Exactly What's Going On Here?

It's official: I go in for surgery next Tuesday to remove the little spot under my left chin that the PET scan picked up and the FNA confirmed as MCC.

Dr. Guerrier, the radiologist, doesn't want to start radiation until four weeks afterwards to make sure I'm well healed, so that means I'm looking at the end of February (the 22nd to be exact) before I can start any treatment aimed at eradicating this stuff as opposed to picking off chunks that are visible to the naked eye.

It's aggravating, sure, but overall I'm glad it was caught before RT and chemo began.  Resection is still the best way to treat this cancer and it would a hundred times as disappointing to go through everything, be "disease free" for a few months, then wake up with a lump under my chin one morning.

So in the surgeon's office this morning, he reviewed the CD of my PET scan images.  And kept reviewing them.  And kept reviewing them.  Then he jumped up to palpitate my left neck and under my mouth, then looked at me almost consternated!  It's as if he didn't believe that there was a pea-sized bit of death hiding under my teeth.  He had reason to be confused: he couldn't feel anything like a swollen lymph node in my neck.   I had to show him on the computer screen where the tumor was!

The only reason I knew where it was, was because Dr. Gueirrer had shown me, and the only reason she knew was because someone who does nothing but look at PET scans all day had shown her.   Dr. Reintgen acknowledged that the bright spot I pointed at must be the MCC, but the only way he knew for sure was because of the FNA report.

My surgeon certainly isn't incompetent and neither are your doctors.  This is just an example of how difficult it is to practice medicine.  It's a wonder that anyone wants to become a doctor at all given how many variables and variations humans and diseases come in.  That's why I'm suspicious of medical "miracles" where someone is suddenly "cured" of a disease.  I think has less to do with miraculousness and more to do with the fact the we just didn't have it right in the first place. 

The more I get involved with this, the more I'm amazed at how imprecise medicine is!  I, along with everyone else, demand 100% surety from my doctor and his tools but that's just not reasonable.  After reading doctors' notes, lab reports, pathology reports and such, I noticed they all couch their results in language that seems to avoid responsibility.  Words like "suspicious for", "indicates that", "presents as", and "consistent with" -- these are not terms that inspire confidence in me.  Avoiding responsibility has nothing to do with it of course; it's that the human body is so incredibly complex, it's impossible to know exactly what goes on inside of it.  The best we can do is divine an approximation of what's happening with our crude tools and acknowledge that approximation with precise, imprecise words.
 
This has been one of the most frustrating parts of this disease.  I can tolerate some uncertainty and generalities in many parts of my life, but it's wearying in this aspect where the stakes so high.