Squeamish, Squamous

Within two days of each other Jeff and I were both mistaken for fitness buffs.  A member of our church thought I was a gym teacher (she doesn’t know what gave her that idea; nor do I since brisk walking is my game) and Jeff’s oncology nurse, Heather, tried to recruit him for a 5K run to benefit Be The Match bone marrow registry.  We had a good laugh about it and were maybe a bit too proud that we could pull off these misconceptions.

Dr. Samimi and Jeff spoke at length on the phone to discuss the results of his skin biopsy.  Rosie played happily on Grandpop's lap as he tried to take in the details.  He called me afterwards and told me, “The type of cancer I have sounds like ‘squeamish’ but it’s not.”

A quick Google search of skin cancer and there it was:  Squamous Cell Carcinoma.  He has two significant risk factors – radiation and immunosuppressant use.  This cancer tends to recur and puts him at higher risk for other skin cancers.  Mohs surgery on the biopsied area later this month (a whole-day procedure of scraping and scanning, scraping and scanning until no cancer is detected at the margins of the tumor) as well as regular visits to the dermatologist are warranted.

The sores on his face, the result of topical chemotherapy, are quite remarkable in quantity and appearance.  Other patients might hide indoors for a month but Jeff takes it in stride.  He says, “When I look out of my eyes, everything looks the same as usual.”  When he is out in public, he forgets that he looks diseased until he catches someone staring at him.  I like his attitude.  It means we can carry on as usual.  No hiding.  He admits, however, that he finds his reflection alarming.  If you are squeamish, do not scroll to the photo at the bottom of this post.

Jeff seemed discouraged by this new development.  “This is bad,” he said.

“Not at all,” I said.  “We caught it.  People don’t die from skin cancer if it’s treated.”

Jeff began to list the people we knew who had died of skin cancer.  Well, there were more than I realized and the fact that he could list them so readily gave me a glimpse into his deepest thoughts.  For most of those people – as for Jeff, skin cancers were their secondary cancers.  A good reason for diligence.

At Dr. Porter’s office this week, Jeff was tempted to pull an early April Fool’s joke on Heather and Dr. Porter by allowing them to comment on his scary, scabby face and then pretend, “What do you mean?!  Is something wrong with my face?!”  He didn’t joke, though.  Heather was able to offer more information about Mohs surgery and helped to alleviate some of Jeff’s anxiety about it. 

Jeff’s blood counts were good.  Dr. Porter is also monitoring immunoglobulins (antibodies).  If Jeff’s are low, he will need an infusion to boost his immune system.  I think this is what Doug Olsen (one of Dr. Porter’s early CART19 patients) has to do every three months.  Doug says it is no big deal.  Evidently, the results were good because the infusion was not ordered.

In a strange collision of three worlds, we were asked by Gift of Life to run a swab station at the national college fencing tournaments (our youngest son, Keith, was a fencer) which is to be held at Bensalem High School (where Jeff and I met).  We are looking forward to hearing the clinks of foils and epees (although perhaps not the beeps of the scoring machines) and to see our old high school. 

Halfway through treatment