Angirvik pikiaq is the Inuit word for “wolf bite” or “bitten by a wolf.” It is written in their language as ᐊᖏᕐᕕᒃ ᐱᒋᐊ.
This post is Part II of my battle with cancer. It would be much more relevant if you visited my first post here before attempting to read this one.
If you wish to read my day-by-day notes from when cancer was first discovered in me, you can find them here.
To date:
I have spent twenty-four of the last twenty-eight months battling bladder cancer. For a brief month or six weeks, my wife and I lived under the assumption that my cancer was in remission. As a result, my chemotherapy was discontinued.
Two weeks ago, I passed an alarming amount of blood mixed with my stools. I was added very quickly to the colonoscopy schedule, and a week later (today), I was scoped.
The surgeon briefed me and my sister-in-law, who was kind enough to drive me to the procedure and then back home. The surgeon said she saw:
An infiltrative and polypoid non-obstructing mass...in the transverse colon. The mass was non-circumferential, likely from the uroepithelial origin. No bleeding was present. This was biopsied with a cold forceps for STAT histology.
The surgeon said that it was waxy in appearance or texture and gray (see greenish mass in image). According to Pathway, “Infiltrative describes a lesion that spreads into surrounding tissues, often indicating aggressive or malignant behavior. Polypoid refers to a lesion resembling a polyp and can be benign or malignant.” The good news (if any) comes from the term “non-circumferential.” Non-circumferential masses are clinically significant because they often indicate a less extensive disease process compared to circumferential masses. For example, in the gastrointestinal tract, a non-circumferential mass may suggest a localized tumor or inflammatory process, whereas a circumferential mass could “indicate a more advanced or aggressive condition” (Pathway.)
Her opinion is that it is related to my bladder cancer, but I am not so sure.
Either way, I have to wonder if I’ve been bitten again by the wolf.
The Plan
My surgeon ordered STAT processing on the biopsy and a PET scan. While STAT usually means “immediately,” in my case it was two weeks later. PET stands for Positron Emission Tomography. Unlike other common scans that map out the structure of a mass, a PET scan allows a radiologist to trace its metabolism, particularly concerning glucose, since cancer cells have “sweet tooths,” so to speak. At that point, I’ll likely be handed over to an oncologist for some regimen or possibly to a surgeon if surgery is an option.
The Wolf
I don’t blame the wolf. It is only following the programming in its DNA, just as cancer does. It is a predator that only wants to live, to thrive, and to reproduce, just as cancer does. While wolves generally hunt in packs, a single (lone) wolf is often more successful than a pack. Perhaps because it attracts less attention and can slip by your consciousness when you least expect it?
A gray wolf lives 6 to 8 years on average, but sometimes twice that. Males can grow as large as 70 to 130 pounds. Gray wolves communicate through howling, barking, whining, and growling, as well as through scent marking.
The gestation period of a wolf is 62 plus days. I’ve studied the fetal development of the wolf. I constantly read descriptions such as “rapid cell division occurs” and “angiogenesis takes place.” This is fundamentally descriptive of cancer as well. I’ve looked at photos and models of the wolf fetus. In their very early development, they could be almost anything: an adorable otter, a chipmunk. Later, they resemble a dog, or fox or coyote. But eventually the breed of the fetus is unmistakable. Still, wolf pups soon after birth can be disarming. They are playful, cuddly. They love to explore, pushing their boundaries. In cancer, they call this metastasis. And yet there is something that sets them apart. Something sinister.
We have a golden retriever and it has the outgoing, affectionate nature of a golden. My wife and I will watch television and sometime the show will have a barking dog. Our golden will zoom in and sit in front of the screen when it hears another dog bark. One day I was watching an old western show and they had the howl of a wolf. Our golden heard that, and she was shaking with fear. Mind you she never encountered a wolf before, but there was something about that howl that terrified her. It wasn’t even digital, but it was shattering to her. And it should terrify you as well.
Wolves today have been acclimated somewhat by the encroachment of people. Given a choice of fight or flight, many wolves would choose the latter. But how wolf welcome you on it’s home turf, hundreds of miles from other humans? What if the wolf were hungry? What if you were wounded, an easy kill? What if it had pups it thought were threatened by your presence?
Reflections
A younger, healthier person who is attacked by any animal probably has a better chance of survival than a much older person all other things considered. Unfortunately, cancer can ravish people of any age, but younger people might better tolerate the treatments. Or not.
Nor do I question the fundamental fairness of someone approaching 80, like myself, getting cancer. If I were a young person with small children, that might be more problematic for me to consider. But at my age, I am grateful for the time the Good Lord has given me in this life. And while I have a good wife who I love in the next life waiting for me, I also have an outstanding woman as my mate in this life. And I would appreciate more time to spend in her company. To date, and in my battle with bladder cancer, God has sustained me. Compared to colon cancer, bladder cancer in its early stages is relatively easy to manage–or at least it was for me. But I can speak bravely enough during the day. The nights are different as you well know. That’s when the fears and uncertainties are more apt to creep into your mind.
