The Unsuspecting

I am facing another health challenge. On May 20, 2017, I visited a dermatologist to remove a nodule I believed to be remnants of a bike sore - the result of continual friction between skin tissue and fabric. After all, we road-bikers occasionally get these small annoyances after riding for long hours. The excised tissue was sent to the Florida Hospital Pathology lab for analysis.  Several weeks later, the dermatologist called to inform me of the results of the pathology test. "I am concerned about a Pathology report I have received about the nodule I removed a few weeks ago. The Pathology report indicates a positive test for angiosarcoma. I would recommend that you see an oncologist. Do you know one?" It seemed like a lot of information to absorb; but it had been only about 20 seconds since he had greeted me with "Mr. Archer, how are you?"  "Please fax me the report immediately and also send it to my oncologist," l responded, while providing him with my oncologist's contact information. "By the way, please also send a copy to my Primary Care Physician." On receipt of a copy of the report, I scanned it and emailed it to my wife and children.
I have been blessed with a wonderful family. My wife is the ultimate homemaker and caregiver. My son, a hospital executive, is thoughtful and analytical. My daughter, a lawyer, has an eye for the detail that many of us might miss along the way. Later that evening, as we met to discuss the next steps, we decided that we should have a second opinion, another Pathology review of the tissue.  Several days later, the second opinion, performed by Moffit Cancer, confirmed the first. It was described as epithelioid angiosarcoma, a cancer of the lining of the blood and lymph vessels.(http://sarcomahelp.org/angiosarcoma.html). Unsuspecting! (By the way, this is totally unrelated to my experience with nasopharyngeal cancer in 2007.) 
Whether there was metastasis or not, was at this time concerning as the cancer cells were too close to the margins of the incision. Suspicion loomed and a reexcision was recommended. My oncologist ordered a PET scan which appeared normal. Good news! A team was assembled to review my medical status and make the appropriate recommendations. The surgical oncologist and a radiation oncologist collaborated and came up with a treatment plan. Surgery (a wider excision) followed by radiation. 
An initial attempt of surgery was terminated due to complications during anesthesia. My trachea became extremely scarred, narrow, and warped during my radiation treatment in 2007. As a result, intubation during anesthesia is risky. In 2012, a failure to complete intubation during anesthesia resulted in a tracheotomy. My surgeon therefore decided to abort anesthesia and suspend surgery before the critical decision to perform a tracheotomy. 
After a life of relatively good health, with a fairly active lifestyle, this was an unexpected diagnosis and is a reminder of the tenuous nature of life on this planet. Although I had a normal PET scan, the risks are obvious, but the prognosis can be described as guarded to good. At this time, I am prepped for radiation and after a short time away visiting my parents in Tobago, I will make a decision regarding another attempt at surgery, or proceed with radiation only. My previous experience with cancer, notwithstanding, I am hopeful and I look forward to a rapid recuperation and full recovery. 

Love and blessings!

Len