meant I had a recurrence, but it was localized near the original site and not in any major organs (it was actually growing inside a lymph node in my groin).

We were able to get scheduled for a surgical appointment quickly. I mentioned a possible third procedure when I had my original surgery if the sentinel lymph node had reported as positive. This operation is called a lymphadenectomy or commonly known as a lymph node dissection. There is an area in the groin which a cluster of lymph nodes resides and they would go in and remove all of them. They showed no signs of activity on the PET scan, but this was to rule out any microscopic areas which don't show up on routine scans.

Since this surgery involved a more extensive procedure, I would be required to stay in the hospital up to a week for recovery. The operation turned out to be successful, removing the tumor site and extracting 11 nodes with each one reporting back negative for cancer. Again, as before, I was "clear" of any visible traces of the melanoma in my body. The recovery was similar to the first time, as the incision was painful enough where I couldn't walk for a few weeks without some support. The biggest side effect I would have from the operation would be lymphedema, which is a build up of fluid in my leg and groin because the lymph nodes would no longer be there to remove it. In fact, even today I still wear a full length compression stocking, which helps prevent the fluid from pooling up.

We were hoping at this point my fight would be over, but we were just getting started.