Cancer in the Family

First, the good news. Our number-two daughter’s cancer is slow-growing. The not-so-good news is that it’s aggressive. And, of course, that she’s got cancer.

I learned about the cancer in early January.¹ The family knows a little more now, and I’ve gotten the okay to talk about it. Which isn’t easy. I’ve been — distracted — and that’ll very likely continue.

• Putting Feelings in Perspective
  • Previous Experience
  • “…Feelings, Woah, Woah, Woah, Feelings….”
• Diagnoses, Definitions, Surgery, and (Probably) Good News
  • Another Operation, Radiation, and Prayer

Putting Feelings in Perspective

Another bit of good news is that our granddaughter’s left arm has healed nicely. She broke all three bones last year. It’s particularly good news, since she’s a lefty.

Back then, I said “Life Happens, and That’s Okay“, which made sense at the time: and still does.

Which doesn’t — emphatically doesn’t — mean that I felt good about our granddaughter’s pain, or our number-two daughter’s recent cancer diagnosis.

So — how do I feel about one of our children having cancer?

That’s a good question.

I’m pretty sure I’m worried, but it’s hard to tell.

I’d say that I feel numb, but that’d be a step up. It’s more like I feel blank, emotionally. That’s a bit unsettling; or would be: if I hadn’t experienced unpleasant emotions, and their oxymoronic — it’s a real word, look it up! — absence, before.

Our youngest child died in early February of 2002.

Previous Experience

We’d lost one of our children in a miscarriage, but figured our sixth pregnancy would end in a normal delivery.

It didn’t. As we were approaching the Interstate exit nearest the hospital, something went wrong.

My wife tells me that our baby thrashed around: then stopped moving.

I see that I haven’t talked much about this since 2017: not surprising, since it wasn’t a pleasant experience. The good news is that my wife survived, which I’m told wouldn’t have happened if the placenta had given way near the edge.

The point of reviewing that spot of unpleasantness is — actually, it’s at least two points.

First, I learned what another sort of sudden loss and grief feels like. I could rehash that, but I won’t. Here’s an excerpt from 2017, discussing what happened in 2002:

“I tried — briefly — bargaining with God when we lost Elizabeth, our youngest child.

“When the somewhat one-sided conversation was over, I was accepting the unpleasant realities, and asking for help dealing with them: so I don’t feel particularly guilty.

“I suspect that some folks say bargaining with God is always wrong because they see it as trying to manipulate God. That’s a bad idea: also impossible. The Almighty is just that. I can’t make God do anything. (Catechism of the Catholic Church, 268-274, 2118-2119)

“God is good, merciful, and loving. But because we live with consequences of a really bad decision, seeing that love as jealousy and vengeance is easy; and that’s another topic. (Exodus 34:6; Psalms 73:1, 103:8, 136:1–26; Catechism, 270-271, 385, 397-406, 1472)…”
(“New Daily Prayer Routine” (February 19, 2017))

Second, when I wasn’t stewing, fretting, or praying, I was postponing sadness, misery, grief, and emotions whose ID tags got lost in the shuffle.

I’d been sitting up with my wife. Folks at the St. Cloud hospital were on duty, and would have been far more useful in a medical situation. But I wanted to be available, in case she woke up and wanted unskilled help. Besides, I wanted to be there.

At the time, I could feel — metaphorically — things snap in my mind, each time I blocked a rush of emotion.

I knew that there would be consequences: later, when I had free time. Which there were, but the nervous tic and auditory hallucinations eventually ended.

What I’m feeling, or not feeling, now is different. No surprises there. I’m 22 years older, and the circumstances are different. Just the same, I’m wondering when or if this ‘blank’ feeling will give way to something more definite.

“…Feelings, Woah, Woah, Woah, Feelings….”

Despite a distinct gap where feelings like fear, anxiety, and great galloping heebie-jeebies should be,² I’m pretty sure that at some level I’m worried about our number-two daughter’s health.

I’d be worried if I wasn’t worried.

Now, about emotions and me.

