Amended Flight Plan

Today, Jim visited his dermatologist due to the changes in the spot by his thumb.  In the last couple of days, it has grown and darkened.  Below is a picture from this morning, in contrast to the picture posted on Saturday.  It isn't as obvious in the photos, but the spot truly had changed quite a bit in a short time.

Due to the changes, the doctor biopsied it, taking the entire visible spot.  In addition to that, there was another spot she had been watching and biopsied as well.  These biopsy sites were wider than the last and were not candidates for stitches.  So, the doctor cauterized both.  Hopefully, they will heal without too much discomfort.  

As of now, the topical chemo cream is on hold, although it did arrive in the mail today.  These two biopsy sites are both on his right hand, which will definitely be too raw for the chemo for awhile.  The initial biopsy site that will require surgery is on his left.  So, neither hand is a good candidate for the cream at the moment.  Also, the dermatologist would like the results from today's biopsies before deciding exactly how to proceed.

The surgeon had the opportunity today to consult about Jim's treatment.  He felt that due to the location of the original biopsy and the potential need for a larger incision, it would be best operated on by a plastic surgeon.  Jim's dermatologist is working on surgical options for us. One possibility is a civilian plastic surgeon and another possibility is seeing the plastic surgeon at the V.A. hospital in Seattle.  Both options have benefits and drawbacks, so with the guidance of Jim's dermatologist, we will make our decision very carefully and thoughtfully. 

Thank you for all of the prayers and well wishes during this uncertain time.  We both feel so supported and grateful for our loved ones.  A friend mentioned today that the hardest part is the unknown.  That is exactly what keeps us both up at night, the unknown.  Thankfully, what we do know is that we have awesome support, Jim is in good hands with his medical team, and he will definitely be victorious in this battle.  We are so thankful for each of these things, especially our loved ones.  

The Journey Begins

Well…. Shit……  It appears as though I am once again in the cancer blogging business.  This time around, my husband has graciously brought the C word back into our lives.   

The Facts:

**His diagnosis is squamous cell carcinoma on both of his hands. 

**His prognosis is absolutely excellent.

**The treatment is potentially hellacious, but will have a happy ending.  

And now for the rest of the story….

Almost a year ago, Jim’s hands started looking sort of angry – red, splotchy, and a little scaly.  He saw a doctor (or three), walking away each time with a diagnosis of eczema and some prescription cream to treat his woes.  Despite his diligent efforts, the scales and splotches grew, along with the discomfort and worries.  This winter, he endured two biopsies that came back beautifully benign.  While we definitely appreciated the cancer free status of those results, we both felt extremely frustrated at the complete lack of answers.  At a loss for answers herself Jim’s primary doctor referred him to a dermatologist.  Thankfully, she zeroed in on a spot between his pinky and ring fingers and sent another sample off for testing. 

After almost two weeks of waiting for results, the day came to get out Jim’s stitches from the latest biopsy.  Before he rushed out the door that morning, I shared my growing suspicions with Jim.  With each previous biopsy, we received results within a week, right to our mailbox.  Here we were nearly two weeks out and no mellow letter.  He kind of sighed and said he would let me know what happened, both of us shaking our heads and hoping the pits in our stomachs were all for naught.

Well, what happened at his appointment confirmed our fears.  From being escorted to an unusually private room for stitches removal to his dermatologist making a personal appearance at a routine appointment, Jim knew his goose was a little cooked, but thankfully only a little.  She shared the news that his biopsy did reveal squamous cell carcinoma, well defined.  Well defined means we are looking at stage 1 cancer, a very, very good sign.  She did tell him that his hands look like those of an 80 year old farmer who spent his life in the sun.  We aren't really sure why his sun damage is so extensive, but have entertained many possibilities.  At this point, it doesn't really matter why, rather we are focusing on getting through the treatment.

Sweet Jim will be starting a round of topical chemotherapy – six weeks per hand, one hand at a time.  The chemo is called something big and fancy, but the abbreviation is “5-FU.”  Considering the pain and burning promised with treatment and the way the chemo kills the top layer of skin so it can slough off, I’m thinking the “5-FU” is aptly named.  He will begin treatment at home, with daily applications of the dreaded cream as soon as it arrives in the mail.  The side effects sound survivable, but not so pleasant.  We have read a few sites that talk about the burning, itching, and pain, as well as a couple references to the skin hardening and peeling off.  Jim will also need to keep the treated skin completely covered when outside.  So, he can either rock the Michael Jackson look or go with the two-glove OCD option.  We did find a pair of biking gloves designed for UV protection that are set aside and ready as soon as treatment begins.  

In addition to the wonderful chemo news, Jim also learned his margins were not clear.  So, the biopsy site will require additional surgery.  The biopsy was taken from the webbing between his last two fingers of his left hand.  That spot has proven both painful and slow to heal, but Jim has learned to tape those two fingers together.  The spot opens easily with typical hand movements.  Hopefully, the surgery will not be much more invasive than the biopsy.  

Jim and I waited until this weekend to tell our boys.  Honestly, I was a little freaked out.  Unfortunately, those little men know more than most of their peers when it comes to cancer.  They witnessed many tears, fears, and frustrations as my friends faced their own cancer journeys just a short year ago.  Quentin, our 7 year old, was so affected by that whole experience he is now growing his hair out for Locks of Love.  Cancer has touched our little home in profound ways. 

Thinking of my sweet boys, I did what any anxious mom would do (at least that is what I am telling myself!) and googled how to tell your kids dad has cancer.  While I found some stuff that clearly would not fit our situation, I also found some good tips.  So, with a sip of wine, a deep breath, and legos scattered across the table (that part was spontaneous) Jim and I approached our two young guys.  As soon as I uttered the words, “We want to talk to you,” Morgan responded with a quick gasp and the question, “Oh God, what’s wrong?”  We got the basics out – skin cancer, very treatable, not life threatening, not very fun treatment, and were met with three questions:

 Will Dad lose his hair?

     How will he shower without hurting his hands?

     Can we play with our legos now?

Jeez!  No need for all the comforting skin cancer facts I had dug for on-line!  But, we are thankful that they both are doing really well.  They know Dad’s hands will hurt and look pretty awful.  They know he will be wearing gloves throughout the spring and summer.  They know that their crazy mom has taken on the role of sunscreen nazi.  AND, they know that their legos are pretty damn awesome.  I guess that is plenty at this point.

And now, here we are.  Jim expressed a wish to chronicle his hands in pictures and to communicate his updates easily to all of our loved ones.  Lucky for him, his wife has a smidge of experience in the cancer blogging world. 

Jim's hands 4/19/14

The brown spot at the base of his thumb is the newest addition to his cancer family.

The biopsy site.  This is where the surgeon will go deeper.