I have met with two doctors now, the first gave me 90% odds that I have lung cancer, the second, the surgeon who will do the actual operation thinks most likely I do not have lung cancer. In a slightly strange coincidence, my first doctor: Dr. K. Patel works out of a small two floor office building with maybe 3 or 4 offices, on the floor over his is housed another Dr. Patel -- Dr. H. Patel (no relation). Dr. K. Patel refers me to a surgeon Dr. Lo. Dr. Lo is in a one floor two office building, Dr. Lo the surgeon in one, Dr. Lo the psychiatrist in the other (I don’t know if they are related). I accidentally entered Dr. Lo the psychiatrist’s office first (directly off the parking lot), and the first thing I was asked "Are you here for Dr. Lo the surgeon?" I answered yes, and was instructed to go around the side of the building. I enter the correct office this time and inform the receptionist that I’m there to see Dr. Lo. Her first question: "Are you here to see Dr. Lo the psychiatrist?" "Ummm, no... Do I look crazy?" I reply in my best deadpan. It is evident they are really used to this common office confusion. It is strange the entrance ways, which are not visible one from the other, do not point out more clearly that there is another entrance for another Dr. Lo close by and what specialty.

This has been moving week, I will post more about this soon. The new apartment should have much better air – a prime requirement given my questionable health status. The speed of the move due to trying to get it done while I still had two fully functional lungs. And now it looks more likely I will get to keep both lungs anyway. Still I’m sure Nian will like the new place much better.

I had been tempted to go with another leading picture insert, Jeremy Irons, playing both rolls of twin doctors in "Dead Ringers" but it was a little obscure, and too dark in title.

Gotta go… Still moving boxes, boxes, boxes.

Tomorrow marks two events of significance. At 4pm I'll talk to a surgeon about when my upcoming operation will be scheduled. I hope to bring up the subject of how best to preserve as much lung function as possible. The rest of the day before and after will be spent moving to a new apartment. I'm not inclined to believe my current abode is the cause of my lung cancer, but I promised Nian I'd move. She believes my below grade apartment creates an unhealthy air. This may be true in part, as my carpeting was underwater last year when the storm drains failed on this end of town during a sustained rainy day. This is not the first time the carpets have been saturated with water, having also been immersed to a lesser degree when pipes from the apartment above gave way, not once but twice. As such there is no saying they might not indeed have some degree of mold infiltration. Being below grade might also increase radon levels to unhealthy degrees.

All this said, a move now probably comes too late to be of much good even if my apartment is implicated to some degree in my condition. Still, I promised Nian. Even if my lungs could suffer such assault before, best to live in better air once I'm down 40% in lung capacity. I had been planning on having the carpets replaced in any event should they be a factor in my recently diagnosed asthma, but might as well move if you have to go through all that confusion anyway. My current landlord has offered help in the rush job of a move to a second floor apartment within the same complex. It is a newly remodeled unit, so it is a small step up in accommodations as well as height. Not exactly a deluxe apartment in the sky, but a place in the sky is exactly where I'm trying to avoid (I'll have to explain this reference to "The Jeffersons" to Nian).

Nian has me on a garlic treatment of sorts, or at least a health adjunct. I have been soaking cloves of garlic in Chinese vinegar and downing them raw. I know garlic is reputed to be a healthful food and full of anti-oxidants (everything seems to be full of anti-oxidants these days). I can't say I have high faith in the effectiveness of this practice, but I can't really say my usual life style has much proof of being healthy enough, a thing Nian was concerned with before this recent turn of events. The stuff tastes vile straight, but I don't really see how I could refuse Nian this small request at taking a possible palliative.

Given the volume and potency of the garlic I'm downing, I've no doubt my coworkers will notice a rather sudden and dramatic change in my breath and body ordor. Hopefully Nian will not insist on a full four to six cloves a day for the rest of my life.

