The Tests and The Shock

Cancer often presents in a way that is remote from the source of the cancer cells. As well, there are so many different cancers, and treatment programs focussing on each can be different, so it is important for the treating Oncologists to be certain. Patient health is another variable that has to be considered before, during and after treatment. The same treatment program may result in different patient outcomes with respect to the cancer, general health and side effects, during and ongoing, of which there are many.

Leading up to my diagnosis and treatment program being devised, I had a lot of tests. Firstly to determine if the lump was cancer, then to isolate the location and extent, then to identify and isolate the primary (source).

In my case, the tests identified that the cancer cells formed on the remnants of my right tonsil, which then travelled to my neck to form a squamous cell carcinoma. Other than the lump in my neck, I had no other symptoms.

The tests commenced with a simple ultra-sound, which initially identified the lump as a cyst because it appeared to be filled with liquid. My GP then referred me to the Perth Radiological Clinic for a Fine Needle biopsy. Under local anaesthetic, the Doctor sticks a very fine needle into the tumour to get material for testing. The first four needles, all distributed to various parts of the lump, came back with liquid. The Doctor realised that she needed to get cells to be tested so, unusually, continued to take more samples – up to 8 eventually I think. Thankfully she did. She mentioned to me that normally they take 4 samples for initial testing. The results take a week and if more tests are required, they ask you back to do it again. In my case, the Doctor knew this would be the case having taken liquid so kept ‘digging’ until she got the cells she needed. These came from the shell of the lump, and subsequently were diagnosed as malignant cancer cells.

The results were sent to my GP at Illawarra Medical Centre who rang and asked me to come in immediately. Obviously this was a difficult time because we knew why the tests were being done and in all the times we've been to this medical centre, none of our family had ever been called by them. We knew it was unusual and unlikely to be good news.

Vicki came with me to that appointment. Her rational nurses mind proved beneficial because she was able to ask the relevant questions, whereas my mind had already assumed the worst and was racing with “ how long have I got? will I see my kids grow up, is my Will updated and the like?”

At the time, it was quite hard to hold it all together, but I figured I’d get on the front foot and learn as much as I could before worrying about the outcome. I read as many relevant medical journals as I could, as much medical research as I could find, and Vicki even found an online chat line with people discussing neck cancers. All of which eased my mind a lot. One of the things I learned was that cancer is no longer an automatic death sentence. And my cancer is at the ‘good’ end of the scale compared to many others.

I was referred to an Ear, Nose and Throat specialist who gave me more news and information about my specific condition, and explained the process I’d now be going through.

I was sent for a CAT scan to create black and white images of my body from my head to my waist. While the lump is noticeable in these scans, a further PET scan is required to determine the extent of the cancer and to try to identify the primary site. The PET scan is in colour and involves a radioactive glucose solution being pumped into your body for the scan to pick up. Apparently, cancer cells latch onto the radioactivity moreso than ordinary (good) cells and they glow bright like the sun as a result.

The PET scan showed the shell of the tumour and the most likely primary site being my right tonsil. It also looked like some cells may have travelled to my lymph nodes.

To confirm the primary site, I went to Hollywood Hospital for a biopsy on my tongue and tonsils under general anaesthetic. The results confirmed my tonsil was the primary site.

Fortunately in my case, the CAT and PET scans also confirmed that the cancer had not spread to other parts of my body.

The Doctors and nurses who treated me were excellent and I didn’t feel any pain from any of the tests, apart from the initial prick of the needle and cannula through the skin.

Once these had been confirmed, my ENT Doctor referred me to the Cancer Centre team at Sir Charles Gairdiner Hospital.