First off, emotions — feelings — happen. They’re part of being human. So is thinking, or should be. (Catechism of the Catholic Church, 154-159, 1763ff)

Thinking. Right. About that: I have free will. I can decide to act, or not act. Believe, or not believe. Think, or let feelings, whims, and impulses decide for me. (Catechism, 1730-1794)

Developing, maintaining, and using, my conscience isn’t always simple or easy. But it’s a good idea, anyway. (Catechism, 1786-1794)

Feelings connect “the life of the senses and the life of the mind.” (Catechism, 1764)

By themselves, feelings aren’t good or bad. They just happen. What I do with them: that’s up to me. With practice, I can control them. To an extent. St. Thomas Aquinas talked about that. And, as usual, it’s complicated. (Catechism, 1767)

Emotions can tell me that something needs attention. Feeling worried, for example, isn’t necessarily a bad thing. What I decide to do about feeling worried, or angry, or elated, or whatever — that’s what can be good or bad. (Catechism, 1765, 1767-1769)

Ideally, my feelings and my reason would be working together. In any case, I’m expected to think. (Catechism, 1777-1780)

Diagnoses, Definitions, Surgery, and (Probably) Good News

I deleted much of the research I’d done for this post Wednesday morning. By accident, which didn’t make it any less lost.

If I wasn’t so distracted, distraught (probably), and discombobulated: well, that’s how I’ve been this week, so I’ll work with what I’ve got and move on.

On January 15, I heard that our number-two daughter is dealing with an adenoidal cystic carcinoma, that it’s aggressive (bad news) but slow-growing (sort of good news). Also that this sort of cancer tends to travel along nerves.

Odds are that you haven’t heard about an adenoidal cystic carcinoma before. It’s what one resource called “a rare malignancy”. On the other hand, our daughter’s version of this problem is a ‘normal’ sort: one of her salivary glands has gone bad.

I was going to talk more about that, and maybe I will — eventually. But for now, here’s an excerpt from a resource that I hadn’t scrambled:

“Adenoid Cystic Cancer“
Mohammad Ammad Ud Din; Hira Shaikh, editor; StatPearls [Internet] (last update April 14, 2023)

“Adenoid cystic carcinoma (ACC) is a rare malignancy arising from the secretory glands, most commonly seen involving the salivary glands. Although uncommon, it is an important differential to consider for a painless swelling in the head and neck region because of its high tendency to metastasize….”

That “high tendency to metastasize” got my attention.

What ‘aggressive but slow-growing’ means isn’t so clear. Particularly since an “aggressive” cancer is (apparently) one that is not slow-growing.

• aggressive cancer
  Cancer that develops, grows, or spreads quickly.
• metastasis [meh-tas-tuh-sis]
  Cancer cells that spread from the primary site where they started to other parts of the body through the lymph system or bloodstream.
• metastasize [ meh-TAS-tuh-size]
  The spread of cancer cells from where the cancer started (primary site) to one or more sites elsewhere in the body, often by way of the lymph system or bloodstream.
• metastatic [meh-tuh-STAT-ick]
  A way to describe cancer that has spread from the primary site (where it started) to other structures or organs in the body.
  (“Cancer Glossary: Definitions & Phonetic Pronunciations“, American Cancer Society)

And at least one sort of slow-growing cancer is called “indolent”, not “slow-growing”. According to one source, anyway:

“…We defined an indolent cancer as including all of the following criteria: clinical stage I nodule on prevalence LDCT scan with a volumetric doubling time >400 days and maximal standardized uptake value (SUVmax) ≤1 on positron emission tomography (PET) scan (when available)….”
(“Indolent, Potentially Inconsequential Lung Cancers in the Pittsburgh Lung Screening Study“, Prashanth M. Thalanayar et al., Annals of the American Thoracic Society (August 2015) via PubMed Central (PMC)) [emphasis mine]

I don’t know how a carcinoma — a particular sort of cancer, and that’s yet another topic — can be both “aggressive” and “slow growing”. The gap in my knowledge is unsettling, but I don’t actually need to understand that particular bit of the current family situation.

Our daughter has had a PET (Positron Emission Tomography) scan³ — details of PET technology are among the notes I inadvertently deleted this week.

