Cancer Support for People with Cancer

Hi. I'm Al Toman. Back in 2007 I had to put my life on hold to go to battle with cancer. It was nasty. But I survived. Though I had my moments, I didn't cry too much. Mostly, I laughed and I joked. My care takers, my medical team, my fellow cancer warriors, and many a stranger all shared a laugh or two.

The following is my cancer story. I have written this selfishly as a diary for myself but also as a inspiration for you to fight your cancer with humor. I also hope that this provides you with information that you should want to know as you enter your journey fighting cancer.

It would be a blessing if you too can share your cancer support story. If you haven't visited my web site, I encourage you to drop by and leave a message or share your cancer story.

July 2006 – Wisdom Teeth are Smart

By Altoman | Published: December 1, 2009

It took 27-29 days. My wisdom tooth finally broke loose naturally, on its own. Okay. Maybe my tongue was curious and often played with the tooth’s wiggle. That’s better then a pair of pliers or door slamming. I thought that that was cool. You see, my jaw is smaller then the number of teeth that God gave me and things were crowded. The wisdom tooth actually bit into my gums and probably was going to be a dentist’s goldmine soon. So, be gone!

Little did I know that Sir Wisdom Tooth was trying to tell me something. I didn’t speak tooth back then. I do now. Yep. Wisdom teeth are smart.

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August 2006 – Breakthrough

By Altoman | Published: December 1, 2009

About mid August, after our trip to Pennsylvania to visit my Mom and Sister and her family, a lesion of sorts appeared on my upper palate near where my wisdom used to be on the right side.

At first, I thought it to be some kind of ulceration and really didn’t give too much thought about it. It wasn’t painful or annoying. It just wasn’t supposed to be there.

Over a period of several months, the tooth neighboring the long forgot wisdom tooth started wiggling and jiggling. Mmm!?! Okay. We’ll go with that. It too finally fell to the floor without any provacation from external forces. At that time, around October, I figured that I better do some serious Internet surfing and see what I can see.

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October 2006 – I suspect that their is an intruder in my mouth

By Altoman | Published: December 1, 2009

After some long hard Googling (it ain’t easy to Google, you know) I finally concluded that this thing was not good and wasn’t going away on its own.

My best guess was that it was some kind of squamous cell cancer. I learned that President Grover Cleveland had it operated on which was contributed to by his hefty partying, cigar smoking, and drinking. I smoked about a pack a day since 18 years old but I’m not much of a drinker. I probably have a beer or two once a week whilst dining out with my wife, Joan.

Through November and December I kept busy enough not to think about this thing living in my mouth. However, it was working into loosening the next to the next to the wisdom tooth. I didn’t disclose this to my wife mostly for personal reasons. My mind told me that she has enough on her plate at the moment and it isn’t a good idea to overload the plate. So, we’ll leave it at that.

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December 2006 – It’s harder when someone says it for the first time

By Altoman | Published: December 1, 2009


One December morning, Joan was working at the kitchen table and realized that my face looked funny. Well, yeah, that’s a given.

The right side of my face drooped. It looked like a hounds drooping flesh. Since I haven’t been to a dentist for a few (hundred) years, her immediate concern was some kind of tooth infection type thing. I finally told her that I think that we have something more serious then that. I explained and she examined this thing growing in my mouth.

She vigourously looked for a nearby dentist who would take me immediately. See, we live in a small local-tourist community here in North Carolina where the winter population is 1400-1700 or so. And, we live a distance from any sizeable city. And, we live in the wood adjacent to the protected wetlands. Fortunately, we hooked up with a dentist just up the road on the main drag on route 24. Joan was home from work to go to her medical appointment in Wilmington, which is a 2 hour drive for us, and here we end up with my going to an appointment instead. God, this stuck with me for months to come.

The folk at the dentist were really, really nice! The dentist examined my loose tooth and lesion, took an xray, and had his assistant take a peak, too. They didn’t want to touch anything and referred me to an oral surgeon who worked in a town up the way by 30-40 minutes.

This next day, my face wasn’t drooping anymore (mystery face). We drove to the oral surgeon’s office and didn’t have to wait very long. They took a panorama xray. Upon examination, the dentist showed me the differences in the left and right sides of my face. He tagged it as T4 squamous cell carcinoma, a term with which I was familiar in surfing the Internet. It started in my right sinus and broke through the upper palate and jaw bone on my right side. Hence, why it is called a T4 and why I was losing my teeth.

