Dear Diary,
I feel that I must document the rest of my trekk through life with lung cancer, as I can document my true feelings and experiences with words that your flat ears can handle, unlike my empathetic family that hurt with my pain.
I was reporting on an intense pain in my chest, aching shoulders, and back-pain after long coughing fits to my doctor. I noticed that I was out-of-breath most of the time, and what little did come out of my usually never-closing mouth was hoarse and raspy⎯occasionally, I would cough up blood alongside mucus. And God, was I scared. I had initially chalked everything up to getting old, but never had I coughed up blood. I was fatigued, weak, and I hadn’t felt my stomach grumble for food in a while.
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My doctor listened to my list of complaints and prescribed both a CT scan and a biopsy (a piece of tissue from the lung is extracted and examined for cancerous cells with a needle). A somber mood replaced the previous one, and I was shocked. Cancer? I tried to compose myself, but I couldn’t help it. My bottom lip was quivering, and suddenly I lost it. My cardiologist had dealt with many patients facing cancer, and tried to comfort me by explaining the specifics of lung cancer. Amidst my panic, he called the oncologist (cancer specialist) and pulmonologist (lung specialist) to check for lung cancer. The cardiologist, whom I thought would tell me something about my chest pain, described to me what lung cancer was. Lung cancer can be contracted by exposure to radon, a natural radioactive gas that rises from the ground, found in most basements of unprotected houses.
With lung cancer, there are roughly four stages: I – cancer is solely in the lungs; II – cancer is in lungs and lymph nodes; III – cancer is found in lungs and lymph nodes in the middle of chest (a “locally advanced” disease); IV – most profound state of lung cancer where cancer reaches both lungs, fluid surrounding the lungs, and affects liver (or other close-by organs).
There is a right and left lung in a chest, separated into lobes and segments. The dissected parts preserve vascular and lymphatic networks wherein an elimination of a lobe (or segment) doesn’t disrupt the patterns of adjacent lung segments. Tumors can be removed due to the individual “drainage pattern” that each lung segment establishes, without threatening a whole lung. Knowing the fundamentals of the pulmonary architecture aids in the treatment of lung cancer.
The left lung is smaller than its right counterpart, because it encapsulates the heart in its 8 segments, where the right side has 10. The lung is divided into smaller lobes from attached fissures, the left sundered bilaterally by a horizontal fissure, creating an upper and lower lobe. Two fissures belong to the right lung (one oblique and one horizontal). The fissures outline three lobes (lower, middle, upper). The azygos lobe, provided by an anatomical-variant, is derived from the peak of the right lung.
The upper lobes are separated from the lower ones through deep cushions that run through the azygos vein; further, the areas of the lung served by different bronchioles are represented by their split lobes. The essential pairing between the lungs and the tracheobronchial tree are illustrated by the graphic. The esophagus lies posterior to the trachea. At the bifurcation of the trachea, the two main-stem bronchi branch off, each branch entering the hilus of their lung.
Progressively, they divide into progressively smaller bronchial airways that expansive networks are formed from, extending through the absorbent lung tissue. Cartilage with rings of smooth muscle compose the outermost layer of bronchi, permitting expansion and retraction. At distal ends of the network, the cartilaginous segments become more irregular. Lymph nodes surrounding the lungs are the primary targets for lung cancer metastases, which then venture through blood canals to other organs, such as bones, the adrenal glands, and the brain.
Depending on the stage, therapy includes surgery (removal of tumor), chemotherapy, radiation therapy, and immunotherapy. I am not horribly disheartened now that I have more understanding on my disease. I take antidepressants to balance my life after the stress of finding out of my cancer, but I am forever grateful that I found out early, and that my cancer can be managed. I carried through life with only crossed-fingers as my back-up, and now, I am content with all that I’ve accomplished.
Until next-time, friend.