The scan picked up a number of anomalies, but no obvious sign that the cancer has metastasized. I’ll take that as good news.

“…Cancer cells can break away from the original tumor and travel through the blood or lymph system to distant locations in the body, where they exit the vessels to form additional tumors. This is called metastasis….”
(“What Is Cancer?“, Fundamentals of Cancer, What is Metastasis?; National Cancer Institute, National Institutes of Health) [emphasis mine]

Another Operation, Radiation, and Prayer

Before outlining what’s being done about our daughter’s cancer, I’d better explain how I see life, health, medical treatments, and prayer. Or, rather, repeat what I said a couple years back:

“…Being healthy is okay. Being sick is okay. What matters is how I act. It’s even okay to help others get or stay healthy. Life and physical health are ‘precious gifts.’ Taking care of both is a good idea. Within reason. Obsessing over either isn’t. (Catechism of the Catholic Church, 1509, 2288-2291, 2292-2296)

“Prayer isn’t always easy, but it’s always possible. Which is a good thing, because living as a Christian without prayer doesn’t work. Prayer is what makes sharing the love Jesus has for us possible. (Catechism, 2742-2745)…”
(“Experiencing COVID-19: It Could Have Been Worse“, Prayer and Making Sense (February 19, 2022))

Our number-two daughter has had her cancerous salivary gland removed. They’ll go in again, I gather, removing ‘might be cancerous’ tissue.

That second surgery will add to the existing scar on her neck, making it more noticeable: which I’m sure is the least of her, or our, concerns.

Then she’ll start radiation therapy.

This is not going to be a particularly placid period for any of us.

But we’re getting by. I don’t know the odds that number-two daughter’s treatments and monitoring will keep the cancer at bay. But I insist on hoping that they’re successful.

Meanwhile, I’ve added prayer for her medical situation to my daily routine.

Happily, if that’s the right word, an item from my role in a parish prayer chain had me looking up prayers specifically mentioning cancer — which resulted in my learning about St. Peregrine; and that’s yet again another topic.

More about life, health, death and options:

• “May 13, 2023: It’s Been an Interesting Week“
  (“Life Happens, and That’s Okay”)
  (May 13, 2023)
• “This Week: Sunshine, Blue Skies and an Echocardiogram“
  (July 16, 2022)
• “In Praise of Lilacs, Blue Sky and Rain“
  (May 29, 2021)
• “Another Trip to the Emergency Room“
  (May 15, 2021)
• “Miscarriage, Stillbirth, and Hope“
  (October 9, 2016)

¹ Distracted since January’s second week:

• “T. Rex, or Not T. Rex, That is the Question” (January 13, 2024)
  • Invitations “…to Even Greater Admiration….”

² Does “Feelings” sound familiar? It should:

• Wikipedia
  • Emotion
  • Feelings (Morris Albert song) (AKA “Pour Toi”, and that’s still another topic)
  • Heebie-jeebies

³ Stuff I was going to talk about this week; but didn’t, for the most part:

• Wikipedia
  • Adenoid cystic carcinoma
  • Carcinoma
  • Epithelium
  • Positron emission tomography
• “What Is Cancer?“
  National Cancer Institute, National Institutes of Health
• National Institutes of Health
  • “Adenoid Cystic Cancer“
    Mohammad Ammad Ud Din; Hira Shaikh, editor; StatPearls [Internet] (last update April 14, 2023) via US National Library of Medicine
  • “Indolent, Potentially Inconsequential Lung Cancers in the Pittsburgh Lung Screening Study“
    Prashanth M. Thalanayar, Nejat Altintas, Joel L. Weissfeld, Carl R. Fuhrman, David O. Wilson; Annals of the American Thoracic Society (August 2015) via PubMed Central (PMC)
  • “Adenoid cystic carcinoma: A review of recent advances, molecular targets, and clinical trials“
    Patrick M. Dillon, MD; Samhita Chakraborty, MD; Christopher A. Moskaluk, MD, PhD; Prashant J. Joshi, MD; Christopher Y. Thomas, MD; (June 2015) Head & Neck, Wiley Online Library, via PubMed Central (PMC)