Sunday, June 6, 2010

A Cancer Scare, a Scar, a Silver Lining - NICHOLAS D. KRISTOF -

My doctor's call came early last month just as I was completing a column noting that 41 percent of Americans come down with cancer. That statistic felt as remote as a puff of cloud in the stratosphere — until my physician, Gary Raizes, gently began to break the news to me that I had a tumor in my right kidney.

The result was a grim monthlong whirlwind of doctors' visits, medical tests and furrowed brows. The doctors agreed that the odds were 10 percent that my tumor was benign, 90 percent that it was malignant. I had no option: surgery was essential.

My built-in optimism was shaken when I read that five-year survival rates for kidney cancer are less than 50 percent.

Ten days ago, I had a three-hour operation. I lost 10 percent of my right kidney, along with a tumor a bit more than an inch long. Afterward, I felt as if I'd been hit by a truck, and I gained a six-inch scar that won grudging admiration from my hard-to-impress teenage kids.

And, boy, did I feel lucky!

The main reason that kidney cancers are so deadly is that they are typically discovered late. My tumor was discovered early only by accident, through a CT scan ordered for another reason entirely. I confess that I had been committing thought crimes against the physician who ordered the scan, Mark Fialk, wondering if it was an example of out-of-control testing — and now I felt that Dr. Fialk might have saved my life.

But I also felt lucky in another way.

This is trite but also so, so true: A brush with mortality turns out to be the best way to appreciate how blue the sky is, how sensuous grass feels underfoot, how melodious kids' voices are. Even teenagers' voices. A friend and colleague, David E. Sanger, who conquered cancer a decade ago, says, "No matter how bad a day you're having, you say to yourself: 'I've had worse.' "

Floyd Norris, a friend in The Times's business section, is now undergoing radiation treatment for cancer after surgery on his face and neck. He wrote on his blog: "It is not fun, but it has been inspiring. In a way, I am happier about my life than at any time I can remember."

I don't mean to wax lyrical about the joys of tumors. But maybe the most elusive possession is contentment with what we have. There's no better way to attain that than a glimpse of our mortality.

My surgeon, Douglas Scherr, said that his patients frequently derive additional satisfaction from life after a cancer diagnosis, and at least for a time are more focused on what feels more important — like families.

In contrast, none of us want this for an epitaph: "He sweated many weekends at the office, ignoring his family but earning a huge bonus."

As regular readers know, I've written frequently about suspected links between chemicals and health. In my own case, I can't help wondering if there might not be a connection as well.

I grew up on a sheep and cherry farm in Oregon, and as a kid I helped mix the pesticides in the sprayer. Dogs on the farm have often died from cancer, and some have had unusual kidney cysts and deformities. Could the orchard pesticides perhaps have some impact on kidneys? Nobody knows.

After four days in the hospital, I spent a week recovering at home from the surgery. As I was finishing up this column, the pathologist's report on my tumor finally came back. Dr. Scherr told me that my tumor turned out to be an oncocytoma, which is benign. Astonishingly, against all odds and expectations, I hadn't had cancer after all. My wife tells me she no longer feels sorry for me, and I'm beaming.

So today I have an impressive scar, a bit less kidney, a big bellyache, and far more appreciation for the glory of life.

My hope is that when you put this column down, you'll think about what you can do to reduce the risk of getting an ominous doctor's call like mine last month:

Stop smoking and avoid secondhand smoke. Slather on sunscreen and avoid tanning salons. Avoid charred meats. Check yourself over for lumps, changes or irregularities, whether in breasts or testicles or skin, and consult a doctor if you have doubts. Try to microwave food in glass or ceramic containers rather than plastic. Toss out plastic food containers that are marked 3, 6 or 7 at the bottom (unless they say "BPA-free"). Buy a radon detector to check radon levels around your house.

And, believe me, it's never too early — cancer or no cancer — to start appreciating our wondrous world, instead of disparaging its imperfections.