When people receive a cancer diagnosis, they are stunned. I wasn’t. The clinician was direct and matter-of-fact. “We suspect cancer.” The calmness was amazing. Not my calmness. His. Thinking back on the exchange, I wish the clinician had hyped it a little more, like that old Dell commercial. “Dude. You’re getting a Dell.” Fist bump and smack, smack. Instead, just the standard textbook delivery that they suspect cancer, followed by a wave of the hand as if to say, “Now get the hell out of here. I am late for lunch.”

Surprisingly, I was ok. I was not bothered by the delivery. I neither broke down and cried, crushed to my knees nor professed to God about why me and why not that dipstick orange guy with the whack-a-do hairdo? Nope. I was calm. “Ok. What’s next?”

I went to the long-COVID Clinic and listed the symptoms attributed to long-COVID, including a significant 30-plus pound weight loss, some on-and-off brain fog, fatigue, and lack of smell and taste. Like most tests during the past two years, I figured clinicians would give me a ceremonial poke, whack both kneecaps with several medical instruments, tell me to take a couple of acetaminophens, and call in six months. “Hasta la vista, baby.” My reaction was different.

“Dang,” I thought later. “I had to wait six months to get into a highly specialized long-COVID Clinic.” Then, sighing momentarily, “I could have used the update like five months ago.”

Several prior, long-COVID clinicians ordered 15 tests, including a comprehensive metabolic panel, CBC, TSH Reflex, CRP, sedimentation rate, creatine, vitamin B12, D25, B1, folate, homocysteine, protein electrophoresis, Kappa/Lambda Light chain, and magnesium. Except for three, everything returned as being normal. While testing indicated normal B12 and folate, I have a functional deficiency of folate or vitamin B12 (meaning possible renal issues), low vitamin B12, and a high kappa light chain level.

A kappa-free light chain test measures the levels of a particular type of protein. Plasma cells (a type of white blood cell) make light chains that usually link up with other proteins called heavy chains. Together, they make antibodies that help the immune system function properly. It’s normal to have some kappa and lambda light chains. However, some people have abnormally high or low levels of one or both types of free light chains. Therefore, anything outside of the ordinary might indicate a plasma cell disorder (like cancer, multiple Myeloma, or plasma cancer). For example, a bone marrow test must be performed to verify multiple Myeloma. Thus, when a clinician says ‘… suspect a plasma disorder,’ they believe you have cancer but have not confirmed which one. Yet.

The root causes of my health are well documented. For example, pills hide the pain from 8 partial ligament tears in my left knee, with 6 in my right. Forty years ago, I was partially paralyzed from a spinal injury. Surgeons removed bone chips were removed from the spine. My feet suffer from such severe arthritis that sometimes the left foot locks. In addition, I experienced two concussions, one eardrum tear that requires hearing aids, experienced a silent heart attack, several cracked ribs, a fractured wrist, a shoulder separation, cervical stenosis, lumbar osteoarthritis, a cervical spinal tumor, and Parkinson’smultiple. Often overlooked are people like me who self-medicate, hoping the number of prescription drugs is enough to keep working for another day.

By visiting a specialized medical facility at the University of Illinois Chicago that specializes in long-COVID, I was assured the program would combat an onslaught of vague, persistent symptoms. Yet, I only received a cancer diagnosis. The more complicated part was explaining the diagnosis to my family doctor.

Most family doctors are unaware of the ins and outs of most cancer treatments. For example, plasma disorders, let alone Multiple Myeloma, is not in a general practitioner’s skillset of knowledge. Other cancers, like colon cancer, are more understood. “what is a kappa-free light chain test? I never heard of it.” she wrote in my patient portal. “Who ordered this test and why?” After providing some background and why the long-COVID Clinic ordered the test, I deduced that it would take about a week to hear back. After that, my practitioner will take the test results I sent her and try to get some background knowledge about what’s next if anything.

I’m not sure it will matter. The five-year survival rate for Multiple Myeloma averages 55%. [Kappa] light-chain deposition disease (LCDD) survival rate is four years. If cancer has spread to multiple locations, that survival rate drops quickly. In such cases, the median survival rate is 23 months. Cancer specialists believe there’s at least a solitary plasmacytoma hanging out somewhere in my body, probably on the spinal cord.

A solitary plasmacytoma is a tumor of abnormal plasma cells that grows within the soft tissue or bony skeleton. It can be present as a discreet solitary mass of abnormal plasma cells, in which case it is labeled “solitary” plasmacytoma, or it can be present in multiple locations (i.e., as in Multiple Myeloma). If I had to guess, it’s probably in my neck, where part of the original tumor in 2019 is located.

So, congratulations, Unknown Buddhist. Dude, you probably have cancer.