He said that he doesn’t do this kind of surgery and referred me to yet another surgeon in yet another town 30-40 minutes away. He said that it isn’t going to go away. My immediate concern was whether this surgeon was a medical guy or a dentist because I don’t have dental insurance. Fortunately, he was a medical surgeon and Dr. Vincent told me that he’d place my visit on BCBS too. (I later got a bill because apparently, BCBS didn’t accept the diagnosis visit as a medical visit.)

I’m not sure if I was in shock or if I already knew in my mind that it was T4 Squamous Cell Carcinoma or what. But I really didn’t hear the impact of it until Dr. Vincent said God Bless to me. I felt like I was being read my last rites. It’s harder when someone else says it for the first time.

I met up with my wife in the lobby and we walked out the door at which point I told her, “It doesn’t look good, babe” and I broke into tears. We sat in the car for me to regain my composure whilst Joan assured me that we’d pursue it and the surgeon would take care of it. To this day, the picture of this visit roles in my mind like a bad movie from beginning to end.

The drive back home was long and quiet.

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December 2006 – Christmas, anyone?

By Altoman | Published: December 1, 2009


I honestly can’t even tell you if Christmas happened in 2006 or not. I can tell you that my anxiety level doubled. Everything is out in the open. The cards are face up on the table. Regardless, my visit with Dr. Arowood wasn’t as emotional or dramatic. Hey, I already got the Blessings.

Upon examination and confirmation, Dr. Arowood said that he hasn’t done any number of these surgeries and referred me to a team of doctors at UNC in Chapel Hill. It’s near a four hour drive, to the big city, but it’s nearer civilization too. So, a visit to the UNC team was scheduled. I was supposed to meet up with a Doctor Shores on January 7, 2007.

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January 7, 2007 – Dr. Carol Shores, PhD, MD

By Altoman | Published: December 1, 2009

The first visit to an institution the size of UNC is mind boggling. The buildings! The people! It is simply overwhleming. After signing up and form filling, they took me back into the clinic. I didn’t have much of a wait. The first thing the nurse does is take your weight. 152 pounds. I didn’t have much of a weight.

Next, they walk you through what reminds me of rows upon rows of horse stalls where they’ll start pitching hay at you. At the trail’s end they sit you into a barberchair of sorts in one of these tiny examination rooms (stalls) and close the door. You hear all kinds of stuff going on out in the halls and realize that it takes a lot of noise for things to happen. I sit there with my hands folded and wait.

Dr Carol Shores, MD, PhD

Dr Carol Shores, MD, PhD

Dr. Carol Shores makes her entrance by slowly cracking the door and peeking her head in first, extending her hand out saying, Hello Mr. Toman, introducing herself, and the fun begins.

One thing I learned early, from this day on, when Dr. Shores enters the room, people and things fly. Dr. Shores has power.

Dr. Shores talks constantly, explains what she has, what she read, what she’s done, what she’s doing, and what she will be doing.

She sprayed some lidocane up into my mouth at the T4 squamous cell growth. The red nozzle, the kind you see on cans of WD40 flew off. I tried to laugh but how do you laugh when your mouth is stretched wide open?

She confirmed Dr. Vincent by visual inspection and information and the biopsy of the growth would later definitively confirm the cancer.

Dr. Shores described the typical procedure, the typical expected outcome, and the rareity (as compared to breast cancer) of my cancer.

We scheduled surgery for mid afternoon, February 7, 2007.

Later, Joan asked me about the comfort level and about second opinions. Well, I was completely relaxed and in my mind, established within the first 30 seconds of meeting her that Dr. Carol Shores is #1 in my book. Today, her performance out-performs #1. So, she’s at that place that comes before #1.

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January 2007 – See Me. Feel Me. Touch Me.

By Altoman | Published: December 1, 2009


Prior to surgery, you get the blood tests, the chest xrays, the CT scans, and I think I got a MRI because the CT wasn’t clear enough for Dr. Shores to clear a path to the cancer. I’m not used to all of this stuff.

The young lady who took my blood sat across from me, chatting to her associate in the next booth over. She finally said to me, whenever you’re ready. I said to myself that I was ready a long time ago. She then asked, What arm?. I then realized that I had to pull up my shirt sleeve to draw blood. Duh. Okay, so I’m lame.

