Out of the fry pan...

It gets tiresome to report bad news. We are, at the moment, jumping out of the frying pan and directly into the fire.

My oncology appointment went...well and poorly. Well in the sense that, because of my current lifetime dose of radioactive iodine, and the amount I am expected to need in the future, I won't have an ablation at this time, nor will I have another scan until November, 2010. That is excellent news, as I hate to be separated from my family for the long periods necessary after the iodine scans.

Then came the bad news. I have two tests each time I go for a scan, the whole body scan, which looks for iodine uptake: this came back relatively normal, with minimal uptake in my neck and lots of uptake in my pelvis (typical as the iodine is eliminated by bowel and bladder). Secondly, I have a blood test for a tumor marker (thyroglobulin). My tumor marker, which had been mildly positive even after the surgical removal of my cancer, was completely negative after my ablation: the best news possible - it appeared that all of my remaining thyroid tissue and cancer was killed by the ablation! At three months post, in March, my tumor marker level was 0.05, considered "undetectable". Remember the celebration?

Now my thyroglobulin is 2.5 ug/L. That's 50 times higher than it was just seven months prior. Yikes. While it is still within my doctor's "acceptable" range - meaning I don't need another ablation (treatment) dose of radioactive iodine in January - it is high enough to confirm that there is active cancer somewhere in my body. It is somewhat concerning that not much showed up on the scan, because that means we still don't really know where the cancer is lurking or whether or not it is still susceptible to the radioactive iodine. Both my endocrinologist and OB/GYN surgeon are very concerned about the mass on my ovary in light of the new lab test value. The OB/GYN has previously said it is probably a cyst, but this was without full understanding of how my tumor manifested in 2008. Of particular concern is the appearance of the mass on ultrasound, as well as the similar level of growth following a pregnancy. There is still a chance that the mass could be a large hematoma that is not being reabsorbed, or an abcess.

But the most likely option is cancer. Thyroid cancer growing on my ovary. Metastasis.

I am scheduled for an ultrasound tomorrow to get another look at the mass, which can now be felt from the outside on my lower abdomen. I will have surgery at 10 a.m. on Monday, January 4th. My surgeon will start with laparascopy, and then move to an open abdominal incision if it looks like either cancer or abcess. Obviously, recovery from a laparascopy - as well as an outcome of finding a cyst rather than a tumor! - would be highly preferable. I would beg for prayers to that end.

I am trying not let worry carry me away. What would it really profit me, at this point? I can't do anything beyond what I've already done. I suppose I should have had it removed earlier, but it just didn't work, with cancer scan and Christmas filling my schedule. It is altogether too reminiscent of my original diagnostic experience with the original cancer in June, 2008. The constant reassurances that it would be so improbable to have that large of a cancerous tumor suddenly appear on my ovary. The nagging feeling that I knew this was coming - this specific thing. I read several articles (preview here and here) about this rare occurance last year when researching prior to my ablation. And I just had a gut feeling it would be me in those shoes. I don't know why. That just means I won't be shocked if it's cancer, I guess.

Jesus, I am resting, resting,
In the joy of what Thou art;
I am finding out the greatness
Of Thy loving heart.
Thou hast bid me gaze upon Thee,
And Thy beauty fills my soul,
For by Thy transforming power,
Thou hast made me whole.

Ever lift Thy face upon me
As I work and wait for Thee;
Resting ’neath Thy smile, Lord Jesus,
Earth’s dark shadows flee.
Brightness of my Father’s glory,
Sunshine of my Father’s face,
Keep me ever trusting, resting,
Fill me with Thy grace.
~ Jesus, I am Resting, Resting by Jean Pigott, 1876