A Completely Reasonable Explanation of the Situation

(As told by someone who has seen too much but now technically only sees half as much)

      So here’s the deal.

• Yes, this confirms eye cancer — the sneaky, aristocratic kind called choroidal (uveal) melanoma.  AKA rat bastard charlie.
• The entire right eye was removed, like a condemned building, and examined inch by inch by people with microscopes and no illusions.
• The cancer itself was mean, ambitious, and biologically rude — but it was fully removed.
• It did not crawl into the optic nerve, did not escape the eye, and was cut out clean at the edges.
• Unfortunately, it has the personality profile of something that might try again someday, so now we watch. Closely. Forever-ish.

And now  the answers to the questions you might want to ask

AUTOPSY RESULTS  OF A TRAITOROUS ORGAN

1. It was choroidal melanoma — a malignant tumor that starts in the pigmented layer inside the eye. Not skin cancer. Not visible. Not polite. It behaves like melanoma does everywhere else: quiet growth, long memory, potential for distant revenge.

2. What kind of cells were running the show? Well Over 90% were epithelioid cells. These are the worst-behaved cells. The kind that don’t believe in compromise. The biological equivalent of a room full of lawyers with knives. There were a few spindle cells — calmer, less dangerous — but they were outnumbered and ignored. And you ask Why this matters? Well Epithelioid-heavy tumors are much more likely to spread, given time and opportunity. Which time always provides.

3. And how aggressive was it? Oh, it was busy. Cells actively dividing — not resting, not reflecting, not repenting. About 25% of the tumor was actively growing at any given moment. Hell, parts of the tumor outgrew their own blood supply and died, which is both horrifying and impressive and strangely somewhat satisfying to know. Unfortunately the majority of the cells were PRAME-positive. Which in cancer language means: “Don’t trust this thing.”

4. Did it invade nearby structures? Yes, but not enough to win. It barely invaded the sclera (the white outer wall of the eye). It did not escape the eye. It did not touch the optic nerve. It crept toward the front of the eye, then stopped — like it heard sirens.

5. Were cancer cells found in blood vessels? Yes. Because of course they were. Some tumor cells were found inside a blood vessel within the eye — basically standing near the highway with a suitcase. And this matters because it means the tumor had access to the bloodstream — not that it used it, not that it succeeded, but that it knew where the exits were.

6. Were the surgical margins clean? Shockingly: yes. I’ll take this as a win for me. No cancer at the edges. No cells left behind. No microscopic squatters hiding in the walls. The surgeons got all of it. Which is rare enough to be worth repeating: They got all of it.

7. Tumor size (because size always matters). This thing was large. About .75 inches across. Up to .6 inches  thick under the microscope. In eye cancer terms, this qualifies as “significant”, which is doctor code for “we’re not pretending this was small.” On the bright side – Still  gone.

8. The Genetic Verdict (The Line Everyone Pauses On) The tumor is Class 2.This is the part where the room gets quiet. Class 2 tumors have a higher risk of metastasis.The liver is the usual destination. While this does not mean it has spread. The damn thing likely had ambition. Think of it as a bad Yelp review written in DNA.

WHAT THIS REPORT DID NOT SAY (IMPORTANT FOR THE ANXIOUS)

It did not say that The cancer has spread. It did not say that the optic nerve is involved. It did not say that there was anything was left behind. It did not say that this is untreatable. And It did not say that I’m on a clock (even if it feels like you are).

 

THE BOTTOM LINE (NO POETRY, JUST FACTS)

I had a serious, aggressive eye melanoma. The eye was removed. The cancer was fully removed with it. There is no evidence it has spread. But the tumor had enough red flags that medicine will now keep one eye open — metaphorically, of course.

 

WHAT HAPPENS NEXT (THE SEQUEL NOBODY ASKED FOR)

From here on out, life will  include regular liver scans, blood tests, oncology visits, and Doctors who say things like “out of an abundance of caution”. Nothing dramatic, nothing cinematic, just persistent vigilance in a universe that does not care.

Welcome to surveillance mode. It appears that the enemy is gone. But there might be a few stragglers out there looking to set up shop. The battlefield remains, and the future is untrustworthy.

I’ll be meeting new people, which is to say: I’ll be sitting in quiet rooms with an oncologist, calmly discussing “the plan” — a document that will exist because entropy never sleeps and medicine refuses to look away.

Meanwhile, I’m already working with a proctologist, because nothing says “dignity” like checking whether the rat bastard might be hiding out in my prostate (not “prostrate,” though at this point either feels accurate). I do have a special MRI scheduled for February 5th, dedicated entirely to answering the question:

“Is there another problem, or are we done being surprised for now?” This is all precautionary.
This is all responsible. This is all deeply, cosmically funny in the way only mortality can be.

 

 

 

Laissez Les Bons Temps Rouler