Steps Toward Treatment - Week of August 14

Damaris and I enjoyed the company of our daughter Raquel and her fiance Alex Schoup on Sunday.  We made a trip to Calvert Cliffs State Park intending to take the park trail to the beach below the cliffs, to walk along the beach and search for fossil shark teeth eroded from the Miocene deposits exposed at the cliffs. However, rain threatened and we lacked rain gear, so we decided to retreat to Raquel's car and continue south to Solomon's Island.  We found cinnamon rolls and coffee in St. Mary's county across the high Patuxent River bridge, a great thing on what turned out to be a rainy day.

Being in the greater DC area where Raquel lives and being able to spend time with her and Alex is a silver lining of the cloud of tonsil cancer.  Prior to our first trip to Johns Hopkins to drop off my test results from CIMA Hospital in Costa Rica, Raquel put together a schedule and checklist so that we would get to Johns Hopkins on time and not forget anything.  She also called Dr. Gourin's assistant to talk about her concern. that I receive timely care.  Her positive manor no doubt helped get me scheduled for my first appointment with Dr. Gourin that same Friday.

I made a dental appointment Tuesday to have fluoride trays custom made in order to begin daily fluoride treatment of my teeth to protect them from decay caused by expected reduced saliva production during and after radiation therapy, a common side effect.  Unfortunately, the impression of my lower teeth had to be re-done this morning, delaying initiation of fluoride treatment, which I'll begin as soon as the trays are ready.

Dr. Gourin called today (Thurs., Aug. 18) to inform me that both biopsies that she had taken last Friday from my left tonsil and the area in my nasopharanx (high posterior nasal cavity) tested positively for HPV.  This is good news because HPV-caused head and neck cancer has a high prognosis for successful treatment.  Dr. Gourin didn't expect that the area in my nasopharanx was cancerous, although that's not unprecedented.  She told me that I can likely qualify for ongoing NIH trials.  Treatment and trial participation will be discussed and likely determined at my appointment next Tuesday morning scheduled with Dr. Shanthi Marur, medical oncologist.  The appointment will likely also include Dr. Quon, radiation oncologist, and others from the Head and Neck Cancer Multidisciplinary team.  It's possible that my actual treatment will begin Monday, August 29.  Treatment planning next week will involve another MRI and fitting of a thermoplastic mask that will be fastened to the linear accelerator table to hold my head still during irradiation to precisely target treatment to kill cancer cells and minimize effects to normal cells.