By coincidence, I had my annual physical exam the next morning. My doctor looked into the eye and said, “You need to see your eye doctor soon.” Within the next twenty-four hours, I saw three doctors—the eye doctor, a retina specialist, and an eye-inflammation specialist. It was amazing how quickly the second two doctors, whom I had never dealt with, saw me. The inflammation specialist told me the inflammation could have three causes: infection, auto-immune disease, or (least-likely) cancer in the eye. He drew some blood and scheduled a biopsy.
The test results would take days or even weeks to come, and the cancer tests were slowest. My eye doctor suggested a neuro-oncology consult, where they tested my cognitive functions (walking in a straight line, naming the last five presidents backwards), pronounced me normal, and scheduled an MRI that Friday to test further for cancer in the brain. With the normal cognition test and a negative preliminary biopsy for cancer that had just come in, I wasn’t particularly worried.
I was eating lunch, only hours after the MRI, when my cellphone rang. The person said my MRI showed “a problem.” I needed to get to the hospital pronto. The word “cancer” was not used, and I, somewhat catatonically, although without panic, headed for the subway and proceeded to the hospital.
When I had checked in and saw a doctor, I quickly asked, “Is there any benign explanation for these results?” “No,” she said. The doctor didn’t use the word, but it was clear I had cancer.
Not surprisingly, much of this year for me since that short exchange has been dominated by cancer, and these are the topics of the rest of this essay. Some of what I learned taught good things about myself. The most surprising is that I did not fall apart in connection with my diagnosis or treatment. Why didn’t I go into a tailspin, as I normally am wont to do at any hint of a medical problem? But I also confronted less-flattering things about myself, including not having paid enough attention to friends or neighbors, and not doing enough volunteering. Both were related to obsession with work. I needed to decide how, if at all, I would change my life in what would I hoped would be my post-cancer world.
The day after I checked into the hospital I got a PET scan to see whether the cancer had spread beyond my brain and right eye. The doctor told me the scan showed no spread. Then came more of what sounded like good news: My tumor was small and had been caught early. I smiled, and involuntarily patted the doctor on the back. Without waiting, she proceeded to tell me that I had lymphoma, and that while lymphoma is common, in the brain (central nervous system or CNS lymphoma) it was extremely rare.
Chemotherapy, she continued, was to begin the very next day. Chemo for lymphoma, she explained, was divided into two stages, “induction” and “consolidation.” Induction, which would take place in seven cycles every two weeks, was to get the tumor to recede. Consolidation was to prevent it from coming back.