Setting the Stage

The process of finding out I had cancer was very bizarre.

First, I needed to recognize the symptoms; in my case, by the time I had symptoms that were troubling enough to ask my doctor to schedule a colonoscopy, I was already on the highway to the danger zone. (I love you, Kenny Loggins!)

The day of the colonoscopy came and went, and then we had to await the biopsy results anxiously. It took an eternity (also know as three days) to get the pathology results, which showed the samples were malignant, a fancy way to say “its cancer.”

Now there were more questions to answer, the first being what type of cancer do I actually have, rectal or colon? At the time, I didn’t know there was a difference, but it turns these are treated differently. In a nutshell, it depends where the tumor sits in the large intestine. If its closer to the exit, its rectal cancer, if it’s past the first turn, stage right, its colon cancer. I took the liberty of mapping out where my newly discovered “buddy” resides. Of course, the little jerk is positioned right on the border so they couldn’t determine which type I had during the colonoscopy.

Based on my understanding, rectal cancer typically can be treated with chemotherapy, radiation, and surgery, whereas colon cancer usually is treated with chemotherapy and radiation only since radiation could harm the small intestine and surrounding organs. (If you happen to be a medical professional reading this, feel free to chime in in the comment section below!)

The second question we needed to answer was staging. Simply put, staging determines how deeply my little “buddy” has dug in, and if it invited others to the “try to kill Ben quietly party.” I’ll describe staging in more detail later in this post, but most people typically refer to the overall stage, which gets a number, 0-IV, IV being the most severe. I assume they use Roman numerals because they charge insurance companies by the character. To get the staging and positioning questions answered, I needed to have an MRI and CT with contrast.

So… away I went to the radiology clinic to have my scans done. When I got there, they started an IV since both of the scans required IV contrast. If you are wondering, contrast helps radiologists see things better on the scans. So, once I was sufficiently skewered, I headed off for an MRI.

If you’ve never had an MRI; it is quite the experience. I got strapped in and hooked up to the contrast machine, and then plunged feet first into the mother of all dubstep concerts. Seriously, if you never heard dubstep, take a listen. Now compare it to the sound of an MRI. The unfortunate thing, is I happen to like dubstep. Now regular concerts, that don’t rattle my liver are going to be pretty lame compared to these $15K dubstep scans. Anyway… I digress. The MRI took about an hour, and then it was off to the CT scan.

The CT scanner can’t dish out the sick beats like the MRI machine, but it had another type of surprise for me that didn’t disappoint. Before the CT scan, I had the pleasure of drinking a barium contrast smoothie, which looked like a bottle of milk and tasted like a tangy radioactive vanilla smoothie. It’s probably not going to make the cut for the DQ Blizzard of the month… After my smoothie, I was off to the CT scanner. Once I got into the room, I assumed the position on the bed and was hooked up to the IV contrast machine. After a few quick images were taken, it was time for me to empathize with every 50-something female on the planet by experiencing 3 minutes of menopause. I told you the CT scan didn’t disappoint. Unlike the MRI contrast, which felt like nothing, CT contrast puts up a fight. Within seconds of the contrast being injected, it felt like someone opened the doors of a blast furnace (or glory hole for my glassblower buddies out there) inches from my body. The contrast also went for bonus points by making it feel like I was pissing my pants. A few minutes later, the scans wrapped up, the menopause wore off, and I checked my scrubs to make sure I didn’t actually wet my pants (I didn’t).

A few days later, I returned to the doctor to review the results of my scans. First, the good news, the CT scan showed the cancer had not spread to any other areas of my body. Good ass cancer, STAY! Based on the position of my tumor, they told me it is rectal cancer.

Finally, staging. There is a lot of magical voodoo that goes into assigning staging to rectal cancer. In a nutshell, it has a lot to do with how deep into the large intestine things have embedded (T), how many regional lymph nodes are impacted (N) and whether or not it has metastasized anywhere else in the body (M). Each of the criteria is given a score, and then it is assigned an overall stage. The Magic 8 ball showed that I have T3aN1M0 CRM clear by MRI. Clear as mud, right? That formula boils down to me having stage IIIB rectal cancer.

Based on some discussions with the general surgeon that initially discovered the mass, this usually means 8 cycles of chemotherapy (~4 months), followed by 5 weeks of chemotherapy + radiation, followed by surgery 6-8 weeks after everything is healed up from my chemical bender and ass blasting. It’s going to be one hell of a summer.

TL;DR: Docs put a camera up my butt, cut out a few chunks, took some expensive pictures in machines that simulated a bender at a dubstep concert, and then told me I have stage IIIB rectal cancer.