It’s hard to imagine any form of cancer being described as ‘the good cancer.’ The so called ‘good cancer’ is exactly what Gavilan instructor Jane Edberg is facing. The good cancer? Papillary Carcinoma, a form of Thyroid Cancer.

Edberg approached the Gavilan Press in efforts to share information about this rare form of cancer, as well as clear up a few misconceptions people on campus have about what she’s facing. Also, due to the fact that Edberg is a gifted artist, we’re also going to explore the effect this trial in her life is having on her art.
    
Discovery

It started with a strange feeling in her neck in 2005, “I just felt like something was up against my neck so I kept trying to pull my shirt away from my neck,” Edberg says, “and then I realized there was nothing there.” When she sought the advice of her doctor, the symptoms were originally brushed off as relatively minor. After her original consultation, she discovered further seemingly related symptoms, “I realized when I tipped my head back in the shower I would choke and cough and I thought that was pretty strange ‘cause that never happened before.” Her doctor checked her thyroid and didn’t feel anything, but felt it best that she see an ear, nose and throat doctor, so that’s what she did. After ordering CT and Radioisotope scans, the ear, nose and throat doctor referred her to an endocrinologist. The endocrinologist she saw insisted she had no reason to worry. In his opinion, the endocrinologist advised that thyroid cancer was rare, that Edberg was physically fit and that they should meet again in 6 months and do another CT scan. Edberg wasn’t satisfied, “I’m not a wait and see kind of girl,” she told her doctor, and asked for a needle biopsy. After performing the needle biopsy, the endocrinologist only drew fluid, and told Edberg that what she was feeling was caused by a benign (non-cancerous) cyst, and that it wasn’t something to worry about. He also mentioned that it might come back.   

It did come back, and it brought with it uncontrollable coughing and the feeling of choking. A year after her original consultations about these symptoms, she was back in her doctor’s office. Again referred to the same endocrinologist, he performed another needle biopsy and drew fluid again, leading him to believe it was another cyst. At this point, through her experiences investigating these symptoms as well as dealing with other minor medical conditions, Edberg grew tired of dealing with doctors. Two years passed, and the feelings worsened. After consulting her doctor again, she was referred to a new endocrinologist who was less convinced that everything was fine with her thyroid. After performing a much more thorough needle biopsy than the previous doctor, the new endocrinologist informed Edberg of her diagnosis.
 
Diagnosis

Jane Edberg’s doctor informed her that she had papillary carcinoma, a rare form of cancer located in the thyroid. According to National Cancer Institute statistics, only 10 out of every 100,000 people in the U.S. are affected with any form of thyroid cancer, and the occurrence of thyroid cancer only makes up approximately 2% of all cancer occurrences.

Prognosis/Treatment

Of the different types of thyroid cancer, papillary carcinoma is the easiest to treat. In a lot of cases it’s treatable, and in some cases, curable. Papillary carcinoma responds to the depletion of iodine as well as the use of iodine with radiation to eradicate it. Other forms of thyroid cancer are far less responsive to treatment, and thus are more dangerous.

In Jane’s case, the first step was surgery. After a first consultation proposed a radical removal of her thyroid and all her lymph nodes by means of an incision from on side of her neck to the other, Edberg decided a second opinion was in order. Following a recommendation from one of her current doctors, she sought a second opinion at the University of California at San Francisco. There, she was informed of a non-invasive procedure involving lasers and a much smaller incision. Over spring break, she underwent surgery to have her thyroid and 13 of her nodes removed. Though not all of the removed nodes had it, some were found to have papillary carcinoma, meaning that the cancer spread slightly.

In the diagnosis and treatment of cancer, the medical establishment has developed methods of staging patients in 4 stages, from stage 1, which is the best case  and most curable, to stage 4, which is definitely not what a patient wants to hear. Currently, Edberg is has been determined as stage 3. Staging patients allows the medical community a standard way of communicating about patients, and also helps dictate the course of treatment and prognosis for the patient. One thing to keep in mind is that stages are not permanent. Though Edberg is currently at stage 3, the possibility stands that she could be reassessed at a different stage depending on how her body responds to treatment.
The next step for Edberg is radiation. The form or radiation she will be undergoing comes in the form of a pill made of radioactive iodine designed to attack any remaining thyroid cells, cancerous or otherwise. To receive the treatment, she’ll be kept in an isolation room lined in plastic, where a person in a protective suit will bring the radioactive pill to her. She’ll be kept in this room for approximately 4 days, after which she’ll go home and live in a special room she’s prepared which is also lined in plastic. The reason for lining her living space in plastic is that human bodies deposit little bits of matter wherever they go, and being that Edberg’s body will be radioactive, the matter deposited by her body will also be radioactive. Another requirement of the type of radiation treatment she’s undergoing is that she has to severely limit her contact with other people, especially during the first 2 weeks. The precautions of lining her living space in plastic as well as limiting contact with others is due to the fact that she’ll be radioactive for weeks or months after she takes the pill, and especially for the first 8 days or so, she’ll be radioactive in amounts that are dangerous to others, especially young people.

