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Better Late Than Never ...



... to get a second opinion about one's first cancer, especially if there's now a second cancer to consider. For most of the nearly 12 years during which I've been a cancer patient, my diagnosis has been non-small cell lung cancer stage IV. Within the past 10 months or so, it has become apparent and subsequently confirmed by a surgical biopsy of a tumor located in my lungs that I have papillary thyroid cancer. The big question remains - and has not been agreed to by my endocrinologist and oncologist - is whether I have two types of cancer or just one. And moreover, whether I've always had two types or one primary  (previously undiagnosed) that has now metastasized after 10-plus years from the thyroid into the lungs?

From my understanding - or actually what I've been told - it's possible, though hardly prudent to biopsy all the remaining tumors in my lungs to confirm exactly what type (types) of cancer I have. According to my doctors, the medical risks to me are too great. Therefore, the decision has been made to treat the thyroid cancer and to monitor, for lack of a better description, the lung cancer. And I can live with that (hope to live with that I should say). Nevertheless, it seemed an opportune time to get, for the first time in my cancer life, a second opinion. This week, after waiting out the transfer of medical records and a thyroid cancer specialist's evaluation, Team Lourie will be going to the Lombardi Cancer Center at Georgetown University Hospital for an independent assessment. To say we are extremely anxious is an understatement.

When I was initially diagnosed in late Feb. 2009, we did not get a second opinion. Perhaps we were naïve, but at the moment the oncologist told us my diagnosis and prognosis,  he was not the least bit perplexed and the path forward seemed clear, and we didn't question him too much. A week later, I began chemotherapy. I have never wavered in this decision and I have no regrets about the path I chose. The fact that I have lived years beyond my prognosis has occasionally given me moments of curiosity as to why I was so amazingly lucky to have survived when so many others have not. Not wanting to look a gift oncologist in the mouth (if you know what I mean), I rarely thought to ask. I mean, I was doing so well.

Then about two years ago, a lump appeared under my Adams Apple. Upon examining me/it, my oncologist characterized it as a clone of my lung cancer and did nothing more than note its size and shape when he regularly examined me until the first of three biopsies (of a lymph node) was ultimately performed. It indicated thyroid cancer. This was new information to my oncologist. And so I was referred to an endocrinologist. She took one look at my "Adams Apple tumor," as I called it, and did a needle biopsy right then and there - in her office. She called me two days later with the results. Again, it confirmed thyroid cancer, which subsequently led to the removal of my thyroid a month or so later. A few months after that, a hospitalization followed for radioiodine treatment to locate and kill any remaining thyroid cancer. Within another month, I began chemotherapy treatment for thyroid cancer, which is how I am presently being treated. Nothing more has changed. However, we wondered, what about my lung cancer? It was not being treated? As George Costanza asked after having sex with the cleaning lady on an old Seinfeld episode: "Was that a bad thing?

And so we have taken steps to find out what it is we don't know that maybe the doctors know. Unfortunately, my original tissue sample is too degraded to re-biopsy, but all other relevant medical information has been transferred. I don't suppose we'll be able to go too far back in time, but given the future that I ended up having, there's no time like the present to review the past.

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Wow, what a tale you tell.  Now you have me wondering what will happen next.  I'm hoping they can take care of both cancers and get you back on a healthy track.  I also clearly understand your wanting to know what the cancer type is in your lungs.  Hopefully they'll do some testing just to make sure they are treating it with the most effective protocol.  I'll be watching this entry for any updates.  And you'll be in my prayers as well.


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