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6/12/06 (I did not have time to check English over, but uploading this entry anyway.)

I had a second consultation with Dr. B at BWH, and the wheel started turning suddenly.

His explained that my cancer has possible spreads that are not detected by the PET scan, because the endoscopic ultra sound revealed that the penetration is T3. As far as the staging goes, the cancer can be IIB or IIIA. So, he recommended that I go through the chemo/X ray treatment first to kill the cancer cells and burn the tumor. In order to do it effectively he will insert a J-tube (tube that feed the nutrient directly to my jejunum -small intestine) so that I can maintain my weight. It is well known that chemo/X ray cause severe side effects, but it has the most profound effect in the case of esophagus cancer; you cannot eat while X-ray burns your esophagus. Also, he said he would look at my bronchi, esophagus, and jejunum through different kinds of endoscopy to find the small cancer that could have been missed by PET scan. Oh, yes, he will insert the catheter for chemotherapy.

Therefore, he continued, "he will conduct a surgery tomorrow with 6 different procedures: 1) bronchoscopy, 2) esophagogastroduoendoscopy, 3) dilatation, 4), portacath placement, 5)J-tube placement, 6) jujunostomy." I need to stay at the hospital for two nights.

What? Tomorrow? I could not believe my ears. In the huge hospital like this, is it possible to schedule so nimbly? But he took me to his assistant and explained his plan, and then the assistant took me to the pre-op division without any formal paper works. Obviously my cancer treatment is prioritized and accelerated. It can be that the situation is quite critical, or that I am simply lucky to have a very powerful and decisive surgeon. I, off course, choose to believe the latter.

When I was eating lunch after the examination, my oncologist called my cell. He told me that Dr. B already sent him Email about tomorrow, and that he will see me on Friday for the chemotherapy that he will start next week. What a teamwork!

I felt that I could trust Dr. B. What he explained matched quite well with what are being discussed in Japanese university hospital websites. He was not only quite knowledgeable but also was a good listener. I liked his cautious but decisive manner.

After coming home, I took a walk for about two miles. The sky was blue and high, and I could hear many birds singing. When you focus your hearing to birds’ singing, even human voices (particularly children’s) sound like one variation of birds’ songs.

The upcoming treatment schedule is something like below:

6~8 weeks of chemo/X-ray
4 weeks of rest
Surgery to remove cancer
6~8 weeks of recovery