Only a tiny bit of doubt leaves room for a lot of hope, so although two endoscopies had already come back positive for cancer cells in my stomach, I wasn't going to act like that was real until the University of Chicago confirmed or disputed the pathologist's reading. Today they confirmed it.
I had to do two things: figure out what the hell that meant, and plan to tell my mother. I called two cousins, told them the news, and told them that I'd need them that evening. One of them wrangled a same-day appointment from a well-regarded Iranian GI specialist, and I picked up the ex at the airport, and she and I and my cousin and his wife all met at the doctor's office that afternoon.
"I'd like to examine you," he said, looking around the room meaningfully. All four of us had squeezed into his office, Third World style. "It's ok, they're all family," I said breezily. "I'd like to do a rectal exam." "Everybody out! Family stops at the rectum!"
I was actually surprised by how unpleasant the rectal exam was. They're so paradigmatically unpleasant that you almost expect to secretly enjoy them. But no.
They came back in, and the doctor explained. Yes, this is a very unusual case: the average age of diagnosis of stomach cancer is 71. This type of stomach cancer accounts for only 1% of all stomach cancers. I have none of the risk factors. That said, it's very early, and surgery should cure me. The surgery in this case would be a total gastrectomy.
And by the way...
All four of us reeled; you could feel it in the room--dead air, shock. A total gastrectomy means that the entire stomach is removed. The esophagus is reconnected to the small intestine. You have to re-learn to eat, finding what you can tolerate, in much smaller portions, supplemented by vitamin pills and monthly B12 injections. I had hoped that catching it early meant that most of the stomach could be spared. But apparently not with this type of cancer, which is "diffuse" and hides out in the stomach, and often doesn't even show up in biopsies. I was enormously lucky that it had been found at all, since it wasn't responsible for my stomach pain, and is so hard to detect even when they're looking for it.
We came out of the room looking walloped. "Come on people, you look like hell! Suck it up. I don't want to make my mom suspicious. She has to have dinner before I tell her."
"You don't look so great yourself."