Cancer patients never know when they first harbor cancer cells in their bodies. The cells first arrive on the scene long before symptoms and diagnosis.
I do not ponder that first cell, but I do consider the first symptoms of my cancer long before I knew I had cancer, and, to be clear, long before I knew I was sick. When I look back, I know there were signs that I was already inhabited.
I have had shingles six times. My first case was about two years before my diagnosis. I had a more serious case of shingles, Ramsey-Hunt Syndrome, about 6 months before my diagnosis. My Cranial Nerve VIII was primarily affected, so I had severe ear pain, tinnitus, vertigo, extreme deep, localized, headache, and the classic blistering rash in the ear canal. I fortunately knew what these were almost at once and was quickly treated. Early shingles diagnosis and treatment are key to a faster resolution and to prevent complications. I had three more cases of shingles, each milder, during my first treatment phases, and then another severe case after my transplant. People with lymphoma or leukemia (and I had a form of both) are at much greater risk for shingles. I was on the younger side for shingles, but it is not unheard of for people in their fifties. Not once did I question that I had shingles for any reason more nefarious than having had chicken pox (Varicella) as a child. I am now vaccinated and am a full-year shingles-free.
I had a slow drop over about 3 years in my hemoglobin (a measure of anemia). I looked back at my numbers after my diagnosis. The hemoglobin had dropped steadily during routine, preventive blood work. The lowest number was still in the lower end of normal, so it did not sound alarms. When it did dip into abnormal levels, it did not respond to common therapies. This was a clear sign. The slow, steady drop, I am certain, was secondary to my bone marrow cancers, well before I was symptomatic. The most likely culprit, now that I have years of information and opinions, was my myelodysplastic syndrome.
The other sign was wound healing or lack thereof. I had a superficial scratch on my arm from one of our pets. New puppy scratch. I kept it clean. It never became infected. I never felt that anything more than local care was needed. It did not heal. That scratch would start to scab a bit and appear to be healing but did not go away. I had a couple of other minor scrapes that did the same thing. Not healing to the point of complete resolution. I had lingering minor wounds. After my stem cell transplant, the wounds all healed. The puppy scratch and the scrapes are completely resolved. Gone. They had stuck around for many months. The puppy scratch had been present for over a year. I had resigned myself to believing that it would be a lifelong scar. Nope. Gone. When I fell and broke my tibia after my transplant, I had several scrapes from the same fall. Those scrapes healed more quickly than I recall any wound healing in the past few years. That was the moment when I put all of this together when I focused on the incredibly poor healing with cancer and now rapid healing with functioning brand-new stem cells.
Maybe someone else with blood or bone marrow cancer will have shingles, anemia, and poor wound healing and put it together and be evaluated sooner. Just for fun, I put in the search terms shingles and anemia, and the first hit was a case of a man who presented with those two things and had myelodysplastic syndrome. Do not panic if you have shingles or anemia, but the two together plus slow healing of minor wounds? Maybe a clue lies therein. Do I wish that I had been diagnosed sooner? Not for one second. I was diagnosed when I was unmanageably symptomatic. All that an earlier diagnosis would have done for me is make me worry for longer.
I enjoyed many more days without cancer worry. I would not wish for more. I have never felt that I had a delayed diagnosis. I had a denial of symptoms for a few months, and then I was rapidly diagnosed. Those months made no difference in my ultimate prognosis. I am glad I had them. If signs and earlier diagnosis of blood and bone marrow cancers can help someone’s survival, I hope to help with that.