It's Jan. 9, just three days after the cone-down began, and life is getting a bit better.
I'm getting the same amount of radiation in treatments 29-38 that I got for 1-28, but it's being directed at about half of the number of places ("fields" as we say in the radiation biz) that were getting zapped before. Not only is that cutting in half the amount of time it takes for each treatment, but parts of my neck that were fully involved before now aren't getting any radiation at all.
Because of that, the red-to-brown color the skin on my neck was turning because of The Process no longer seems to be as red or brown as it was before the cone-down began. One particular part -- the inch-square section that had been peeling like a sunburn -- is now healing quickly.
Today is day 31. When I leave the hospital today I'll be almost 84 percent done and only have six more treatments left.
But the calendar isn't the only indication that this part of The Process is almost over. Yesterday my radiation oncologist and I put together the initial post-treatment plan and for the first time in weeks it involves many of the other members of Team Stan.
I'm going to see my internist in mid to late February to get a full physical. This was my call: I want an assessment of my overall health after the radiation therapy to see how it affected everything else. Plus, I have enormous confidence in my internist and want to bring him back into The Process as soon as possible to discuss the follow-up.
I'm also going to see dermatologist #1 about the same time I see my internist. I need her both to look me over in a routine exam (remember that this all started with a rare form of skin cancer so I need to be very diligent) and to look at and help me deal with any negative effects the radiation had on my skin. My radiation oncologist said there shouldn't be any but he agreed that it wouldn't hurt to let a specialist make that determination.
About two weeks later I'm going to see both my medical oncologist and my dental oncologist. The visits to the medical oncologist will likely continue every six weeks for the next six months and then go to every three months for the next two years.
I need to see the dental oncologist because the surgery and radiation have reduced the quantity and quality of the saliva in my mouth and for the rest of my life will need to start doing fluoride treatments to compensate.
About three months after the radiation ends I'm going to have what I suspect will be the first of many PET scans to confirm that the Merkel cell is nowhere to be found. I'll review the results with my radiation oncologist about a week later. I'll probably repeat the PET scan twice a year for the next two years.
I now understand more about why The BTW has been so eager to keep seeing her team years (now decades) after she was treated for breast cancer: it's comforting to know that it's not just you against the disease. I suspect that at some point this will all get old. For now, however, the fact that the team will be in place for a while longer is definitely reassuring. It should also be sign to the Merkel cell carcinoma that I'm not the kind of patient you mess with. As I said when this all started, it's never come up against someone like me before.
In the meantime, my health insurance changed on Jan. 1 as the new benefits from the company that acquired my firm on Christmas Eve started to go into effect. It wasn't a big deal; my new health care benefits are actually better than the ones I had before and the new company made special arrangements to get me on the books immediately so that there would be no interruption of any kind with The Process. I received my card from the new insurer in less than four hours.
This is a continuing series of blog posts by Stan Collender about his experience fighting cancer. "The Process" Stan is describing began last August.