Opinion: Column: Treat One, Get Two.

Opinion: Column: Treat One, Get Two.

I'm sure you regular readers are waiting with bated breath for the confirmation of my updated health status. Unfortunately, for the moment anyway, we'll all have to wait a bit longer. Though the needle biopsy of my "Adam's apple" tumor did indeed confirm thyroid cancer, stage 2, no such confirmation or clarification as to its origin was made, or whether it's been thyroid cancer that I've been living with all these years, instead of non-small cell lung cancer, stage 4 or not. However, there is a path forward. Surgery to remove my thyroid gland, along with my "Adam's apple" tumor, and possibly a lymph node, is in the planning stage. As such, scheduled for next Friday is an appointment with a head and neck surgeon to determine my fitness for surgery. All we've been told so far is that the surgery is usually outpatient – arrive in the morning and leave that afternoon (maybe I'll bring along my dry cleaning). Apparently, this is the next step "on the road to find out" (Cat Stevens).

If I am indeed home that same evening, I've been told by my endocrinologist that the recovery period is approximately two weeks. At present I don't have any details of what "recovery" exactly means/entails. If all goes according to the pre-surgical-actually-discussing-the-procedure-with-the-surgeon conversation, a month or so after the procedure, I will revisit my endocrinologist to have radioisotopes administered somehow. Once inside my body, I will be scanned by a machine looking exclusively for thyroid cancer. This will confirm, if I understand the process correctly, whether the tumors in my lungs are thyroid or lung cancer.

In the interim, I am to continue with my immunotherapy ("I. O.") and with any other appointments, scans, etc. I recall something that my oncologist said about my lung cancer tumors during his "exciting" phone call. He said that my tumors never really acted the way he anticipated, as if they weren't non-small cell lung cancer at all. And sure enough, some of them, as confirmed by the first of my recent two biopsies, were thyroid cancer. As I've been joking, this is what my oncologist gets excited about, as opposed to what yours truly would get excited about: a World Series Championship. And also, as he said, thyroid tumors are more treatable, with more choices and better outcomes – which is exciting for me.

OKAY. So I have thyroid cancer and it's more treatable. Wonderful news. But do I still have lung cancer? If so, where's the future in that? Is it somehow no longer a "terminal" disease because I've outlived my original "13 month to two year" prognosis? Will I now be treated for thyroid cancer only to die of lung cancer? Moreover, am I now going to get treated twice, in two medical suites, one for each cancer? Have these multiple biopsies simply determined that the doctors were actually right – both times – and I'm just the unfortunate patient to be so wronged?

For 10 or so years, until last January, I was treated for lung cancer – with chemotherapy. However, this past January, the "Adam's apple" tumor appeared and we switched to immunotherapy. The reason for the change: the lung cancer had spread, according to my oncologist. Now, a year later, the story/diagnosis has changed, thanks to my most recent biopsy. The tumor wasn't lung cancer that had spread, it was thyroid cancer that had spread. I didn't even know I had thyroid cancer. Now you're telling me it's spread? How lucky am I? Two cancers for the price of one. I guess this will make health insurance more affordable, sort of like buying in bulk at Costco.

The big question: did my lung cancer treatment inadvertently prevent my thyroid cancer from manifesting/metastasizing or did its non-diagnosis allow it to grow unimpeded and now present this quite unexpected/unanticipated complication? Explain though it may to my oncologist why I haven't succumbed to my original disease, it doesn't quite explain to me what the hell's been going on and why.