After a relatively short wait, the Supervising Doctor appeared.
He told me that the CT Scan didn't show any signs of Cancer elsewhere.
Colo-rectal cancer tends to gravitate to the lungs and/or liver.
The Doctor indicated that there were no "hot" spots on the CT Scan.
That news was well received, but, I still had cancer.

I now made a smart decision.
I asked that an original duplicate be made of the CT Scan so that I could begin to assemble my own file, a portable file, that I could take with me when I visited consulting professionals.
This allowed me to move faster since none of the consulting professional I visited would have to wait until the records department retrieved and forwarded my tests. It also comforted me to know that I had a backup set in case either the original or my duplicates were lost or destroyed.
On every test I would take, I asked for an original duplicate for my portable file.
While you may meet bureaucratic resistance to this request, remember, YOU'RE the person with cancer, not them, and you're paying for the duplicates. You're entitled to a copy, and not just of the summary report, but the study/test itself.

Every Surgeon and consulting physician would review my portable file, but then, they would re-examine me and take their own evaluative tests before rendering an opinion. I would add copies of their tests to my file, hence, my portable file swelled rather quickly.

Just because your CT Scan doesn't show a hot spot doesn't mean that the cancer has remained localized. CT Scans can't detect liberated cancer cells, locally or coursing through your body.
That's important to understand for the following reason.
We all want to get healthy, to cleanse the cancer from our system.
Thinking that the cancer hasn't spread can lead one to take short cuts with respect to the decisions they'll make and the treatments they'll take. Don't err on that side.

Remember, I immediately adopted a headset that was extremely aggressive.
I wasn't going to be cavalier, cocky or careless.
I was going to be thorough, I was going to go the extra mile, irrespective of the discomfort and inconvenience it caused. That philosophy would come back to protect and reward me.

So, here I was, exactly one week later, relieved to be diagnosed with cancer that hadn't appeared to have spread. I had a relaxing weekend. Keeping my head clear allowed me to continue to formulate my plans of attack. I was never in denial, I never got angry and I never questioned, "why me ?" I needed to be sharp, focused on the goal of how to best deal with my cancer. My plan began in the simplest of terms, more due diligence, more diagnostic evaluation.

I had to interview surgeons, oncologists, radiologists and other diagnosticians.

I'm not what could be considered the ideal patient.
I want to know everything.
I ask an inordinate number of pointed questions.
If the answers don't gell with me, I ask more questions, until I reach my level of satisfaction.
I told every doctor that I didn't want them exercising diplomacy as a method of communication, that I wanted everything eye to eye and "right between the eyes". I needed clarity, not candy coated or vague terminology.

As of Sept 19th, here's what I knew.
My biopsy said I had cancer. My CT Scan seemed to indicate that it was localized.
But, the critical question was: What STAGE was my cancer ?
It didn't appear to be Stage IV, but, was it Stage I, II or III.

Determining the Stage and Grade would make a big difference in my approach and my decisions.
Staging and Grading is the categorization of your cancer.
You have to know what kind of cancer you have, the medical name, then determine its category
I had colo-rectal cancer, but, in what categories ?
Staging and Grading are identified with Roman Numerals or with the initials "TNM"
"T" stands for the class of the tumor, I, II, III or IV.
"N"stands for the degree of lymph node involement
"M" stands for Metastasis, whether the cancer is localized or has spread elsewhere.

I had to know "exactly" what I had in order to make the most informed decisions with respect to eradicating it.

Ultrasound, Sigmoidiscopes and digital exams.

The above three tests determined that my tumor was approximately 12 to 14 centimeters up on the left wall and approximately 3 centimeters in size.
The Colon is about 150 centimeters in length and is divided into five (5) sections.
The location of my tumor was almost at the bend where the rectum transitions to the sigmoid-colon. So, I had rectal cancer, which is treated like colon cancer.

My wife, who was nothing short of spectacular during this entire ordeal, insisted upon accompanying me on every visit to every doctor. She's much younger, more reserve and very attractive. She shared my concerns about our son not growing up without his father.
She was frightened by the diagnosis and the uncertainty of what might lay ahead.
While I wanted the doctors to be brutally frank with me, I think they sensed her fear and tried to soften a message meant for both our ears.

In our face to face meeting the physician tried to be comforting and upbeat, indicating that it could be Stage I or Stage II. His official report was quite clear. T-2, N-0, M-0
Stage II tumor, No Lymph Node involvement detected, No Metastases detected.

My initial research had created more questions than it had answered.

Should I have laparoscopic, traditional or hybrid surgery ?
Should I have pre-operative radiation & chemo, or, should I have the surgery first, evaluate the findings, have no further treatment, or, undergo post-operative radiation and chemo therapy ?

That physician gave me some great advice without telling me how to proceed.
He told me several things.
First, to trust my gut, my instincts.
Second, to elect a method of surgery that would best enable the surgeon to see and take out the lymph nodes.
Third, to lean toward the procedures with the least complications.

My research seemed to indicate that Laparoscopic Surgery was the method of choice in Europe.
It shortened the stay in the Hospital from 8 to 4 days.
It shortened the normal post operative recovery period from 8 to 4 weeks.
It's survival rates for Stage I and Stage II cancers were about the same as with traditional surgery.

