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"Woe to me because of my injury! My wound is incurable! Yet I said to myself, 'This is my sickness, and I must endure it.'" (Jeremiah 10:19)
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I found out yesterday that I have cancer of the thyroid. I have had a goiter (enlarged thyroid) for seven years, and tests this year indicated a "cold nodule." I had surgery last Monday to remove the left lobe of my thyroid after tests could not determine whether or not the nodule was malignant. A pathologist performed a full biopsy of the removed part of the gland and diagnosed me with stage I follicular thyroid carcinoma (I am cobbling together the wording, so I may not have it exactly right). What this means in English is that I have a cancer that is rare, was caught early, and has the best survival rate (97% according to one source) of all types.
My surgeon predicts a full recovery.
I am scheduled to return to the OR next Wednesday morning. My surgeon will remove the rest of my thyroid gland. The cancer seems to be only in thyroid cells and was caught at an extremely early stage (I spoke to a pathologist today and he told me if he had to have a tumor he would want mine :-). The gland will be removed, then in six months I'll have a test that will expose any remaining thyroid cells in my body. If there are any, I will take a dose of radioactive iodine to kill those cells.
Those are the facts, and my spirits are optimistic. As an ad for a cancer support group put it, cancer is a word, not a sentence. I cling to the Bible's promise that all things work together for good to those who love God.
My surgery was two days ago, and it went well. I was out of the hospital the next day. I'll be taking a pill every day from now on to supply my body with a synthetic form of the thyroid hormone.
I looked up some more statistics on the Web. The mortality rate for all thyroid cancers is three out of a million in the whole California population, 1988-1991, according to one study. That broke down into no deaths for men my age, increasing as age increases, according to a more detailed data analysis from that same study.
I'm into the next stage of treatment.
Last Thursday I drank 29.9 millicuries of 131I. It's a radioactive isotope of iodine that has a half-life of 8 days. Seems that 30 millicuries requires isolation in the hospital. I'm probably emitting 1 or 2 millirads a day, although I haven't been measured.
Since publishing this journal, a few people have taken the time to write to me. Thank you all for your well wishes. I feel fine. The radiation treatment went as expected. No side-effects. I'm going in for a follow-up scan soon. I feel cured, thanks be to God!
I've been preparing for a routine follow-up thyroid scan. I have to be hypothyroid so that my TSH (thyroid stimulating hormone) levels from my pituitary gland are high (measured at about 34). My doctor put me on Cytomel about seven weeks ago. It's an alternative synthetic thyroid hormone like synthroid. But synthroid takes several weeks to get out of my system, while Cytomel is out in about 24 hours. That makes it easier to get the TSH levels up. It's all very routine, so I'm told.
Well, I should have had my scan a week ago. My TSH levels are over 100! Because of scheduling (mine, not the hospital's) I am only today taking my iodine scan dose. Then Wednesday I have the scan.
Last week I noticed that I had gained almost ten pounds. Then I started feeling sluggish. My muscles don't respond as quickly as normal. By last Friday my limbs felt heavy. Also, friends noticed last week that my voice had gotten lower. It sounds like I have a sore throat, but I'm in no pain. I called my doctor, who said it is "a secondary hypothyroid problem. It should resolve once I resume my medication." I don't feel especially sleepy. In fact, it's a little more difficult to get to sleep. I had to take naps this past weekend. The heavy limbs continued. I noticed that my jaw gets tired when I eat. I stopped chewing gum because that makes it worse. I remember the limbs and jaw from the last time I was hypothyroid. The worst symptom is some ringing in my ears the last few days. The room is silent as I write, but I hear ringing. Even driving without a radio it sounds like there's static. I had slight but chronic headaches last week, too. That's most unsettling. I'll remember if I have to do this again to make it a higher priority to get the test done and get back onto my synthroid promptly. I feel very out of sorts today. A little short-tempered, too.
My doctor called with my scan results. There's slight thyroid activity on the right side of my neck, but no activity anywhere else. Before the oblation last year, I was at 9.1% activity. Now I'm at 0.06%.
Catching up on my journal. Wrote this month's entries. Now that I've heard my last scan results, I feel very secure about my health. Yet I also am still coming to terms with what it means to live without a thyroid gland. I have a friend who knows someone who died of complications from hypothyroidism, which I would suffer from if I couldn't get adequate doses of synthetic thyroid hormone. My friend said it takes years. This person gained a great deal of weight and died from some organ failure -- the heart or kidneys, I think. The details don't really matter to me. What is sinking in is the phrase from the Lord's Prayer: "give us this day our daily bread." My "daily bread" seems to include a dose of synthetic thyroid hormone for the rest of my life. I'm not sure I'll have much motivation to write in this journal anymore because my treatment is over. I do expect to continue writing, though.
Have come to terms with a couple realities of being a cancer survivor:
Got e-mail about a woman with cancer. Was inspired to write about it in my newsletter.
Finally moved this journal to my new Web site after seven years. In the process, I eliminated broken links and did slight editing. Motivated to do the work after getting an e-mail a few days ago asking what it's like to live without a thyroid. I didn't think it was appropriate to say in my reply that it sure beats not living without a thyroid. But, hey, this is my journal, so I don't mind making that joke here. As I read my old entries I realized that it looked depressing to see the entries end in 1998. Rest assured, as long as I keep updating my home page, I'm still living without a thyroid. After that, well... Are you sure your parachute is going to open at the end of your fall?
As I was reading the Bible recently, Jeremiah 10:19 stood out for me. The prophet Jeremiah writes his lament to personify how all of Israel ought to interpret their suffering -- it is a consequence of their sin. That's a little heavy for one individual to bear. I am forgiven through the work of Jesus that was finished on the cross; however, I do find Jeremiah's words to be a helpful reminder of my condition. I decided to add them to the top of this journal to set the tone for what follows.
I don't accept that God always metes out specific punishments for specific sins today. ("You mean, you're open to the idea that sometimes he does?" Yes, why not? He continues to be active in history, so it may suit his design to get someone's attention in a dramatic way. Too many people tell stories with gratitude about something terrible happening to them that got their attention. They are also prone to quote Romans 8:28. He's no longer known as the wrathful God of the Old Testament, who had to hold Israel -- "a stiff-necked people" -- together long enough for the promised Messiah to come. Jesus reveals God to be the loving Father who disciplines his children for their own good.) Some suffering is a natural consequence of specific actions. For example, if you smoke, you greatly increase your risk of lung cancer. It's scientific cause and effect. If someone chooses to drink and drive, and she t-bones a car and kills an innocent child, the resulting suffering can be traced to that drunk driver's irresponsible choice.
Other suffering cannot be explained so easily -- and much suffering cannot be explained at all. But we are promised that in the new heaven and new earth there will no longer be any suffering. When it cannot be explained any other way, I accept that suffering in this world can be traced back to the The Fall, and I take comfort in the promise that suffering is absent from God's ultimate plan for his creation.
Science can explain many mechanisms of cancer, but it's natural for those who have it to wonder, "Why me?" It's hard to find a satisfactory answer to that question. When I need comfort, I can turn to Jeremiah's words.
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Last Updated: 13 April 2008
This document is http://alum.mit.edu/www/tbc/cancer.htm. Copyright © 1996, 1997, 1998, 2005, 2008. Tim Chambers, firstname.lastname@example.org, http://alum.mit.edu/www/tbc 1E4AF729D5CEFFD0. All rights reserved.