There seems to be little purpose to having a blog if there isn't something to write about. Well it seems I've stumbled onto a new vane of material for my blog, and one that to tell the truth I'm not all that crazy to be chronicling -- my battle with lung cancer. It is a battle I plan on winning, but one I'm none too anxious to engage in. If you read my last entry you know I was just about to receive the results of a PET scan regarding a suspicious spot that showed up on a chest X-ray back in June, and was rechecked by X-ray in September. I think you can infer the result.

I spent about a day being morose about my likely hood of having a much diminished longevity, but the next day provided a little more perspective and hope. I had quoted in my last entry that five-year survival is about 15%, but in the case of non-small cell stage-one lung cancer -- which is what I likely have -- the percentage is more like 60%, perhaps higher than 80%. What's more, getting past the three year makes for a much greater likely hood of not having a recurrence (I owe Nian for these better-researched statistics).

Before getting the PET scan I was informed the outcome would either be something like virtually 100% cancer or only 5% likely cancer. Leave it to me to get an ambiguous in-between result of something like 90%. So there is still some chance I could dodge this bullet. Normally a needle biopsy would be performed at this stage, but due to the location of my suspicious mass, we get the drama of going under the knife and not knowing until I wake up whether I have cancer or not. To make the experience extra fun, I'll be losing 2/3 of my right lung should the biopsy prove cancerous upon rapid inspection.

Nian has conducted intensive research into my best course of treatment, and I must say I appreciate her efforts. You would think that I would be the one burning up the internet looking for answers myself. But with the doctor's initial word of a 60% five year survival rate (which he only provided at this early stage because I asked), and with a small chance of not having cancer, and with having not yet talked to the surgeon (I have an appointment on Monday). Well... I was just going with the flow. Waiting to see how things go before truly freaking out.

My pending marriage to Nian in November is almost certainly on hold for now. We will still get married, but it will have to wait until I'm back on my feet after surgery. Even the biopsy surgery is likely to slow me down for a couple of weeks even if they don't take most of might right lung. To Nian's credit she insisted I get the surgery as soon as possible and not postpone until after our wedding day. Given this thing's slow growth and tracer uptake rate in the PET scan, four weeks would likely make little difference -- it's already been over four months since we started monitoring this thing. Though she might not let me, I would prefer to make the journey and see China with two intact lungs, and not appear weak, delicate, or easy to tire when I meet her parents.

I have for years now stated "Fantasy" by Earth Wind & Fire and "Maniac" by Michael Sumbello to be my favorite songs of all time. Today I decided I have a new (singular) favorite song: "Beautiful Life" by Ace of Base. I really loved this song when I first got it on Laser Disk, back when I was working much more as a DJ/VJ. I recently archived most of my Laser Disk music video collection to computer and came across this cut and saved it out special in it's own file, the only individual song to get this special treatment. This was about a week before my CAT scan and PET scan, but now it seems some small kind of irony. Today I replayed the file a couple of times, and it gave me a pleasant tingle up the back of my neck each time, the tingle I get when I hear a song I really like. I hadn't yet shed any tears over my present circumstance (which is probably not all the dire as it turns out anyway), but a tear or two leaked down my face as I listened to it. I honestly couldn't quite put my finger on my emotions as the small tickle of wetness touched my cheek -- but they weren't fear or despair. If I had to say, they were some kind of joy -- the joy of being alive and having hope -- the joy of knowing the love and support I'm getting from Nian (damn, there goes another tear or two). And finally perhaps just the joy of listening to a (new) favorite song.

Well it's been a while since I last updated my blog and this is partly due to sloth, partly due to a lot of other things requiring attention, and partly due to an uncertainty hovering around the current state of my health.

