After my diagnosis of renal cell carcinoma, my oncologist praised my positive attitude in facing the disease head-on, but when you are dealing with a life-threatening illness like cancer, what other attitude can you have?
Until I was diagnosed with stage III renal cell carcinoma in early 2008, I had no firsthand experience with cancer. To my knowledge, there is no history of cancer in my immediate family, and despite a smoking habit I picked up when I was young, I had been in relatively good health in the 56 years leading up to my diagnosis.
So it came as a complete shock when I went to the bathroom one night and saw blood filling the toilet bowl. I was so frightened and immediately went to the emergency room, only to be told to make an appointment with my primary care physician. But before I could see him, I continued to pass blood, and the pain in my lower back became so severe, I headed back to the emergency room to find out what was wrong.
This time, a computed tomography (CT) scan was performed, which showed a large tumor in my right kidney that extended over my right adrenal gland and part of my renal vein. A biopsy of the tumor confirmed advanced-stage renal cell carcinoma, and 3 weeks later, a surgical oncologist removed the kidney, adrenal gland, and part of my renal vein. No other treatment was recommended. Although I was still feeling a bit fatigued, I went back to work soon after the surgery but had to quit several months later as my level of fatigued increased.
Facing Multiple Recurrences
During conversations with my oncologist about my diagnosis and treatment plan, I never received a prognosis and was not sure what I could expect in the future, although I knew I was at high risk for cancer recurrence. And because coping with such a serious illness was all so new to me, I didn’t know what questions to ask or even where to find information about my cancer. Unlike the more common cancers, such as breast, prostate, and lung cancers, my doctor’s waiting room didn’t include pamphlets about renal cell carcinoma, and he didn’t offer me material I could take with me.
The fact that I was closely monitored the first 2 years following my diagnosis—I had a CT scan every 3 months—gave me confidence that any recurrence of the cancer would be found at an early enough stage that my life wouldn’t be threatened. And that has basically been true so far.
Eighteen months after my primary diagnosis, the cancer recurred in my left adrenal gland, necessitating surgical removal of that gland as well. I was prescribed hydrocortisone to manage my adrenal insufficiency.
I remained in remission for 5 years, and during that time, other than not being able to work full time, I lived my life without too many constraints and generally felt well. But in 2014, I began experiencing a sharp pain in my left shoulder, and an imaging scan showed a peach-sized tumor: The cancer was back again.
This time the treatment was more intense. Because the tumor was large, one-third of my shoulder blade had to be excised along with the cancer, followed by 20 rounds of radiation therapy. Four months later, the cancer showed up in my liver, and I was prescribed 800 mg/d of pazopanib (Votrient), which has been effective in shrinking the seven lesions peppered throughout my liver.
Looking Toward the Future
After my diagnosis of renal cell carcinoma, my oncologist praised my positive attitude in facing the disease head-on, but when you are dealing with a life-threatening illness like cancer, what other attitude can you have? I want to live, and despite my three recurrences—and the fact that I’ll probably have more—I don’t believe the cancer will kill me.
There are goals I still want to achieve in my life, and I believe I have time to see those goals realized. ■
Robert Bonney lives in Coos Bay, Oregon.