‘I’ve got the results of your biopsy and it’s an unusual result,’ he tells us.
Marie and I look at one another, faces grim. I’ve been on this skin cancer journey long enough to know that ‘unusual’ is not good. It’s going to be as bad as ‘medically interesting’ was the last time.
‘So it’s not another melanoma, which is good, but it’s not an innocuous Basal Cell Carcinoma either, as we’d hoped,’ I say.
‘No,’ he says. ‘It’s a Merkel Cell Carcinoma.’
‘What ‘Merkel’ as in Angela Merkel, the German Chancellor?’
‘What? Yes, that’s right. The bad news is it’s an aggressive skin cancer —fast growing — as you’d be only too aware from it growing from a tiny pimple-sized lump to a largish marble by the time we’d cut it out several weeks later. The good news is that we got it all and with good margins on all sides.’
‘I’m glad there is some good news.’
‘But they can recur, even in the same spot and we recommend a course of radiation therapy. That reduces the risk of the cancer returning by 50 percent.’
I feel ill. Oh, not again!
‘You’ll need to have treatment five days a week for six weeks to your lower lip, chin, neck and the lymph nodes in your neck. There’ll be side effects— worse because it’s your face and neck. You’ll get mouth and tongue ulcers. You’ll get a dry mouth as the salivary glands will be damaged — that will most likely be permanent. Your voice will deepen. You’ll lose your sense of taste — that comes back in a few months to a year but is a permanent loss in some people. Your face and neck will become swollen and the skin in that area will become fire engine red — and then the skin will itch and peel. You’ll have trouble swallowing and eating generally because your mouth will be so sore. You’ll need to see a specialist dentist — they may need to clean your teeth for you as your gums may be too sore for you to do it properly.’
His words hit me like numbing blows, one after the other.
How many times has he given this spiel, doing it almost without drawing breath and without looking up from his computer screen? But he is kind and concerned — he’s fitting me in before he goes on leave.
‘We’ll start Monday. Oh and you’ll have to wear a mask for each treatment. You don’t get claustrophobic do you? We’ll get you in tomorrow for a simulation and to make the mask. It covers you head, shoulders and upper arms and it’s strapped down firmly so you can’t move. Oh and we’ll push the barrel of a syringe into your mouth to try to keep your tongue back out of the way. The mask is like that one there. ’
He gestures to beneath the examination table.
When he leaves the room to book my appointments, I pull the mask out from under the table. It’s quite heavy and feels metallic but is probably only a hard plastic. I try it on. It’s a finely woven rigid mesh. You can just see out of it and breathe.
‘I do get claustrophobic,’ I want to shout after him.
‘I don’t think I can do this,’ I say to Marie.
‘Yes, you can. You’re stronger than you think.’
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