Laryngeal Cancer

I have been diagnosed with squeamish cell laryngeal cancer (cancer of the vocal chords). I know from past experience that having a family member or friend tell you about a diagnosis like this causes many questions. In order to answer those questions as completely as possible, I am putting all the information at my disposal in this post.

The first thing to know is that my prognosis is as positive as it can be. I have had a PET scan and a neck CT scan and they have confirmed that the cancer is stage 1 and has not spread to my lymph nodes, which is the first place it would go if it was more advanced. This means that the cure rate is 95% plus. I have had no other symptoms beyond hoarseness in my throat and have been functioning normally. This includes regular exercise, which for me means at least a 40 minute walk just about every day.

This cancer has nothing to do with the skin cancers that I have previously had removed. It is most often associated with long term heavy smoking and drinking. It can also be associated with the HPV (Herpes) virus. The biopsy was tested for the virus and came back negative and I do not have a history of smoking and drinking that would cause this issue. Thus, there is no firm explanation for the occurrence of the disease.

The lesion is dampening my vocal chords and this is why my voice is hoarse. Think of it as someone laying a hand over the strings of a guitar. The vocal chords vibrate just like the guitar strings in order to create the sound of your voice and the cancerous growth puts pressure on them, keeping them from vibrating properly.

Here is the basic chronology:

• In late May or early June I started experiencing hoarseness in my throat. This persisted and did not go away. After six weeks (give or take), I called my doctor and asked for an appointment. Rather than seeing me himself, he referred me directly to an ENT. I had to get tested for COVID before I could go to that appointment. That test came back negative.
• July 22, Initial appointment with Dr. Hamdan, ENT. He stuck a scope threw my nose and into my throat and told me that I had a hemorrhagic lesion on my right vocal chord. He scheduled a biopsy in order to check for cancer. I had to be checked for COVID again before the procedure. That test was also negative.
• August 7, Biopsy performed.
• August 17, Phone call with the preliminary news that the lesion was cancerous.
• August 20, Initial consult with Dr. Ansari, Oncologist and Dr. Tran, Radiologist. They both examined me and told me that the lack of any other symptoms or lumps in my lymph nodes meant the disease was likely stage 1 and thus highly curable. Follow up tests were scheduled to confirm the staging.
• August 25, PET and CT Neck scans
• August 27, Follow up with Dr. Ansari with confirmation that I am stage 1.

The local head and neck tumor board has their monthly meeting on Wednesday of this week. My case will be discussed and treatment recommendations will be finalized. I have another follow up appointment with Dr. Ansari that morning where the final decision on treatment will be made.

Treatment will be either laser surgery or radiation.

Surgery is less likely because it has the potential to damage the vocal chords permanently. The determination to do surgery would only be made if the doctors are completely confident that they can perform the procedure with no risk of permanent loss of my voice.

It feels 90% likely that the treatment selected will be radiation. I have already gone through pre-planning in the expectation that this will be case. They fitted me with a mask that will hold my head steady during the treatments by laying a piece of pliable plastic over my face (felt like a warm towel) and forming it tightly to my features. I get to keep it at the end so I will never have to wonder how to dress for Halloween again.

The doctors refer to this as the organ preservation option, meaning that it does not pose a serious risk to my vocal chords. This treatment would likely cause a long term change in my voice, making it deeper, but the voice should recover to near normal.

The treatment involves going into the office every day at the same time, Monday thru Friday, for seven weeks with weekends off. The treatment itself lasts about 15 minutes. I can drive myself back and forth so Denise’ day to day schedule will not be interrupted.

Side effects are fairly minimal and I should tolerate them without much problem.

• There is typically no diarrhea or vomiting.
• I will not be at an increased risk for COVID.
• Hair loss will be limited to the treatment area, so just the part of my beard around the Adam’s apple.
• My skin will be irritated in the area of the treatment. I will likely not be shaving my neck as I normally do and may look a little extra scruffy. I will be trying different lotions to see what helps best with the irritation.
• I will get dry mouth and will be using lozenges, etc. to try and alleviate that.
• At times, I will be more tired than usual. When that happens, I am just supposed to rest.
• For the first three weeks, I may actually feel better and my voice may improve as the cancer cells are destroyed.
• The closer I get to the end, the more the irritation in my throat will grow. My voice will come and go and my appetite will be effected. I have been told to feel free to bulk up a little ahead of starting the treatment but I can expect to lose a little weight by the end of the treatment cycle. (This is all good as I have already lost twenty five pounds on purpose with diet changes and exercise in the last few months and have ten more or so to go.)

