I seem to have become asymmetrical.  Mohamed noticed it first: a slight bulge on the left side of my abdomen, the bottom of which is level with my navel.  It doesn't hurt when I press on it, but the flesh feels firmer when pushed than the other, flat side.  We're concerned that it is the kidney tumor (it's the left kidney that has the tumor) that has grown enough to be visible from outside.  I e-mailed the oncologist two days ago to ask whether that was a possibility and if so, whether I should have another CT scan when I come in on the 22nd of this month for what is just scheduled as blood work and a consultation with the physician assistant.  So far, he hasn't replied.  Usually e-mailing has been the most effective means of communication--no phone tag--and he's always replied the same day.  I'll try again today, this time including Jennifer, the physician assistant, in case Dr. Van is out of town.  (Still, he must check his e-mail.) 

I think I've done a pretty good job of keeping calm and carrying on over the last two years, but it's difficult not to be a little scared by this development.  I find myself looking in the mirror before I take a shower, pushing on the bulge and trying to reassure myself that this is just one of the consequences of the body's unpredictability as one grows older.  And during the day, I find my hand wandering under my t-shirt to see if I can still feel the bulge. 

The norm for stage 3 and stage 4 (mine) kidney cancer is not to remove the kidney, since by this time the cancer has metastasized to other parts of the body.  For me, the first signs of cancer were the erosion of bone in the scapula and the femur, and there are tumors in other bones, including the spine.  Perhaps three or four months ago, when the primary tumor in the kidney was growing, but slowly, we talked with a surgeon about removing it.  Taking out the entire kidney rather than just the tumor could be done laparoscopically (spell check doesn't like my spelling of this word, but it looks right to me); removing just the tumor would require full surgery.  I liked the surgeon who wasn't gung-ho to operate.  Removal wouldn't prolong my life; what it might do is make the symptoms less severe at the end.  And there could be additional complications because of my compromised immune system.  We decided against surgery.  Now, however, should my fears be grounded and should the tumor continue to grow, maybe it's time to re-think the decision if only for vanity's sake.  I don't want to look lopsided.  Vanity of vanities--all is vanity.  Sometimes the Bible got it right.