1. Introduction
I am 38 years old and live in Australia. 16 years ago I was diagnosed as having HD stage IA and subsequently received radiation treatment. The disease did not recur and I've had "trouble free motoring" despite a false alarm last year with an enlarged thyroid gland. The following is a brief account of my experiences.

2. 1979 - a stressful year
Two significant, stressful events occurred in my life before the first appearance of the HD tumor. One of the events was the unexpected death of my father early in 1979. In November of that year I was looking in the mirror at work when I noticed that the left side of my neck had significant swelling. A close friend had been diagnosed with glandular fever and I automatically assumed that I too had the disease. I have always wondered whether exposure to the virus or my level of stress that year had triggered the growth of the HD tumor.

3. The initial tumor
Overall, the lump in my neck was the size of a small clenched fist. On the lower extremities you could feel that the lump was composed of a series of smaller lumps that had joined together. It was not sore and felt very hard. At the time I had been feeling tired but had no other side effects. I visited a doctor and was sent for a blood test. When the results came back, the doctor looked grim, told me nothing apart from the fact that I did not have a virus and that I probably had something more serious. He then sent me to the local hospital.

4. A mysterious week in hospital
That day I was admitted to hospital and spent a week being observed, poked and prodded without any hint of a diagnosis. I was then sent home and told that I would need to come back to the outpatients' clinic to meet a surgeon who would perform a biopsy of one of the nodes in my neck. I had to wait for two weeks for the appointment and when I arrived at the clinic a nurse told me that the surgeon had gone on holidays. Because of the Christmas and New Year break I ended up waiting until January to have the biopsy performed. I remember not being distressed at the delay as it had not crossed my mind that I had any form of cancer.

5. Dr Jones to the rescue
I re-entered hospital in January and had some blood tests and x-rays. I then met another surgeon who would perform the biopsy - Dr Jones. I felt a bit scared at the thought of a general anaesthetic as this was my first operation. After the procedure I was amazed at how little discomfort I was feeling and the following day I was sent home to await the results.

6. The diagnosis
I returned to the hospital a few days later and was told by a physician that I had HD. He said that I was lucky as this form of tumour responded well to treatment and grew slowly. I remember returning home via the local library to find out more about this disease I had not heard of. I looked up an old book and felt sick when I read the words used to describe the tumour "malignant neo-plastic growth". That was the first time that I realised that I had cancer. I felt more sick when I read the prognosis. Thankfully the text I read was very old and the medical profession had made such drastic improvements in cure rates - even 16 years ago. Over the next few days I went through phases of saying such things as "Why me?" and feeling very depressed and frightened at the prospect of what may lie ahead.

7. Back to hospital
I returned to hospital a month later to undergo some tests and a staging laparotomy. The tests I had were as follows:
- Bone marrow biopsy
- Lymph-angiogram
- Liver biopsy
- IVP.
All tests were clear.

At the time I had an enlarged spleen and I remember my physician and a young resident doctor making a bet on whether my spleen was involved in the HD. The younger doctor had been looking up research into enlarged spleens and the incidence of malignancy.

8. Dr Jones to the rescue again
Dr Jones performed a laparotomy and splenectomy. I remember feeling pretty bad after the surgery. However after around two days I started to feel a lot better. Fortunately the young doctor won the bet with the physician as my spleen along with biopsies of lymph nodes and my liver taken during the operation were pronounced free of the disease. I was therefore diagnosed as having HD stage IA.

9. Treatment
My treatment was by mantle radiation therapy in April 1980 with my lungs and thyroid gland being shielded by lead placed on a shadow tray. I had 20 treatments on weekdays for a 4 week period. The tumor in my neck which had grown significantly over the 4 months since I originally discovered it disappeared within a few days of commencing treatment.

The treatment caused some hair loss, nausea, and difficulty swallowing. I also suffered skin problems similar to bad sun burn. Overall, it wasn't too bad but I still remember the lonely feeling of lying under the machine for a couple of minutes while everyone left the room. I also remember the distinctive smell of the building which made me feel sick each time I visited.

10. Outpatient for 15 years
Over the next 15 years I visited the oncology clinic at first monthly, then 3, 6 and finally 12 monthly. Each visit would leave me feeling a little anxious at the prospect of the disease reappearing. However this wore off over time.

11. More lumps and bumps
In 1994 my wife noticed that my neck was again swollen, this time at the front. I had a scan which indicated that I had a common goitre growing on my thyroid gland and it was most probably Hashimoto's Thyroiditis. It was decided to take no further action until last year when I noticed the lump had grown further with a large mass on the right side of the gland and a small hard marble-sized lump on the left. The smaller lump felt like a small HD tumor. I was referred to three different doctors at the hospital. One of the doctors performed two fine needle biopsies of the gland and both times lymphocytes were present. I then saw a surgeon who decided to put me on a 6 month waiting list to have the entire gland removed. He also indicated that there was a chance it was malignant.

12. Dr Jones to the rescue yet again
I was very concerned and would have gone crazy waiting six months for an answer. I found Dr Jones in the phone book and went to see him some 16 years after he last operated on me. He performed a partial thyroidectomy within a couple of weeks and thankfully the report came back saying that I had Hashimoto's and there were no malignant cells in the gland. I was told that the thyroid problems were most probably caused by the radiation treatment in 1980.

Steve Willemse

Write to Steve! s.willemse@qut.edu.au

©1996 Diana L.E.G. Hinnrichs