Saturday, June 23, 2007
I had my mediport placed yesterday. As explained to me, a mediport is a small titanium reservoir embedded under the skin between my shoulder and neck, near the collarbone. Its rubber covering allows access via a special needle, and at the other end, a tube attached to the reservoir empties into a nearby vein. They choose a larger vein to minimize irritation from the chemotherapy drugs that are going to flow through it. The doctor explained that a lot of the sickness chemo patients experience comes from running the drugs through small veins.
I was sedated for the procedure. Good thing too, as this was essentially minor surgery. I didn’t feel any pain while it was going on, and was able to walk from the hospital to the train station shortly afterward. But the experience and sedation knocked me out. I fell asleep soon after I got home and slept for twelve hours.
The doctor who performed this surgery is the same one who did my pulmonary biopsy. “Do you have any questions for me?” he asked.
In fact, I did have a question that others who know me may have wondered also. “Are there different types of cells for different cancers? They found cancer cells in my lungs. Why is my diagnosis melanoma and not lung cancer?”
He explained that pathologists do in fact have ways of distinguishing among various forms of cancers. They use a number of different stains to clarify and identify characteristics. There was a pathologist with a microscope in the room with us during the biopsy, so they were able to look at my aspirated cells right away. He remembers that they appeared dark, indicating the presence of melanin, the pigment-producing skin element where melanoma grows.
This begs the question: Is it better or worse to have metastasized melanoma or lung cancer? In fact, every case is different, but that may be more of a philosophical issue than medical.