Becoming Stage IV

It’s funny, the random things you remember and tuck away for later, without knowing why. A few years ago, I read an interesting article in the Washington Post about a drastic cancer surgery pioneered by a local man. Maybe it was his name that made it stick in my head: Dr. Sugarbaker. Such a pleasant name, so incongruous  with what sounded like a kind of torture, a procedure involving the patient’s internal organs being basted in hot chemo drugs like a bizarre spa treatment after all-day open abdominal surgery. I remember remarking on it to my husband; joking about the name. I remember thinking “God help the poor people who have no options left beside that!”

Fast forward three years. My oncologist is calling, which can’t be good: He’s an email guy. I don’t even know his phone number. It’s after hours and it sounds like he’s on his cell, driving.

It’s about the scan I had that morning, the one he ordered after watching the tumor marker (CEA) in my bloodwork slowly climb in the past few months despite being on a chemo drug meant to prevent recurrence.

There are “suspicious spots” in the peritoneum, he is saying. (What’s the peritoneum again? Oh, right, the lining around the abdominal organs. I learned that from my surgeon. The one who had removed the tumor and sewed me back together so beautifully six months ago. My pathology report said the margins and lymph nodes were clear, and I was declared stage IIB: no metastasis. I was elated.) Suspicious for what, I ask?

Metastasis, he says, as gently as possible.

I begin to shake. My husband walks in, looking worried as I slump down onto a stool in the office. I put the phone on speaker.

“Does that make me stage IV?” I ask, barely choking out the question.

The answer, of course, is yes. But it’s not hopeless, he says quickly. There are surgeons who have ways of removing peritoneal metastases. In fact, there’s one right here in Washington…

The memory of that article falls off the shelf of my brain with a sickening thud.

“Oh my God,” I interrupt, “you’re talking about the Sugarbaker surgery, aren’t you?”

He’s surprised I know what it is, but says yes, that could be my best shot. If I’m eligible. One step at a time. I’ll need chemo first, the hard stuff — infusions and a portable pump rather than the pills I’ve been on all summer. He tells me I’ll need a central venous catheter, called a “port,” surgically implanted in my chest as soon as possible.

In the meantime, he advises me to go ahead as planned with a three-day work trip to Colorado. Because really, these are just tiny, tiny spots on the scan, the size of grains of rice. He can’t even be 100 percent sure they are tumors. But “we have to proceed on the assumption that they are,” he says, “or we’ll lose our window.” I can tell he hates having this conversation as much as I do. He’s a brilliant doctor, and a kind man. I know he will do his best to save me. But I also know, because I read too much, what the long-term survival odds look like for stage IV colon cancer patients.

I can’t stop shaking all night long.




One thought on “Becoming Stage IV

  1. Amanda, you write so beautifully. Thanks for sharing your blog link with us, thanks for writing through some of the difficult emotions and experiences of having cancer. I’ve been thinking about this image ever since reading it a couple of weeks ago: “The memory of that article falls off the shelf of my brain with a sickening thud.”
    I hope Eleanor gets well soon! It is so hard to see the little ones bewildered by how they’re feeling, but also so satisfying to be the one who can help them just by snuggling and being together.
    Love to you all!


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s