By the time you read this my health status will be known, but as I write this today, Tuesday October 18th, 2005 -- I don't know. Tomorrow I will receive the results of a PET-scan I took on Oct 11th. For long time visitors to my blog they might remember I mentioned a suspicious spot on one of my lungs that showed up in a chest X-Ray back in June this year. I had gotten an appointment for a persistent cough that would appear after any minor cold or flu. The doctor diagnosed me with asthma triggered by allergies. The spot was not overly suspicious, but he recommended a follow up X-Ray in 8 weeks. Assuming no change then to monitor every 6 months for two years and cancer could be ruled out. It then just being a run of the mill granuloma, some irregularity of my lung, perhaps (and I'm speculating here) like the pearl an oyster makes by surrounding an irritating speck of sand. So I've had the follow-up X-Ray and was informed no change... but to be really safe he recommends a CAT-scan, a 3D X-Ray that requires a dye tracer to be injected into the body. A week later I'm informed they still can't quite rule cancer out. The result remains ambiguous as there isn't quite as much calcification as they would like to see for a normal granuloma. A biopsy is recommended to settle the matter once and for all. The biopsy specialist recommends against one however due the spots placement which makes collapsing a lung a real chance during the biopsy. A PET-scan is recommended.

Each step seems reasonable and prudent, but I am beginning to realize that the odds of cancer seem to be tipping towards, rather than against. A PET-scan (positron emission tomography) involves being injected with a radioactive isotope of fluorine bound to a sugar molecule that disintegrates into an oxygen atom by emitting a positron. The positron plunks quickly into the first electron it encounters and emits a pair of gamma-rays in opposite directions from the mutual annihilation. Sensors in the PET machine detect simultaneous gamma ray events and extrapolate what line the emission occurred upon. With enough of these straight line events a 3D image of the interior can be extrapolated by computer. This scanning takes time (over half an hour) even though there are 10^11 positrons being emitted every minute inside my body. Since the fluorine is bound to a sugar molecule should my spot be cancerous it would take up the sugar preferentially due to a higher cellular metabolic rate than healthy cells and appear bright on the final image. This fluorine isotope has a short half-life however (about a week) and is also flushed from the body quickly. I'm told the radiation load is equivalent to about 100 chest X-Rays or about what my PET-scan technician receives in a year. Still it is odd to think of Anti-Matter and Gamma Rays being generated in your body continuously for a week or two.

So on the plus side for this being a benign granuloma, I'm a non-smoker, relatively young 47 (most lung cancers later in life) and while I had had a persistent cough from time to time, it seems to have gone away with the asthma treatments.

On the minus side for being cancer, about 1 out of about 100 non-smokers will develop lung-cancer in their lifetimes (about 1/8 the rate of a smoker), given I have some symptoms consistent with early lung cancer and given the aggressive test regimen my doctor has ordered...… well the odds have to be much worse than 1 in 100.

No one has quoted me any odds, so in the absence of any way to really know for sure I guess I have to just assume 50:50. The real odds are almost certainly much higher or much lower.

Amazingly I am able to put this all out of my mind for the most part and am sleeping quite well at night (we'll see if tonight is any exception). Should I have cancer I'm determined to battle through it, or at least as long as life on average seems better than not. But the sad fact is only 15% of lung cancer victims live 5 years. This number had gotten better in recent years, but probably largely due to early diagnosis, thus starting the clock running early, rather than any real improvement in treatments. Certainly early intervention will add some time, but just making it past the five year mark doesn't mean you've licked this thing -- even after apparent remission it seem come back with very high frequency. 10 year survival is probably unlikely despite however encouraging your early treatments tend to be. Technology marches on of course, treatments will be better in five years from now, and better again in ten. Better enough? Who knows, using the past as a guide on the fight to defeat cancer are not encouraging. Still it offers hope. And any amount of hope can make the days bearable.

This post is a little long and on the dry side. I can't risk posting this until I've talked to Nian about whatever the outcome is. Should the news be bad I suspect she will be more devastated than I. I am of course hopeful for good news, but hope to be a model of composure and good natured coping in the face of adversity should things go the other way. We all must all face the Reaper someday, whether today or fifty years from now I hope to do so with dignity, composure and lack of fear. I am not a religious person, an agnostic through and through. Even thought I don't have the crutch of self-deluded false-knowing of a religious person, I also don't have the curse of absolute false-certainty of oblivion that a true atheist must have. If not this day, this year, this decade, someday in the future I will have to face the biggest unknown of all - what comes after all this.