The Pathology Report Arrives
The pathology report arrived on the last day of July. The doctor who performed the colonoscopy reviewed it with my wife and me.
According to the report, there is no suggestion of cancer, which is a surprise to us all (including the physician). The tumor appears to be a granuloma, which is basically a benign collection of macrophages and T cells that arrive at a point in the body to fight an infection or inflammation. The fact that the mass is as large as it is suggests that this has been going on over time. Additionally, there is an ulcer present as well. The plan is to proceed with Monday’s PET scan to be sure there is no cancer hiding anywhere, but there is still the problem of what to do about the tumor, which will eventually block the colon unless removed. The lingering questions are: (1) Can it be removed without general surgery using a colonoscope? (2) Will I need to be opened up and have part of my colon removed? (3) Given the chronic inflammation, will they decide to remove all of my colon? This is major surgery.
Why and how do PET Scans show cancer when other tests do not?
Because cancer cells grow and spread as rapidly as they do, they require more sugar (glucose) than most other cells to support their activity. Cancer cells proliferate quickly because they ignore the “rules” and bypass the normal controls that apply to cell function in the body. It’s like the difference between a driver who slows down passing through school zones and pauses for red lights and stop signs and another lawless driver who breezes through intersections without stopping. This hyperactivity requires extra energy, which is contained in glucose.
A PET scan identifies those areas in the body where glucose is rapidly accumulating. A radioactive substance containing a marker called fluorodeoxyglucose (FDG) is injected into your body about an hour before the scan. Following that injection, the marker travels through your body to the individual tissues in and around your organs, allowing the nuclear medicine technicians to see where the glucose concentration is highest.
However, low uptake areas are also important to note, because some cancers grow slowly such as low grade lymphomas and low uptake can also indicate dead tissue which does not need sugar. In the brain, any tumor whether cancer or not must generally comeout because there is no room for it to grow within your skull, so low uptake areas there require noting and reporting.
However, cancer cells are not the only type of cells that use glucose at a higher-than-normal rate. Immune cells, especially neutrophils and macrophages that fight infections, as well as the inflammation associated with infections or other types of tissue injury, also require glucose. Therefore, a nuclear radiologist needs to compare your PET scan results with other X-rays and scans to arrive at a logical diagnosis.
A PET scan is probably the gold standard in diagnosing cancer if you could only have one test. But while it is necessary, it is often not sufficient by itself.
I wanted to share my recent PET scan experience and walk you through it.
The report begins by noting that I have a history of uroepithelial cancer and that there is a mass present in my colon. In fact, the cancer is called urothelial cancer, but I’m just being picky.
The reference to “FOG” images refers to artifacts and other imaging that are not clear enough to make a positive determination of what might be present or occurring.
You’ll note a bit further down that they measured my blood sugar. This is important because if they did not, and I was a diabetic who had breakfast, my glucose might be three times that number, which could skew or cause the doctor some confusion about what was going on inside me, given all the glucose they were observing.
Because there was no prior PET scan, this serves as a baseline against which to compare future scans.
Referring to the brain, the word “symmetric” is welcome because it indicates that both hemispheres are equal in appearance, as they should be.
The Waldeyer’s ring refers to lymph tissue in the throat (tonsils, adenoids, and so on). Fortunately, that appears to be normal as well.
My lymph glands here and chest are clear, and though the report says they cannot see my thyroid, I know I have one, and it works; I just take synthetic thyroid hormone daily.
My chest (including lungs) is clear. That is a relief since the lungs are a common place for cancer to metastasize.
My heart has cardiac artery calcification, but that is being monitored, and it is not significant enough to warrant surgery at the moment.
The tumor in my colon is the prominent concern for the abdomen and pelvis. I think I have a benign granuloma with a good deal of inflammation. I can’t take steroids to reduce the inflammation in my colon because it could make my bladder cancer more likely to reappear.
Bad news about my liver: I do have nonalcoholic fatty liver disease and that might be what the radiologist is seeing. My liver function tests are normal. Hopefully, I will be able to “run out the clock” before my liver goes bad.
Musculoskeletal: Vertebral body hemangiomas are the most common, and hemangiomas are generally benign. I did not even know I had one. No worry here.
One other good piece of news is something not mentioned in the report. Included in the scan was my urinary bladder, and if I had active cancer there, the PET scan would almost certainly have shown it. So it looks like my remission in terms of bladder cancer is holding for now.
A bit about colorectal cancer
August 31, 2025: Two days ago, I was wheeled into the OR suite for my second colonoscopy in a month. It was more than a routine colonoscopy because the doctor had a specific target in mind: a polyp large enough for the first doctor to call a “tumor” or a “mass.” This was something of a “super duper” colonoscopy because an ultrasound was used to determine how deep into the lamina (mucosa, submucosa, muscularis propria, and serosa) the mass extended. In my case, it reached the submucosa. According to Pathway MD, the submucosa is described as:
“. . . a dense irregular connective tissue layer between the mucosa and muscularis propria, containing blood vessels, lymphatics, nerves, and immune cells. It provides structural support, enables distension, and houses the submucosal (Meissner's) plexus for secretion and motility control. The submucosa is clinically important because it is a key plane for endoscopic resection, a pathway for tumor spread, and a site of fibrosis and edema in inflammatory and neoplastic disease.”
