First published: 14 Jan 2017

… when you’re busy doing other things. John Lennon had it about right, didn’t he?


I understand more medical terminology than many people, maybe even most, but I certainly don’t understand it all, nor anywhere near enough.

The ‘second opinion’ arrived tonight:

The biopsy from cervical spinal lesion reveals metastatic poorly differentiated adenocarcinoma. The tumor cells express Cytokeratin, EMA & CK-7 and are immunonegative for CK-20, TTF-1, PSA & CD 38.

So, unless you’ve done your seven plus years of training, it’s all medical gobbledegook. It suggested investigating my lungs for “a primary”. That bit seems pretty straightforward: they think the ‘thing’ started in my lungs and has then clawed its way into residence at my C1 vertebrae, but my friendly Consultants will have to explain the C-3PO and R2-D2 acronyms and abbreviations.


I have an appointment at 5.30 this afternoon. Friday the 13th. Woo-woo-woo … My Yoda-like Consultants will have to decipher the medical code.


We got the results of the analysis from the other hospital. Not good news, really.

The bottom line is they think the tumor started somewhere else and then settled in my neck. They have to find the ‘somewhere else’ so that they can kill the ‘somewhere else’.

So I need more tests – simple ones which entail sticking a camera down my throat and another one up my ass! They are local anesthetics so no big deal, really, but I will check into the hospital for two nights so that I am monitored and supervised properly. That will be tomorrow (Sunday) and Monday, leave Tuesday morning.

The first analysis, during the neck surgery, was that the tumor was a plasmacytosis (I don’t understand these terms and there are lots of them), which I think is the localized one which just stays in one place. Then the post-operative, more detailed analysis at Reliance Hospital indicated it was worse than that and was a ‘metastatic undifferentiated carcinoma’, which is quite a nasty one and could spread. The analysis advised looking for a ‘primary’ – the starting point – in the gastrointestinal (GI) tract (upper part of the stomach) and pancreaticobiliary tracts (lower part). The good news was they were certain there were no carcinoma traces in the bone marrow.

However, they were not entirely sure about the whole thing and they were worried that it may be a worse type, so they asked if they could get a second opinion from some other experts. This is what we now have.

They describe it as a “metastatic poorly differentiated adenocarcinoma” which is a long-winded way of saying it could be particularly nasty and has likely started somewhere else and then settled in the neck just for comfort and fun. So they have to find the origin, the place where it is all starting; what they call the ‘primary’. They suspect it may be my lungs but, at this stage, no one knows.

Previously, nothing showed up on the PET scan which was, in itself, a little strange but nothing about medical science (or any other science) is yet perfect. They’ll start with the simpler test, the gastrointestinal tract, then my bowels, and, if nothing is found, then move onto my lungs.

The GI and bowel tests consist of simply sticky cameras down my throat (endoscopy) and up my ass (colonoscopy) and taking video! That should put me off photography for a while. YouTube eat your heart out. If they find something interesting they’ll cut little bits out and test then to bits. That’s simple really. Lungs may be more complicated, I don’t know.

The tests themselves are done under local anesthetic so they are not a big deal, maybe 10 and 20 minutes each. However, the preparation entails total cleaning of my bowels – probably going to the toilet at least a dozen times the night before (“ensure toilet is close by once the laxatives are taken”) – and the post-test recovery includes quite a risk of stumbling and falling, which I don’t want to do with my neck healing nicely. So I’ve opted to stay in the hospital for two nights, Sunday and Monday, rather than stay here by myself. It’s just me being cautious. Don’t want to be rushing to the toilet or falling without an emergency button at hand. Results will be three to four days.

I have to have a low-fiber diet today and a liquid-only diet from tomorrow morning. Apparently ‘liquid only’ doesn’t cover vodka and tonic.

If they find nothing they’ll assume the worst and start chemotherapy which basically bathes the whole body in cleaning chemicals. If they can isolate a primary origin then maybe radiation will suffice. That specifically targets a particular group of cells and blasts them with light-saber intensity. I don’t think we’re going to end up with light-sabers though; it sounds like a full immersion in chemicals to me.

In other news: rising from my Lazarus-like sleeping position this morning was pain-free. Quite often when I sit up I get a really bad headache for a few minutes, but this morning, nothing. Happy bunny.

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