The History up to diagnosis

Here's the *really* short history on the story of my wife's life as a cancer survivor to date:

On June 14th Robin had a HUGE headache. The prior three days her nose had bled three days in a row - just once each day.

What followed was six weeks in which we saw a primary care provider; three Ear, Nose and Throat (ENT) doctors; two ER physicians; a dentist and an oral surgeon. In that period Robin had both a CT Scan and MRI which were read as indicating a sinus infection. These folks tried to help us understand Robin's increasing pain, and the swelling of her right cheek and gums which began on 4th of July.

On July 18th we saw an ENT who used a nasal endoscope to look up Robin's nose. He could see foreign tissue blocking the passage to her right maxillary sinus. He could not break off a sample, so he scheduled surgery for July 28th to clear out her sinus. We acknowledged that it could be a poorly placed polyp which blocked the nasal duct, or it could possibly (but probably was not) something as rare as cancer in the sinus. Hey - only 2,000 people get that each year and the ENTs we've spoken to only see it once or twice every ten years. The doc was clear that he would start with endoscopic surgery, but if the blockage were severe then he might have to use an alternative procedure (Caldwell-Luc) and make an incision in her gums to get to the maxillary sinus in her right cheek.

Robin had surgery last Friday (the 28th). The doctor first went in endoscopically and removed a bunch of tissue which he sent to Pathology. They replied that the sample was made up of necrotic (dead) tissue. Necrotic tissue happens to be a byproduct of cancer outgrowing the local blood supply. The doc then proceeded with the Caldwell-Luc procedure. Now he could see a mass of tissue. The lab stated that the new sample was a large cell malignancy (cancer) but they couldn't pinpoint the type. Here's one experience in which you would wish to have an "average" disease, and not be special…. The doc cleaned out the sinus, but he did not try to follow the apparent path which it has taken to her gums. We would eventually get the final lab results and then decide how best to proceed.

Today we got the lab results (one week later). Robin has been diagnosed with SinoNasal Undifferentiated Carcinoma (SNUC). We have an article from the Journal of Oncology regarding the "Management of Paranasal Sinus Malignancy". The article notes that there are 2,000 cases of nasal cancer a year, about 1,000 are benign and 500 to 800 are a squamous cell carcinoma. The remaining cases (about 350 a year) are made up of five different types of cancer. SNUC being one of the more rare. So fewer than 60 people in the U.S. are diagnosed with SNUC each year. The article notes that SNUC is "characterized by very aggressive local growth, regional and distant metastisis" It also notes that "Recently, aggressive treatment prorotcols involving comibination therapy with subsequent craniofacial resection have shown promising results".

We do figure that we have the following going for us: (1) Robin is in relatively good physical shape and health (except for the cancer!), (2) the initial position is in her lower maxillary sinus (cancer in the other other sinuses is even more dangerous, (3) we arrived at the diagnosis only seven weeks after the first symptoms, and (4) we've got an incrediblely strong support group of family and friends, all of whom are thinking positive thoughts and many of whom have strong backgrounds in healthcare!

Our next appointment is Tuesday morning and we'll take our next steps then!

Thanks for all your support!