Note that the submucosa contains lymphatic vessels, so the pathology of this polyp (née mass) will be very important. Hopefully, it will be benign; if not, I hope it has been caught early. The surgeon seemed hopeful but non-committal.
Because the polyp had a central crater with a raised circumference, a solution called “Blue Boost” was injected to lift the floor of the “crater” until it was level with the perimeter. At that point, the whole lesion was excised and removed. Due to some “collateral damage” to the lamina, four surgical clips were used either to control bleeding or to maintain the integrity of the colon.
Background information on cancer of the colon
Men and women in the U.S. are generally advised to get their first colonoscopy at age 45. It is somewhat like a rite of passage, though many, and probably most, people ignore this advice. This is particularly unfortunate because people in their twenties are now developing cancer of the colon. These individuals do not fit the older, overweight, sedentary lifestyle that was historically associated with colorectal cancer. Instead, they are fit people—bodybuilders, marathon runners—who eschew fats in their meals. So far, the cause is unknown. If you click on this link you can read the unfiltered comments of doctors brainstorming about the problem.
Most people past the age of 45 will wind up on a ten-year cycle, having a colonoscopy once a decade until they reach 75, after which colonoscopies are still available but not routinely recommended. Whether your insurance pays for it at age 78 is a different story, of course. I was on a five-year schedule because precancerous polyps were removed during my colonoscopies in 2013 and 2018. I was due for one in 2023 but postponed it due to the winding down of the pandemic and my treatment for bladder cancer, for which I was receiving chemotherapy. However, in the back of my mind I could not shake the thought of colon cancer.
So, my wife and I visited my gastroenterologist. He covered my history and the pros and cons. Finally, we asked him “the” question: “If I were your dad, how would you advise me?” He replied, “I’d tell my dad to have the procedure.” That settled it for me.
Wolves get cancer, too
Cancer affects many different species of animals (and plants as well). Many people have lost a pet to cancer. Birds, fish and reptiles all get cancer. Paleontologists will tell you that even dinosaurs battled cancer, according to their fossilized bones. Wolves get cancer, too. There is a caveat here, however, because wolves are wild (and dangerous), because many do not live to old age, and because the sample size of wolves with cancer is likely low, it is difficult to know with certainty that our observations and conclusions are accurate.
The most common types of cancer in wolves are carcinomas and adenocarcinomas. The difference between the two (in humans, that is) is that carcinoma is an epithelial type of cancer, while adenocarcinoma affects hormone-producing glands, among other organs. For example, the human prostate produces prostate-specific antigen (PSA), an enzyme that renders semen into a more fluid state. Adenocarcinoma of the prostate produces more than the normal amount of PSA, which is why a family doctor is concerned when there is an elevated level of PSA in a person’s blood. Adenocarcinomas of the adrenal gland can cause an increase in adrenocorticotropic hormone, which can lead to a disorder known as Cushing’s syndrome.
Carcinoma is an epithelial type of cancer, which means it generally forms in the defining “layers” of an organ or gland. The cells in the epithelium line the surfaces and cavities of organs and glands. These cells form a continuous layer, providing a protective barrier and facilitating various physiological functions such as secretion (as in the milk ducts in breast cancer), absorption, and filtration (as with cancer of the kidney). In people, adenocarcinoma generally forms in the lung, colon, rectum, pancreas, stomach, esophagus, prostate, breast, and ovary, although it can also be found in the liver, cervix, and elsewhere.
The most commonly reported cancer type in wild wolves is carcinoma. Lymphomas and osteosarcomas, which are bone cancers, follow closely behind. Additionally, wolves suffer from a sexually transmitted infection called Canine Transmissible Venereal Tumor (CTVT). Signs and symptoms of CTVT in wolves include cauliflower-like masses on the genitals, enlarged lymph nodes, bloody discharge from the penis or vulva, and so on.
Final diagnosis
September 3, 2025
So, my surgeon called me at 9:00 a.m. to tell me that my pathology report came back, and (1) there was no cancer after all, and (2) I do not need any more colonoscopies for the rest of my life, as I am more than 75 years old. The report said: “Multiple fragments of severely cauterized benign colonic mucosa, some fragments with features of hyperplastic polyp, and some fragments are granulation tissue (suggestive of inflammatory polyp).”
People, as they age, are sometimes prone to developing polyps, or “pockets,” in the lining of their colon. Like the appendix, these pockets or pouches sometimes collect food or debris—perhaps pieces of popcorn hulls or bits of undigested seeds—and as this irritant lodges in the pouch, it inflames the tissue. The person may or may not be aware of the inflammation, but over time, it can also cause an infection. The body sends additional resources to fight the infection, and like a kitchen drain or a toilet, it can clog up. This is apparently what happened to me.
In fact, every other person with my signs and symptoms has a cancerous tumor, and the other half—my half—does not. So, for the second time in the past three months, I have been able to escape the wolf that’s been tracking me.
Thank God!