But, there were other factors.
Previously, I had had three (3) angioplasties on the same lesion in my Left Anterior Descending Artery.
Undergoing Laparoscopic surgery would result in me being under anesthesia for an additonal
1 1/2 to 2 hours. A risk not to be taken lightly, especially for someone with coronary artery disease.
The complication rate for Laparoscopic surgery was higher than with traditional surgery.
All too often, patients ONLY focus on the cancer and diminish or dismiss other issues.
Should the removal or resection of parts of my rectum and colon spring a leak, toxins would flood into my system creating a dire situation.
Lastly, While it appeared that there were NO discernable difference in the survival rates for patients who had Stage I or Stage II cancer, there was a difference in survival rates for patients with Stage III cancer. The survival rates were higher/better for those patients electing traditional surgery versus laparoscopic surgery

More questions popped into my mind.
Without invasive testing, which I was opposed to, how could they GUARANTEE that I only had Stage II cancer, with NO lymph node involvement ? ?

This question not only haunted me, it was a CRITICAL question that needed an answer so that I could decide which treatment path would be the most effective for me.

Once again, diagnostic findings had been presented, but, they raised more questions than they answered.

What next ?

Next it was time to do more research, interview surgeons, oncologists, radiologists and others who could educate and help me.

Colorectal Cancer What to do ?

On 09-12-03, at 6:00 pm, I noticed blood in my stool. Not red blood, but dark blood, almost black blood.
That immediately triggered recollections of prior symptoms that I had discarded as a little unusual, but, not abnormal. The size, shape and color of some of my stools had differed, but, that had happened all of my life at various times. But, with the introduction of blood, the random symptoms occuring over the previous months coalesced into but one explanation ..... Colorectal Cancer.

On the ride to dinner that evening I told a dear, long time friend who was riding with me, that I had Colorectal Cancer.
At first Steve was in disbelief and denial, but after a minute of discussion and knowing me, he felt certain that my diagnosis was probably accurate. He immediately called a physician friend of his, Vince Miller, a lung specialist at Memorial Sloan Kettering Cancer Center in New York City. While Colorectal Cancer was not Vince's specialty, he could provide the road map and guidance needed in my initial phase.

Vince would become one of my Guardian Angel's and a good friend as well.

That evening as I lay in bed contemplating my future and the possibility that I might not have one, I began to construct a plan of attack.

I took a short cut. I didn't go through the process of denial, I accepted that this was the hand I was dealt, and that I needed to play it as best I could.

Denial is a waste of time, emotion and effort.
It's better to be confrontational, to meet the enemy and do battle as soon as possible.

I chose to do things simultaneously, rather than sequentially.

I. Due Diligence

I began to research Colorectal Cancer, radiation therapy, surgery and chemotherapy.
I began to search for diagnosticians, surgeons, oncologists and other Cancer specialists.
I researched institutions that specialized in Cancer throughout the United States as well as other highly regarded institutions.
I also did some statistical research, but, in all honesty, I was only concerned about one statistic ...... ME.

I needed to know what Stage Cancer I had.
Knowing the stage would better enable me to make important decisions with respect to which path or paths I would take.
This is sometimes a difficult task absent surgery and biopsies.

I also decided to err on the conservative or very aggressive side.
I didn't want to take any chances.
I was willing to go through anything if it improved my chances of survival, and I didn't care if the incremental benefits were miniscule to statisticians, I wanted every percentile I could muster.

My first step was to confirm my diagnosis.
09-12-03 was a friday.
Saturday, I called a gastroenterologist whom I knew, Bob Shlein, and told him my tale and made an appointment to see him Monday morning.

I cried Sunday night. Not for myself, my plight or my condition, but, for my little angel, my five year old son. If things got bad, how would I tell him that Daddy was going to heaven.
That I was leaving him, forever, and that we'd never play with each other, hug and kiss each other or see each other again. I didn't want him to see me, the man he looked up to and worshiped, as all kids do with their fathers, as I weakened, as life ebbed from my frail body. Those thoughts devastated me, and I cried. But, those thoughts helped me, they steeled my resolve beyond belief. And, one of the D's came to life. Determination. I was determined to do whatever it took to make sure that I'd never have to have those conversations with my little boy. I stopped crying. It was time to move on, to get a good night's rest in preparation for the journey and battle that lay ahead.

On Monday morning I met with Dr Shlein. He was terrific. He tried to reassure me that perhaps my diagnosis was the result of some other condition. He arranged for a Colonoscopy on Wednesday. On Friday the lab results from the Colonoscopy were back......... I had Cancer.

I had already accepted that fact, so the news, while not favorable, wasn't devastating, and it was now time to continue with my journey into the unknown and marshall my plans for battle.

The next step in the diagnostic phase was a CT Scan to see if my cancer was localized or if it had spread. I insisted that there be no further delay and that the CT Scan be done late Friday, which it was. One of the technicians indicated that the results wouldn't be available until Monday. I indicated that that was not acceptable and that I would wait in the hospital until the results were known.

I must tell you that you reflect on a number of things while you're waiting to see if you have two weeks, two months, two years or an indeterminable amount of time left on this planet.

As I waited for the results, I was at relative peace with MYSELF.
I had had a good life, if a truck had hit me that day, ending my life, I would have had few regrets, But, I had one enormous concern... I had a five year old child and my overriding concern was that I didn't want that child to grow up without a father. That single thought and fear further stiffened my resolve and made all of my decisions easier. I would do whatever it took to prevent that occurence. I would endure any and all suffering, pain and discomfort to make sure that I did whatever was humanly possible to insure that my little boy would grow up with his father. I also had a wonderful wife and two terrific older children from a previous marriage who needed me.

My personality, especially my sense of humor and stubborness were about to become my greatest assets.

To be continued.