It's strange, what one remembers from Medical School over thirty years ago. Apparently, the following story made enough of an impression on me that I still recall it:
In the early 1800s, Alexis St. Martin, a 20-year-old Canadian Voyaguer, was accidentally shot in the abdomen by a musket at close range. Although believing that the wound was fatal, he was, nevertheless, taken to a nearby US Army post where a surgeon, Dr. William Beaumont, treated his wounds. Remarkably, St. Martin recovered, but was left with a healed opening between his skin and the interior of his stomach. Since not much was known about human digestion at the time, Dr. Beaumont realized he had a unique opportunity to find out what happens inside a living human stomach. For the next ten years or so, Beaumont used St. Martin in his studies and contributed to the medical knowledge of the time.
What does this have to do with me and my cancer? Well, yesterday I noticed a tender red lump on my lower leg and it appears to have an increased level of inflammation and pain today. I remember this small skin lesion from the past several years as a scaly patch of skin and had always assumed it was a fairly minor, and benign, sebhorreic keratosis which itched occasionally. Perhaps not. Perhaps it is a cancerous lesion that is reacting to an anti-cancer drug I have been given. Maybe it's a melanoma; maybe it's a squamous cell carcinoma; maybe it's a basal cell carcinoma. But if it is composed of cancer cells, it will be interesting to see how it reacts to the anti-cancer drug infusions I am getting. Even though some of my melanoma metastases can be felt as bumps in my skin, most of the cancer is internal and can't be seen at all, so no other cancer cells are as visible as this lesion on my leg. I may be given the opportunity to actually observe the reaction of cancer to the drugs I am receiving.
This may sound a little strange, to think of this as a positive development, but a lot of the stress, anxiety and worry during this cancer event comes from not knowing either what is happening, or from not knowing what to expect.
The drugs I am receiving (both the standard treatment and the investigational drug) do not work for everyone. Some people respond well, some respond to a degree and some respond hardly at all.
Maybe this lesion will be the predictor of things going on that I cannot see elsewhere in my body -- like the canary in the coal mine. Maybe it will be the harbinger of what is to come in the way of a reaction in other tumors -- like the first sprouts of Spring bulbs pushing toward the light. Maybe it will be the first line of a welcome song that says "you are a Responder -- this drug will fight your disease."
We'll see...
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