Ask Dr. Giles: 6 month scan showed a very small dot, I’m worried.

Jean writes:

I am a healthy 44 year old female with two great sons ages 13 and 22. I had liver resection surgery with Dr Stuart Knechtle at UW Madison, WI in April 2008 due to a large tumor on my liver. Path reports stated it was contained to the liver, no lymph node involvement, no vascular invasion and the doc said he “got it all” with a 1 cm border…which I am told is very large and harldy heard of. I am in the process of going for me 3 month check ups. I went to my second one (6 month) yesterday and am now scared to death. My bloodwork and liver function tests were normal but they noticed a very small dot on the remaining part of my liver. The dot is the size of a BB and too small to biopsy so they suggest I come back in 5 weeks for a repeat CT to see if it has grown, etc. I feel great, not tired, not losing weight, no pain. I thought that this was behind me and I had the rest of my life to live healthy. Looking forward to seeing my children grow up and becoming a grandmother some day. Today I am so down I can hardly function. I am at work right now by the way. The doctor says it could be a glitch on the CT, a benign cyst or something or the dreaded C word. I am trying to be positive but am having trouble in doing so. Many people tell me that a positive attitude is what beats this thing. My realistic side is interfering. Any words of advice would be great. Dr Knechtle has since left UW Madison and is at Emory in Georgia. What do you think the chances are that this is “nothing” to worry about? Also, if it is back, what are my options and do they just prolong life or is there a reasonable chance that I could actually ever be CURED of this? I am told doctors could “zap” the spot if indeed it is cancer. I would appreciate a response today as I sit here on pins and needles.


You are experiencing what most cancer patients go through at one point or another: the idea that, when it comes to cancer, there is no finish line. We are never completely free to consider life without the threat of the cancer returning. This can, at first glance, be a very depressing idea. We may ask ourselves (and others) questions such as these:

We’re never going to be free from the threat of the cancer returning?! Then why should we even go though all this treatment and diet and worry and drama? What’s the point? Where’s the cure?

As humans, we don’t do very well with the unknown. We like guarantees and formulas and maps. We build technology which allows us to peer into own bodies to observe its functioning or to see our world–and even our own rooftop–from space. We explore the unknown until it isn’t unknown anymore. It’s just our nature. So, not knowing what’s going to happen with this cursed cancer can be frightening and/or emotionally draining–if we allow it to be.

The key to preventing our lives from being overwhelmed by the unknown is to focus on what we do know. You have two great sons. Your relationship with them, what you say to them, how you treat them, is completely within your control. There is little unknown about how you feel about them. I would suggest you focus on that. Concentrate your energies and attention on this and the other things over which you have the most influence, and spend very little time on those questions which cannot be answered. Do what you can to make the unknown known, but be careful about getting lost in the unanswerable questions. It’s a difficult thing to do because we don’t like the unknown so we tend to ruminate about it.

But I promise you that if you will turn your attention to that which is clearly known to you and about which you can do something about, you will have less time to worry about the things you can’t control; and you will have more fulfillment and experience more peace–even in uncertain times. I’m reminded of part of the Serenity Prayer from Alcoholics Anonymous:

God grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference

May you have serenity, courage, and wisdom as you face these uncertain times.