Adenocarcinoma - Dealing with the bad news

Hi

Let me begin with my background. I had retinoblastoma, a type of eye cancer, when I was a baby. I had my right eye removed and successful radiotherapy to treat my left eye. I had relatively useful visoin in my left eye for 30 years and have had a pretty decent live.

Now in my early 30s, I noticed a lump and swelling above my left eye early last autumn. Even with my previous history, it took months to get anywhere with scans etc.

I was diagnosed in February with lacrimal gland adenocarcinoma after a biopsy. Initially they suggested they might be able to save my vision but I never really thought that was realisitc. I was eventually advised to have surgery in March to remove my left eyeball and wider area, which has left me completely blind but it was hoped would get rid of the cancer, at least for the time being.

A positive margin was found and I was advised in April that I would need to have 6 weeks of radiotherapy. I was meant to have it done in London but was eventually transferred nearer to my home to reduce travelling.

They decided to do a MRI scan first and found that there were still visible signs of cncer there, even though the surgeon was confident he'd got rid of everything visible 8 weeks ago, which suggests it might have grown back quickly. A CT scan didn't show any sign of spread to other parts of my body.

I was advised that radiotherapy was not normally effective on this type of cancer and the chances of it curing it or even giving it long-term control were slim. The limited reading I have done elsewhere suggests this i quite a rare and normally aggressive cancer and even with removal of eye and radiotherapy survival is ofte three years or lessn.

I know there have been medical advances in techniques to control cancer but I'm not sure if any will be suitable for this type.

There's the small possibility of a second surgery but they think it might be too extensive. 

I'm due to find out today whether they will advise consideration of furhter surgeyr or we jump straight to radiotherapy.

I find the nights the hardest bit - I've woken up by 2 for the last week or two and not got back to sleep, hence why I thought I might as well type this!

Does anyone have advice for questions to ask or how to try and process it all? I largely figure that there's no way of knowing exactly what will happen when and whilst I'm here I might as well try and get on wih life and carry on as best I can - but it's not always so easy!

Parents
  • Hi Readingfan,

    I have apocrine adenocarcinoma which is a type of skin cancer that started as a lump on my scalp and found to have already spread on diagnosis.  

    Rare cancers are really hard to deal with as you quickly realise that the doctors don't know that much more than you and everything is pretty much educated guesswork when there is no standard treatment pathway to follow or data to reference - especially the absence of data, which seems to be more of a challenge for doctors than defnitive "this doesn't work" data.

    After diagnosis, I had counselling which helped me realise that this wasn't something I could control but it was in danger of controlling me if i let it and so have learnt to compartmentalise all the cancer stuff so it doesn't occupy my every thought and I can get on with life.  I continue to work full time and have a busy family life and my ongoing cancer treatment fits in with that, not the other way round.

    It also helps to have a forward thinking consultant.  Mine referred me almost straight away for clinical trials and I ended up on one for 2.5 years before things started to progress again.  Perhaps this is something to suggest to your team?  They can look at the genetic makeup of your cancer which might open up targeted treatment options - this is what happened in my case.

    One final thing is to acknowledge that there will be good days and bad ones and you just got to roll with it.  I'll have bad days when it all completely overwhelms me.  I'll have a good cry, a long bath or some other little treat and then feel better about it all the following day.  Funny how the mind works really.

Reply
  • Hi Readingfan,

    I have apocrine adenocarcinoma which is a type of skin cancer that started as a lump on my scalp and found to have already spread on diagnosis.  

    Rare cancers are really hard to deal with as you quickly realise that the doctors don't know that much more than you and everything is pretty much educated guesswork when there is no standard treatment pathway to follow or data to reference - especially the absence of data, which seems to be more of a challenge for doctors than defnitive "this doesn't work" data.

    After diagnosis, I had counselling which helped me realise that this wasn't something I could control but it was in danger of controlling me if i let it and so have learnt to compartmentalise all the cancer stuff so it doesn't occupy my every thought and I can get on with life.  I continue to work full time and have a busy family life and my ongoing cancer treatment fits in with that, not the other way round.

    It also helps to have a forward thinking consultant.  Mine referred me almost straight away for clinical trials and I ended up on one for 2.5 years before things started to progress again.  Perhaps this is something to suggest to your team?  They can look at the genetic makeup of your cancer which might open up targeted treatment options - this is what happened in my case.

    One final thing is to acknowledge that there will be good days and bad ones and you just got to roll with it.  I'll have bad days when it all completely overwhelms me.  I'll have a good cry, a long bath or some other little treat and then feel better about it all the following day.  Funny how the mind works really.

Children
  • Hi everyone. I just wondered how everyone was getting on with their treatment and where everything was now at? Hope you are doing o.k 
    I have not been doing too bad relatively speaking. I had a baseline MRI scan in October which revealed minor enhancement. Apparently this could mean cancer is present or might just be swelling and changes from all the radiotherapy - I'm not sure exactly what this means? 
    I had a follow-up MRI scan today and should get results around Mon 17th Jan so will have an idea of what's going on then. 
    I've asked a bit about clinical trials but it's not gone any further yet. My doctor seems quite caution and more focussed on standard treatments and seeing how I fare with them first.