The CT is a flat narrow table at which one end is a huge doughnut through which the table navigates. The MRI is more of a tube but there may be an open MRI available, as well. I’ll cover the PET scan later. It’s very expensive and no, don’t bring your PET dog Ruffy. The imaging is a series of slices, a slideshow of your insides, if you will. The hot spots or cancer appear in white.

The technicians constantly talk at you. You are always aware of what’s cookin. Hopefully, none of your body parts. They needle feed you some stuff that makes you feel wet, like you wet yourself. Yeah. It’s that warm feeling running down your leg. Well, you didn’t. So don’t get all soggy about it.

The tube may be scarey if you freak on closeness. Personally, I think it is a cool experience. The MRI bangs different tones. I mean bangs! However, today, they pad your ears so well that it is hardly noticeable. This voice comes from above too. It instructs you to stop breathing, we’re doing the lower neck, or we’re almost finished.

Okay. You can start breathing again.

You also have to go through the pre-surgery. They look through your file, ask you questions, then give you a bottle of hospital soap with the instructions to bathe yourself with this stuff from the neck to the toes the morning of surgery.

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February 7, 2007 – ER, General Hospital, Gray’s Anatomy, & Scrubs, NOT!

By Altoman | Published: December 1, 2009

They have a registration room. This is where you book-in your stay for surgery. Once given wrist bands and your data is entered into the computer, you’re sent off to the waiting room. Some old guy (grin) varifies your wrist band and tells you to wait.

I hate waiting. Especially when the magazines are Golf, Football, or Baseball. Who reads this stuff when you should rather be playing golf, football, or baseball. I mean, do you get it? I don’t. The magazine selection could be Southern Living, or Home Theater or some women’s magazine. Come on! The Newsweek or Time is always anywhere from 3 months to 2 years old. If you’re really luckly they’ll have a copy of national geographic. There isn’t a television. Probably because there isn’t anything on anyone of the 800,000 available channels.

There is no drama in the waiting room. Personally, I didn’t even feel anxiety of going into surgery. Listen, I Learned early to fight cancer with humor. I had the mind set, the support team (my wonderful wife is my rock), and an excellent surgeon, Dr. Carol Shores.

I hate waiting. I hate waiting rooms.

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February 7, 2007 – Pina Colata

By Altoman | Published: December 1, 2009

Once they are ready, the waiting room attendant gets a phone call. Everyone looks over when the phone rings. Yes. It’s your turn.

The one nice thing about hospitals is that it’s easy to get lost. There are so many hallways and thousands of doors that go to thousands of rooms. You begin to realize that you are not the only thing happening here. The long walk through convoluted hallways ends up in a what I think is the prep room. It has a long hallway with a bunch of stalls. They land you into this big cumfy chair in one of the stalls.

This is where a bunch of people start approaching you as if you’re the victim in that Zombies movie. But really, these people are the nicest people on Mother Earth. They introduce themselves and always make sure that they are talking to the correct patient, then, they thoroughly explain what they are about to do and will do.

It being a teaching hospital, it adds another layer of fun. Teaching hospitals aren’t bad and if you really think about it, a necessity. I don’t mind teaching hospitals as long as the teacher is right there most all the time. That’s very important to us patients. That’s why Dr. Carol Shores is an angel from heaven. She plays the script well.

Sock up! They give you a bag with surgery clothing. Your clothes go into the surgery bag. When you go for surgery, go lean. Don’t wear much. You pull a curtain for privacy then start stripping. My wife helped and my daughter waited outside of the curtain.

The first thing I tackled were the socks. They’re designed to push the blood back up towards your head. So, they are tight and extend up to your knees. It seemed like a half hour before I got the first one on. I yelled out to my daughter (she’s a MD PhD as well) that it took all this time to get on one sock! The second one fitted in seconds.

Of course, there is the gown, of course. The gown. How many decades has the gown been around and it’s still, the gown?

Once re-garbbed, they setup the I.V.’s and tell you to go pee.

This is when the next wave hits you, the anethesiologists. For the umpteenth time, they pull out their copy of your file and review your information. It’s going to happen, so get used to it and make the best of it. Once you suck down the Pina Colota through the I.V., it’s sweet dreams.

Thirty seconds later, you’re awake once again but this time in the recovery room. Actually, several hours have passed. Mine was a 5-hour surgery with 2-hours in recovery.

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