Medical question: slow growing but inoperable/terminal cancer

Dragonwriter · Apr 26, 2015

Hi medical experts,

I have a character I want to have gotten a diagnosis of cancer, but I want it to be something slow growing that doesn't show too many symptoms at first and would be very difficult/impossible to treat (so it's essentially a long-term death sentence, especially since this character is a "tough guy" who wouldn't subject himself to long bouts of chemo/radiation/hospital stays--he'd rather just go naturally in his time). Bonus if it's something that wouldn't stop him for working, at least not for the short term. This guy's a police detective in his late 50s. The cancer isn't a big plot point--it just explains why he takes a dangerous chance that he might not otherwise take, feeling he has nothing to lose.

Is there a sort of cancer that would fit with that? Extra bonus if it's something that has symptoms that might cause him to go to the doctor about them, thinking they're something easily treated (like bad indigestion or a nagging cough).

Thanks!

Lauram6123 · Apr 26, 2015

It depends what you mean by long term. How long does he need to live after the diagnosis? Are we talking one year or many?

Dragonwriter · Apr 26, 2015

Lauram6123 said:
It depends what you mean by long term. How long does he need to live after the diagnosis? Are we talking one year or many?

I'm thinking maybe 2-5 years. I don't want to make it too melodramatic--just that the guy has a reason for making what would otherwise be a very unorthodox decision (helping out my MC, a mage, to deal with a supernatural killer who's holding someone hostage on his own, instead of involving the department).

Maryn · Apr 26, 2015

Kind of like Eastwood in Gran Torino? He had lung cancer which caused weight loss and a cough, as I recall it.

But that's fiction. I'll wait with you for the people who have real-life knowledge.

Maryn, sharing her Diet Coke

Lauram6123 · Apr 26, 2015

How about a brain tumor? He could go to the doctor with anything from weakness, headaches, disturbance in his vision, etc. He'd need an MRI. Then hit him with the diagnosis. Low grade astrocytoma can grow slowly and he could keep on working. Most of the time, it gets you in the end. Oligodendroglioma is another slow growing not very aggressive tumor.

Dragonwriter · Apr 26, 2015

Lauram6123 said:
How about a brain tumor? He could go to the doctor with anything from weakness, headaches, disturbance in his vision, etc. He'd need an MRI. Then hit him with the diagnosis. Low grade astrocytoma can grow slowly and he could keep on working. Most of the time, it gets you in the end. Oligodendroglioma is another slow growing not very aggressive tumor.

That sounds like a good possibility. Would it affect his work, though? As a cop, I think he'd be responsible enough not to keep working if he had something that would cause blackouts or seizures, as opposed to something that might upset his stomach or something similiar.

Just as an aside, something supernatural in the story will happen to him that will "cure" it as a side effect.

Lauram6123 · Apr 26, 2015

He does not have to have seizures or blackouts. That differs from person to person. You could just give him headaches or nausea or numbness. The symptoms should be on one side though if he's going to have numbness.

asroc · Apr 26, 2015

Maybe pancreatic cancer? The age is right, usually no symptoms at first and by the time of diagnosis it's often metastasized beyond the pancreas and cannot be successfully treated anymore. Very low survival rates even for early detection. 2-5 years may be a little ambitious, though, and there tends to be significant pain, especially in the upper abdomen and back.

Deb Kinnard · Apr 26, 2015

I believe our city's very late cardinal George got pancreatic cancer, and lived around 5 years after the diagnosis. You might google him to discover the course of the disease. He wasn't pain-free toward the end; you can see it in the TV videos.

Pyekett · Apr 26, 2015

Two particular slow-growing cancers come to mind: prostate cancer and follicular lymphoma. The former won't generally be the cause of death (it's that slow), but the latter can be if not caught early. Unfortunately, it usually isn't. Stage III or more usually makes it a cause of death, especially for a subtype that coverts into rapidly progressing cancer.

http://www.lymphomas.org.uk/printpdf/2085

What are the symptoms?
People with follicular lymphoma often have few symptoms – you may not have any. The most likely symptom you will have is one or more swollen glands (lymph nodes) in your neck, armpit or groin. Usually these are painless and you may simply have noticed a lump by accident.

Other symptoms you may have include:
-loss of appetite and weight loss
-fever
-drenching sweats, especially at night
-tiredness or fatigue
-widespread itching, without any skin problems
-being more prone to infections.

There's not much specific in the way of symptoms for follicular lymphoma. One that might fit your bill storywise is numb chin syndrome from metastasis to head nodes. Some people with follicular lymphoma and numb chin syndrome discuss it at http://csn.cancer.org/node/157133 .

Numb chin syndrome (NCS), also called mental [means "related to the chin"] neuropathy, is a sensory neuropathy characterized by numbness involving the distribution of the mental nerve and is an uncommon, but also underappreciated, manifestation of metastatic malignancy. . . . Symptoms of NCS typically include unilateral numbness of the skin of the chin, the lip, and, occasionally, the gingiva ["gums"]. . . . but motor function of the lower face is intact [so can speak coherently still].

http://www.turner-white.com/pdf/hp_jan00_chin.pdf

Added:

Transformed non-Hodgkin lymphoma (TL) arising from follicular lymphoma carries a poor prognosis, and the median survival time after transformation is approximately 10 to 12 months.

http://leukemiaandlymphoma.eu/treat...porating-allogeneic-stem-cell-transplantation

So, slow slow slow with few symptoms, a few potentially interesting for character development (rubbing chin, etc.), but always with the potential to turn deadly out of the blue. Quite a sword to have hanging. Age is right, too.

Dragonwriter · Apr 26, 2015

Thanks! Those are some great ideas, and I'm sure all of them would work fine. I think I'm going to go with the slow-growing brain tumor with nausea and headache--nice and straightforward, since it's not meant to be a big plot point.

I love this place.

Dmbeucler · Apr 26, 2015

I can second non hodgkin follicular lymphoma. My mother has it now, and when she was diagnosed at stage one she was told it was incurable. Her only symptom was an enlarged lymph node on her collarbone.

Almost 3 years later now she's getting radiation and the prognosis has changed, she's got a 50/50 shot of it being cured now because it is still stage 1 and the new data (and new doctor) say radiation can take care of it. Otherwise she was told that it was very slow acting, and to treat it when the symptoms came back, and that she could have 20 years or so, and most likely die of something else.

So if you character's doctor has old data (and my mother had to see one of the top doctors in the field to get find out that stage 1 could be curable) or if it is not in stage one... there ya go. It's an environmental cancer as well, not genetic (at least from the research and the doctor information I have found.)

Medical question: slow growing but inoperable/terminal cancer

Dragonwriter

Fluorescent Pudding-Brain

Lauram6123

Dragonwriter

Fluorescent Pudding-Brain

Maryn

Baaa!

Lauram6123

Dragonwriter

Fluorescent Pudding-Brain

Lauram6123

asroc

Alex

Deb Kinnard

Pyekett

I need no hot / Words.

Dragonwriter

Fluorescent Pudding-Brain

Dmbeucler