I'm cancer-free. At least that's what my last "tumor marker" test showed after a few weeks of intensive treatment with radiation and chemotherapy.
The test result caused my oncologist to smile — a rare sight.
Call me a skeptic, but I wanted to know more about the test and its veracity. The radiation doctors (three or four of whom I saw during my 5.5 weeks of daily treatments) had told me several times that this test, called CA 19-9, is considered accurate only if a prior test has shown an elevated level.
Some people are just not sensitive to the test. Furthermore, I had read that it is only accurate in a diagnosed case of pancreatic cancer, which in my case, it had been explained to me, was in question.
"It might be or it might not be [pancreatic cancer]," the radiation doc said to me one day, out of the blue. "We'll never know for sure, but I think it is."
This statement had been nagging at me for weeks when I finally saw for myself the results of the post-surgery biopsy. Puzzling through the medical jargon, one thing was clear: The tumor wasn't in the expected location. It was next to the pancreas, not in it.
But could it have sprung from it? A special test was ordered to determine this, and it indicated a tumor of pancreatic origin. So that tipped the scales back to the middle.
So this explained the doubt in the doctors' minds. At this point my question was: Did the tumor marker test mean anything?
So I hunted down a prior test — taken before any chemo or radiation treatments — and it showed the same number. Exactly.
The "normal" result for this test is 0 to 37. My number in both was 17. Did this mean I'm not sensitive to the test? Is it worthless? Apparently not, or my oncologist wouldn't have been smiling when she gave me the results, right?
But why wasn't it zero? I asked her. If I'm getting all these treatments, it should wipe out the cancer cells completely, no?
"Everybody has cancer cells," she reassured me. "Your number is normal. I could have that number. That's good."
So was I cancer-free before the exhausting and debilitating treatments? Did I really need to subject my body — after a difficult surgery — to the further assault of radiation and a 24-hour infusion of chemotherapy?
Should I have gotten the proverbial second opinion before embarking on this treatment? Maybe. But in dealing with a serious illness, you have to listen to what is not said, as well as what is.
The first time I saw my oncologist, weeks after surgery, her face was grim. She thought I was stage 4 — the worst case.
This was because she thought she saw something on my ovary indicating the cancer had spread. It had not; I am 100% sure (and tests confirm) that I do not, at this time, have ovarian or any other kind of cancerous tumor. I've been scanned and probed for tumors virtually from head to toe.
As my oncologist explained it, that's why they are attacking the cancer at the cellular level, "mopping up" with an overall preemptive strike, like fire retardant dropped from an airplane after a wildfire. My body is a forest; embers of cancer cells might be lurking and every effort must be made to wipe them out before they spring back to life. It's a good analogy and a strategy that makes sense to me.
But there is that question: What kind of cancer was it that my surgeon so expertly and thoroughly removed? And if it wasn't pancreatic cancer, which is my hope, then how do I know it's gone? Where is the test for that?
"We'll keep testing you for three years," my oncologist said. (I thought the standard time period to declare a patient cancer-free was five years, but in my case, apparently three will do. Why?)
It was news to me that everyone has cancer cells in them — that we all, in essence, have cancer. But in most people, these cells — which are dangerous because they can proliferate out of control and cause growths that become tumors and invade organs — are kept in line.
Why the cells sometimes go haywire and decide to make the body their playground is the reason so much money is being spent on cancer research. No one really knows. Environmental factors, heredity, diet and stress all no doubt play a role.
There are still so many questions.
CINDY FRAZIER is city editor of the Coastline Pilot. She can be contacted at (949) 302-1469 or firstname.lastname@example.org.