The Good Cancer?

While Edberg is lucky that the form of cancer she has is often treatable and possibly curable, the road she must travel is not an easy one. While papillary carcinoma typically doesn’t present the often brutal battles that more severe forms of cancer do, like those found in the brain or the breast, there are still a lot of logistical and psychological factors that can be hard to handle. Sometimes, she’ll see a tear in her husband’s eye and know he’s thinking about it. Edberg’s diagnosis is also hitting her daughter hard, as the two are quite close, not only as mother and daughter but also as friends. Edberg, however, is taking life as it comes, and is ready to face whatever this cancer, as well as life, have in store for her. The cancer she’s facing could go either way; it could disappear and she could be evaluated at Stage 0, or it could come back and spread. Only time will tell which way Edberg’s cancer will go, and she remains hopeful but realistic about it. Currently, her doctor gave her a 97 percent chance of survival, which are some pretty good odds, though there is still the slight chance the cancer could take a turn for the worse.

One thing to remember is that though papillary carcinoma is treatable, in many, it’s recurring, and some patients spend 15 to 20 years balancing medications with surgeries and radiation treatments. With added surgeries, comes the risk of losing your voice. This is a prospect Edberg isn’t thrilled with. “[Talking] is what I do. It’s how I make a living,” she says, when discussing the unwelcome prospect of losing her voice. Some people tell Edberg to stay positive, and while she knows that it’s important, she also knows the importance of being prepared for the other possibilities she may face. “If that bridge comes up,” she says, “I’ll go ‘Oh yeah, I’ve thought about that,’ and I wont be spending a lot of time trying to recuperate before I put my foot on it. My foot will already be on it.”

Misconceptions & False Cheerleading

Unexpectedly, Edberg has faced a lot of strange questions and comments regarding the cancer that she’s dealing with. Most of these comments and questions are fueled by misconceptions regarding cancer. A common misconception is that she’ll go through chemotherapy and lose her hair. Some have even gone so far as to assume she’s already going through chemo and losing her hair, due to the fact that she’s recently cut it short. The hair cut is completely unrelated to her cancer, and Edberg is in fact not slated for any form of Chemotherapy in the near future.
    

Other than strange and misguided questions, Edberg has faced a lot of over-optimistic cheerleading. When she tells some people that the cancer could go either way, people jump to say “You’ll be the one that survives,” without contemplating the fact there is a possibility she may not, and without actually knowing her prognosis. While Edberg appreciates the positive sentiments she has experienced a degree of excessive positivity bordering on naiveté, and a refusal to ponder the dark possibilities that may be in her future. Edberg says “I think it’s important for people to know that when they approach people that have cancer that it’s a variable and it’s unknown and that sometimes there are things in your favor or not in your favor and there’s no guarantees.” She continues, “I have something in my body that I don’t understand, and it could decide to go in the wrong place like my brain or my bone or my lung and those are the places it goes when it’s going to take someone out.”

The Art

As an artist, Edberg is using her art to help her process some of the myriad of feelings she’s faced in the wake of her diagnosis. While she stays strong for the most part, she admits, “I have moments.”  She continues, “If I’m starting to really feel kind of crazy about it and I’m going through an obsessive compulsive thought about it, I’ll get out my sketchbook and just start drawing all the nasty things I’m thinking about and then other things start happening and then I’m off on a drawing.” In completing a piece of art, she says, “It gets resolved. Instead of holding those feelings in my body, I can let them go.” Edberg feels lucky to have art in her life, “I think most people don’t have that. If you have music or writing or art, there’s a way to kind of pull experience through you and get it out” she says, “it’s kind of like a purging in a way.” While Edberg admits that getting lost in negative thoughts is bad, she notes that sometimes it’s good to dig into the shadowy dark side.  “Life and death just go hand in hand as far as I’m concerned,” she says, “I don’t even think about it being negative or positive, I think of it as being something worth investigating.” Admittedly, obsessing over and getting stuck in dark places is bad, but exploring those feelings and processing them is important, “that’s where you grow” she says.