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Friday, May 18, 2012

109 Reasons

My last blog post was a bit on the negative side. I want to thank everyone for their thoughts and kind words over the past couple of days. I'm sorry if it wasn't easy to read, or if it just came off as a bunch of whining. I'm the kind of person who thinks it's important to confront emotions, even the negative ones. There is something about putting it out there and acknowledging the challenges that allows me to accept the circumstances and move on.

It is important to remember when contemplating the negative, that there is always another side of things, a bigger picture to be seen. Here is the bigger picture.

I know, kind of gross.
Yeah, this is my stomach.
There are 109 reasons why this is all worth it-- the 109 sites of early cancer that pathologists found in my stomach after the surgery.

After the surgery, my stomach traveled to the pathology lab. There, it was preserved, mapped and chopped up into hundreds of slides. After weeks of reading all of the slides, the pathologists mapped out where they had found sites of early cancer.

I had heard relatively early on that they found cancer. It was about a week after surgery when my surgeon came into my hospital room and asked if I wanted to hear a preliminary pathology report. In my hospital-dazed state, I assumed he was talking about the results for some of the blood work that was done, since I hadn't expected hearing about pathology so soon. Then out of nowhere, he said it: they found sites of early cancer.

Examples of signet ring cells in my stomach (yellow arrows).
A couple of weeks later, I met with the pathologist who was in charge of my case. In my scientist mode, I asked to see some of my own slides. I wanted to see what these deadly cells look like.

To look at these cells, the pathologists used a periodic acid-schiff (PAS) stain that detects a protein called mucin. While mucin is normally produced by certain cells and gets incorporated into mucosal secretions, it is overproduced in some cancer cells, including the signet ring cells that are the hallmark of diffuse gastric cancer. These cells show up on the slide as fat and round -- full of mucin.

As a scientist, it is satisfying to have visual proof of these signet ring cells. As a patient, I still can't figure out how I feel about them. It is somewhat terrifying to see the cells that, had they been left unchecked, would have at some point waged war against my body. At the same time, I am relieved that they are no longer in my body. And perhaps the weirdest feeling of all is feeling relieved (happy?) that they were there in the first place, validating my decision to have surgery. (Who in their right mind says they are happy to have stage T1a cancer?)

Regardless of how I feel, the facts are still there: I had 109 sites of stage T1a cancer in my stomach. I had surgery, and now I don't.

So there it is, my 109 reasons why this is all worth it.


  1. Oh wow - so many lesions. The most validating feeling in the world, isn't it? So happy you had this surgery - it is definitely worth the discomfort to know that your cancer is GONE.

    Let me know when you want to chat!


  2. Just wanted to say thank you so much for your blogs. You are honest with your feelings and you should not worry if some of your emotions are not what others might want to hear. Your blogs are helping to get the information out there and you are an inspiration to many. Thinking of you and am so glad you are now cancer free.

  3. 1. Hahaha this was the blog post that I was waiting for!

    2. Wow, genetics is so powerful.

    3. Yay stains!

  4. wow, you really dodged a bullet!

    proud of you for making the hard (but right) decision!


    1. As someone who also has the genetic mutation for HDGC, and has had her stomach removed 5 and a half years ago, I want to tell you that you are doing great! It's so interesting, almost everything you mentioned, I have either gone through myself or my cousin, aunt, or sister have gone through it (they also had their stomachs removed). The adjustments and the eating can still be challenging for me, 5 years later, and it's true, the isolation can feel lonely. I have my family to complain with/and to compare notes with, and that really helps. When I tell them that I lied in bed for 2 hours after eating dinner one night because I was so bloated I could hardly move, they understand, and usually have some practical tips to offer that have worked for them. Sometimes, though, to the rest of the world, I'm sure I seem relatively normal and it can be frustrating knowing they have NO idea what I go through on a daily basis. I feel exactly the same as you though, is it all better than dying of such a terrible cancer as gastric? Yes. In the end, i would rather have my life (bloating, gas, strictures, very little dairy or sugar, chewing each bite 30 times, than dying young, like my Mom, when I was just 9 years old. Stay strong. It will get better, but 5 years in, I have to be honest and say, it's still not always easy.

  5. Thank you for sharing your experiences. I understand what you mean about being happy that you have proof that you made the right choice in having your prophylactic gastrecomy. Please keep blogging!