Coming Out Of The Cancer Closet (Part II)

By: Cheryl Kupfer

Published: January 19th, 2011
Latest update: July 9th, 2012

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Back in the fall of 2002, nine years after my initial diagnosis of thyroid cancer – the last four of those being told that I was cured – my doctors discovered a tumor in the area where my thyroid used to be. (My malignant thyroid been removed via surgery.)

Up until that day, I had never really identified myself as a cancer patient. I had never felt ill at all; I had no symptoms that would have hinted at a diseased thyroid – such as a hoarse voice or trouble swallowing, let alone cancer. My gynecologist had, during a routine examination – one that I had delayed for too long – told me that I had a multi-nodular goiter, a lumpy thyroid. This condition was indicative of a malfunctioning thyroid – not a malignant one. The odds of a multi-nodular thyroid being cancerous are about 5%.

Follow-up tests showed that I had fallen into that 5% minority and had thyroid cancer – albeit a very curable version. In fact, the Jewish surgeon I was sent told me it was mitzvah to have this kind of cancer. I was initially taken aback until I realized he had “bageled me.” (The act of bageling occurs when a “non-Jewish or non-religious individual begins a conversation with a religious Jew and makes sure to include key Jewish terms. … The goal of an individual who is bageling is simply to show that s/he has a nugget of knowledge about Judaism and that he/she is in the know. Of course bageling often backfires; since the person only has a nugget of information which he/she feels compelled to drop at all costs – from Bageling by Basya Shainer, Teens and Twenties Talk, 10-27-2010).

My reassuring, kindly doctor, had mixed up the word “mitzvah with “bracha.” He was trying to point out that if I had to get a cancer – this was one of the best ones to get.

My surgery was uneventful (except for the very long few seconds when the anesthesia kicked in but I was still awake and terrifyingly aware that my lungs had stopped working and I couldn’t breathe) and my recovery was quick.

Beside having to swallow a radioactive iodine pill weeks later, and be in isolation (total solitary confinement) for three days – until the men in the space-suits and the Geiger-counters said it was safe for me to be released into the general population- there were no other treatments.

Having recurrent cancer changed the game for me – emotionally if not physically. I still felt fine but I had to admit to myself that I was now dealing with a more aggressive opponent, one whom I thought I had vanquished but apparently had only laid low for a while. Some of those insidious cancer cells from nearly a decade ago had somehow managed to avoid the knife and the radioactive iodine that was supposed to zap them, and they had had years to hide and reproduce and possibly spread and infiltrate other parts of my body.

Cancer is like Amalek. If – as we Jews have tragically discovered – this evil is not totally eradicated, if even one individual or cell remains, then they will multiply and regroup and attack in a relentless compulsion to destroy.

I realized that I may have won the battle nine years ago – but I hadn’t won the war. I now had to defend myself yet again and launch a counter-attack.

This literally meant having my throat slit again. I remember that first time, when I was in the OR lying on a table draped with a sheet, with only my neck exposed, silently but frantically insisting to G-d that I really wasn’t korban material – I was on too low a madriga to be a fit sacrificial lamb for the klal. And I certainly wasn’t this time.

I again sailed through surgery, but according to the pathology report that was based on an examination of the tumor they had removed, there were cancer cells right to the margins. In other words, had they taken more tissue out, it is likely they would find cancer there as well.

The post-operation diagnosis was recurrent metastatic thyroid cancer. That sounded pretty ominous – but again, I still felt fine, so what was so dire “on paper,” as I rationalized to myself, didn’t necessarily translate to reality.

But there was another reality that I couldn’t be so blasé about.

I had a bone scan as well as an MRI of my brain to see if my original cancer had spread over the years it had gone undetected. And sure enough, the MRI revealed that I had a mysterious lesion on my brain. I believe the very experienced, brilliant neurosurgeon who looked at the MRI said that it didn’t look like anything he was familiar with.

At that point I became a very interesting case- doctors love cases that are atypical and therefore challenging. It is extremely rare for thyroid cancer to migrate to the brain – my doctor said he had seen that happen only once in his 35 year career (which makes me wonder why I had a brain MRI in the first place) – and it is also highly unusual to have a second primary cancer develop while you are dealing with another one.

No one knew if this lesion was benign or malignant and a biopsy to find out was deemed too dangerous. I would have to wait three months for a follow up MRI. If the lesion had gotten bigger then I would be, as they say in Yiddish in “gehakte tzurrus.”

In the meantime, my thyroid oncologist had to consult with various colleagues as to whether I should get my second dose of radioactive iodine. On one hand, they needed to eradicate whatever cancer cells the surgery might have failed to cut out. On the other hand, if that lesion was indeed thyroid cancer that had made its way to my head, the radioactive iodine could cause my brain to swell. Eventually, I got the green light and swallowed an even higher, more potent dose of radioactive iodine. To everyone’s relief, my head did not explode. And again, there were no nasty side effects. No swelling, no nausea, just curiosity if I would glow in the dark.

In the meantime, I had 12 weeks before that crucial MRI to think about my life, and possible demise – in the overwhelming context of my mother’s death a month after my treatment. I thought about my now grown children – relief that they were adults as opposed to a decade earlier when I was first diagnosed – and excruciating sadness that I might not be at their weddings or know their children.

I did a lot of praying, bargaining, pleading, yelling and ranting at G-d. I had unfinished business, and wasn’t ready to close up shop.

(To Be Continued)