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The Cancer Picture Page

Notes
This page is for the help of those who are going through pancreatic cancer with or after me. Two years after the initial diagnosis, I am still doing relatively well. As I tell the medical professionals, other than having Stage IV Pancreatic Adenocarcinoma, I am in good health for a 55 year old male.

These images were taken on September 1, 2006. What they are intended to show primarily is the scars from the several operations I have been through. I am blessed in that, as long as I keep my shirt on, no one would know that anything ever happened to me. I put these images up in order to ease the minds of other people who are going through pancreatic cancer, to show that there is minimal disfigurement from the medical procedures. It is hard enough for someone newly diagnosed with cancer to deal with the first order practical matters of health care, finances, and what the future may hold. For some there will be the additional worries of what they might look like if they should survive the cancer. I.e. what will life be like afterward? It is to these folks that I dedicate these images.

My cancer blog may be found at http://diehlmartin.com/cancer.html

Figure 1 is the big picture. Note that there is a large belly scar from the Whipple Procedure operation on October 21, 2004, and two smaller scars from installation of the port on August 30, 2006. There are a few minor nicks left from the drainage and feeding tube entrances. I will point these out in the detail photos below.

Diehl's chest with scars
Figure 1. The overview

Figure 2 shows the new scars from the installation of the port, which was done to make continuing chemotherapy more tolerable. This image was made about 48 hours after the surgery, and so there is still considerable redness around the incisions, and a bit of a hematoma. These colors will return to normal within a couple of weeks.


Diehl's port scars
Figure 2. Scars from port installation.

All of the internet information said that the port would be installed "under the collar bone." While the outline of the collar bone is visible, the incision is actually a bit lower than I would have expected from their description. Note also that the second, smaller incision is a bit higher than I saw in the literature, It would seem that the catheter from the port is inserted into the jugular vein, as opposed to further down nearer the heart as the literature seemed to indicate.

Figure 3 shows a closer view of the port installation scars. For being less than two days after the operation, the recovery has been extremely quick and straightforward.


Close up of port scar
Figure 3. Close up of scars from surgical installation of port.

The port is in the fat layer, just above the incision. It is a mostly flat object, with a bump in the middle, and has a hollow tubing tail which extends up under the skin to near the second smaller incision, where the tubing in inserted into the jugular vein. This allows the administration of chemotherapy agents without having to place an IV into a hand or arm vein each time. There is a special kind of needle which is poked through the skin into the port, and the chemo drugs are pumped in there. For the patient, this is a much less traumatic event than placing the IV, with the advantage that the patient is more likely to continue to show up for the chemo appointments.

Initially, I did not have a port installed, and one of the other patients talked me into it during one of my chemotherapy infusion appointments. Anything which reduces the dread of the every two week appointments is a good thing, as it is hard enough to live through this awful illness without the added emotional baggage of fear of treatment.


Scar from Whipple procedure
Figure 4. Scar from Whipple procedure.

On October 21, 2004, Dr. Selwyn Vickers and his team performed a Whipple procedure on me, and removed my gall bladder, the head of the pancreas, part of my stomach, part of my intestines, every lymph node they could reach, and various associated things. They then sewed me back together, in such a way that I can live without the parts they removed. They did all of this through what, I think, is a relatively short incision as shown above. Because of a subsequent infection, they had to open the skin and fat layer back up, and let it "heal from the bottom up." What you see above is the fully healed result, nearly two years later. To the right of the big scar is an indentation, which is the scar from the feeding tube which I had to endure for more than a month after the operation. There is the main hole, and three smaller holes around it, where the flange of the feeding tube was sewn to my skin. This was very slow to heal.

There are three smaller nicks to the left and right, (not visible here) which are left from the drain tubes which were inserted at the time of the surgery, and which had to left in until all drainage stopped. These have healed rather well.

As I said above, as long as I leave my shirt on, no one would ever know that there was ever an operation. Nothing shown here hurts or itches at all, so this is really a fairly optimal outcome.

I would urge anyone facing a cancer diagnosis to find themselves a top-notch cancer center, and go for treatment as soon as possible. The sooner you start treatment, the higher are the probabilities of surviving the cancer, and going on to live a normal or nearly normal life. I can personally recommend Kirklin Clinic, and the Comprehensive Cancer Center at the University of Alabama, Birmingham. Find a good center near you, and just go. Cancer is a terrible thing, but the sooner you deal with it, the better the likely outcome.

My cancer blog may be found at http://diehlmartin.com/cancer.html

Update
Diehl Martin passed away in October 2007. If you need to contact someone, please contact Monica Martin.

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