Once the treatment is over, the expectation is that I will be completely cured. I will have to be monitored regularly going forward (the details of that have not been discussed yet), but I should recover completely and return to a normal life.

_______________________

Last November, I took a leave from my job as a construction project manager and never went back. I am effectively retired from the construction industry and currently have no plans to re-engage. I am a kept man and house husband with the very great blessing of a wonderful wife successful enough in her own right that she can provide our basic needs.

This leaves me free to explore a calling I have felt deep in my heart for some time now. While I am retired from the construction industry, I do not view myself as formally retired. This note comes to you from the blog I have started as the beginning of a second career as a writer on religious formation and whatever other topics such a vocation leads me to.

(Although I am describing this as a second career, in keeping with my vocation as a Secular Franciscan, I have no intentions of monetizing this blog. It will remain add free and focused only on providing the best content I can manage. This second career is one that I will not expect to ever retire from.)

This blog is targeted at ongoing formation for Secular Franciscans, but it is also intended to be of broad use to anyone interested in investigating a life of faith. It should be of help to any person, Catholic or not, looking to deepen their relationship with God. But it is also proving to be of interest (I have several subscribers already who are not deeply religious but curious about faith or self improvement in general) to seekers who simply want to better understand what runs through the mind of someone actively engaged in a life of religious questing.

I invite you to visit the home page and have a look around. Or listen to this podcast that introduces the site. There are also other podcasts hosted by a Franciscan friend of mine who used to work for Notre Dame Magazine.

The ultimate success of this venture depends on my ability to attract an audience. The best way to demonstrate that audience is to be able to point to subscribers. If you are at all willing to support me in this endeavor, I would ask that you subscribe to the blog using the link at the bottom of the home page. (I am only posting a couple times a week so you will not be inundated with an annoying number of emails or texts on an ongoing basis.)

_______________________

The other update on me to be aware of is, as the video above indicates, I have recently fitted out my van for camping. One of the advantages of my new career is it can be done from anywhere. I have intentions of going on multiple “drive-abouts”, so if you live a long distance from me, you might find me asking to impinge on your hospitality. (You might also see me add material to the blog related to the diversity and beauty of Creation, also a very Franciscan theme.)

After the loss of Aidan and Christy, and now this development in my health, I am keenly aware of how fragile life can be and the need to live it to the fullest. This includes following what I discern as my true calling, but it also includes catching up with many of you. We are approaching the point in our lives where we need to make moments count in the most meaningful ways possible. It still seems like we have plenty of time left, but it will pass fast. I’m hoping to see many of you soon despite the pandemic.

_______________________

Right after the initial news, my dad asked me how I was doing. I told him, “I feel fine.” He said, “I meant your mental state.”

As it happened (if you are religious, you will see this as more than coincidence), the next blog post I was due to write was on Chapter 11 of the Gospel of John. This post discusses in some detail the idea of “Sister Death” in the Franciscan charism.

Writing this post the day after I got the preliminary diagnosis was restorative to me. I was in a position of waiting. I was optimistic based on the little bit of reading that I had done that the prognosis would wind up as it has, but I knew it would take time to get there. With the news still fresh, it was impossible not to feel anxiety and I did not sleep very well the night of the initial phone call.

But the next day I edited (the basic post was actually written a couple years ago in my role as formation director for my OFS fraternity) and published the post. This proved curative in and of itself. Delving back into that material reminded me that even if I wound up with worse news than I was expecting, I was still loved unconditionally by a God who wants me to spend eternity in His presence.

In some sense, I felt like there could be no such thing as bad news when the final prognosis came. I was reminded that I am destined for eternal happiness and that I am working hard to fulfill that destiny. I believe I am on my way and that God will sustain me in reaching this goal. The only thing the news could tell me is that I might be getting there sooner than I originally expected.

I made the post and forwarded it to my Dad so he would know I was in a good place mentally. The prognosis I received makes it easier to stay in that good place. But I expect that even when the treatment gets a little tough, I will be able to stay in a positive state of mind by rereading that post or being inspired to write others. In many ways, this feels like it will be much easier than what I went through losing Aidan or Christy.

_______________________

I know without asking that I will be the recipient of an unparalleled onslaught of prayers. This is because I am fortunate beyond description in the people that God has placed in my life. Thank you in advance for every thought and prayer that you will send my way.

Be assured that I will be praying for each and every soul that is thinking of me in turn.