Day4 - Understanding the Diagnosis

My Brother and I send one hour mp3 recordings to each other on a weekly basis. We chat about air planes, and computers, and other brother stuff.
Today I got an mp3 from him, and as I listen, I take notes on a 3x5 card. Then when I reply, I have a list of topics that he talked about. I write the date on the top of the card. Only when I was half way through my reply, did I notice, that the date, instead of being August 9 2015, I had written "Day4".
Like the world started four days ago.

The way I look at everything has changed. I walked about 3.1 km to a Chinese shopping mall. I bought a cheese slicer, and a Thermos. Almost every thought is preceded by the acknowledgment that I have cancer.
I looked at buying a new charge controller for my solar panel. That would be a good 20 year investment. Not a good 5 year investment.
Everything I looked at was looked at in a new way, from what it would have been a few days ago.

I thought how most of my retirement money was in precious metals. Gold and Silver. A good thing to have if you expect the world economy to collapse within the next 20 years. But Gold and Silver are not good 3-5 year investments. My whole retirement strategy is now wrong. My whole financial planning is wrong. My whole travel plans are now wrong....My whole life is wrong.

During the walk, I again felt like there is nothing wrong with me. I am carrying a small backpack, walking 6 km on a beautiful winter day. I know many "healthy" people that can't do that. I am strong.

On arrival back at home, I decided to try again to get some meaningful information on my cancer.
When I had asked the Doctor about all the biopsy results he had said. "It's very very bad news. I'm Sorry." I don't know what that means. My last hair cut was "Bad News". Getting dog poo on your shoe is "Bad News". The sun burning out is "Bad News". Those word are so vague as to be meaningless.

A friend that is a very experienced nurse read my biopsy result, and said.
"It doesn't look too good, but there is still hope." What does that mean? Why do all medical people speak in riddles? Those words convey no meaningful information.

Most of the people that now know about my cancer say "Don't give up hope." I again, don't know what that means. Hope what? Hope I die in 8 months instead of 7 months. Hope I never will die? Hope I don't die in screaming pain? What is it I am supposed to be "hoping" for?

I then decided that with my new found access to many credible cancer web sites, I should be able to learn a bit more about my cancer.
I learn that:
Melanoma Cancer is measured in "Stages".
Stage 1 is a red spot, or a mole changing.
Stage 2 is an open sore.
Stage 3 is when it has spread to the surrounding Lymph nodes.
Stage 4 is when it is in the blood, and therefore spread through out the body.

I think the most informative line in my biopsy result is this:
The immunohistochemical profile together with morphological features are compatible with a poorly differentiated epithelioid type angiosarcoma.

OK, so I Google "poorly differentiated epithelioid type angiosarcoma"
Lots of hits.
One  Web site said,

Epithelioid angiosarcoma is a rare rapidly growing malignant vascular tumour with an aggressive course.  Death occurs two to three years after presentation.

Age:  Present in middle aged and elderly male patients. 

Immunohistochemistry:  The neoplastic cells showed positivity for endothelial cell markers - CD31, CD34, factor VIII-related antigen, and Ulex europaeus agglutinin I ; Epithelial markers - cytokeratins and sometimes epithelial membrane antigen; and  vimentin.

It is not uncommon for patients with angiosarcoma to have distant spread at the time of diagnosis. Up to 50% of angiosarcoma patients may have distant spread of disease at the time of diagnosis


Another web site said,

Stage 4 means in the blood..5 year survival rate is 10%.  50% survival is 7 Months.

Another said,

 Stage IV: The 5-year survival rate is about 15% to 20%. The 10-year survival is about 10% to 15%. The outlook is better if the spread is only to distant parts of the skin or distant lymph nodes rather than to other organs, and if the blood level of lactate dehydrogenase (LDH) is normal. 
 
I don't know my LDH level.
I re-re-re-read the biopsy report, and it says

CD31 - Positive (diffuse strong membranous)
CD34 - Positive (diffuse strong membranous)

Diagnosis
- HIGH-GRADE, POORLY DIFFERENTIATED EPITHELIOID ANGIOSARCOMA

I guess that the bottom line is:
It is very bad news, and it doesn't look too good.