[2022-06-01] Surgical follow-up

Today, I had a follow-up with Dr. Boushey, the surgeon who removed the cancerous tumour from my perianal area last November. After his examination, both internal and external, he gave me an A+ report. Everything has healed well, from both surgery and radiation. He doesn't need to see me anymore, and will leave follow-up in the hands of my radiation oncologist, Dr. Jin. I was pleased with this outcome.

The visit today reminded me of this quote: "The only time you should ever look back is to see how far you've come." I haven't reflected lately on my progress in dealing with perianal skin cancer, perhaps because the majority of my recovery is behind me and I'm getting on with my life.

But when I contemplate all the steps that led to today's report card, I see just how significant they are—much more than I had recalled:
  • April 14, 2021 - Annual physical with Dr. Daverne, general practitioner; referral to a dermatologist because of a continuing issue of an itchy patch of skin near my anus
  • September 27, 2021 - Appointment with Dr. Kanigsberg, dermatologist; biopsy performed; diagnosis of in situ squamous cell carcinoma communicated a few days later
  • October 20, 2021 - Appointment with Dr. Boushey, surgeon; surgery required to remove suspected precancerous cells in top layer of skin and to confirm whether cancer has spread to the basal layer
  • November 15, 2021 - Surgery with Dr. Boushey
  • November 29, 2021 - Post-surgery call with Dr. Tropiano; pathology confirmed invasive squamous cell carcinoma (cancerous cells, not simply precancerous cells); would require regular follow-up and possibly additional surgery or radiation and chemotherapy; referral to a radiation oncologist and a medical oncologist
  • December 2, 2021 - Trip to the emergency department of The Ottawa Hospital's General Campus because of a fever, infection and opening of the wound; overnight stay in hospital
  • December 4, 2021 - First of many visits to a homecare clinic in my neighbourhood for inspections of the wound and dressing changes; continuing until January 13, 2022
  • December 6, 2021 - Appointment with Dr. Jin, radiation oncologist; given two options: (1) observation and more surgery or radiation if cancer recurs, or (2) 25 rounds of radiation; decided to proceed with option 2
  • December 9, 2020 - Appointment with Dr. Gotfrit, medical oncologist; request for a pelvic MRI to check my pelvic lymph nodes for cancer; if cancer found, chemotherapy would be required in addition to radiation therapy
  • December 13, 2021 - Preparation for radiation treatment; imaging and tattoos
  • December 15, 2021 - Appointment with Dr. Boushey to remove stitches
  • January 3, 2022 - Pelvic MRI
  • January 5, 2022 - First of 25 radiation treatments; no chemotherapy required as the MRI showed no cancer in my pelvic lymph nodes
  • January 10, 2022 - First of weekly follow-ups with Dr. Jin while on radiation treatment
  • January 13, 2022 - Follow-up with Dr. Gotfrit; official confirmation of MRI results
  • February 8, 2022 - Completion of radiation treatment; time to ring the bell
  • March 19, 2022 - Follow-up with Dr. Jin post-radiation; recovery continues slowly; prescription to deal with ongoing challenges with recovery from radiation treatment
  • April 26, 2022 - Follow-up with Dr. Jin; still not 100%
  • June 1, 2022 - Follow-up with Dr. Boushey six months after surgery; discharged from his care
My next appointment with Dr. Jin will be on July 26, 2022. I will have a follow-up pelvic MRI in September 2022. It's comforting to see the period between next steps getting longer and longer.

Intermingled with these various appointments have been activities associated with monitoring related to ovarian cancer (monthly blood tests and quarterly calls with a gynecologic oncologist), screening related to my risk of breast cancer (annual mammogram and annual breast MRI) and appointments related to other health issues (annual physical and follow-up tests).

It's a lot when taken all together, but when viewed in the way I lived it—one day at a time—it's not so bad.