BY AMBER SMITH
What began as a tiny bump under Donna Colton’s scalp has led the 56-year-old woman from Manlius on an ongoing medical odyssey.
Colton has undergone surgery and radiation. Now she and her doctors are considering whether she should take tamoxifen, a drug commonly used to treat breast cancer.
The words “breast cancer” especially stunned Colton in the fall of 2014 because she had seen her doctor about a bump on her head, not a lump in her breast. But a laboratory analysis of the growth showed what looked like breast cancer cells.
Colton’s doctor hurriedly sent her for a magnetic resonance imaging scan – which showed no signs of cancer in her breasts – and a positron emission tomography scan of her head – which revealed a tiny unusual spot on her left salivary gland.
She saw an ear, nose and throat specialist and underwent more testing. Eventually, she got a diagnosis: adenocarcinoma of the sudoriferous glands. She had cancer of the sweat glands.
It’s a rare disease, and information is not as easy to find as for more common cancers. One study by researchers at the Mayo Clinic said just 220 cases of cancer of the sweat gland were reported between 1965 and 1995. This cancer is usually discovered first in the scalp. While it often spreads to other parts of the body, Colton’s cancer was discovered early.
Colton has felt stressed, although she has not felt ill. She says, “I felt fine through the whole thing.”
Then Colton considered the pros and cons of radiation therapy. “The fear was, there could still be microscopic cells floating around,” she says. The treatments could cause permanent hair loss, but more troubling to Colton – a singer – was the potential damage to her vocal cords.
Colton met with doctors, including some in Rochester and Philadelphia, and chose Upstate’s Anna Shapiro, MD, as her radiation oncologist. Over the summer, she came to the Upstate Cancer Center five days a week for six weeks for TomoTherapy, an advanced radiation therapy designed to spare healthy tissue that surrounds the cancer.
“We used TomoTherapy because of the curvature of the skull,” Shapiro explains. “We were tying to protect the brain, and TomoTherapy is the kind of machine that allows us to treat in an arc pattern.”
Shapiro continues to monitor Colton, who was pleased with her treatment. “All the technicians that I saw every day, the people who greeted me at the door, the valet service … it just made this so much easier to deal with,” she recalls.
She completed radiation in June. A patch of hair is missing, but her vocal cords were not affected.
Now, Colton is considering the benefits of taking tamoxifen, since her cancer cells contained the estrogen receptors so many breast cancers contain. Doctors have warned her the cancer is likely to be aggressive if it comes back.
She wants to be ready, but she does not want cancer to interfere with her music. In November, Colton performed in the “Respect: Central New York Celebrates Women in Music” concert at the Palace Theatre.
She chose to sing the Indigo Girls’ “Closer to Fine,” with lyrics that are more poignant since her diagnosis: “There’s more than one answer to these questions pointing me in a crooked line. The less I seek my source for some definitive, the closer I am to fine.”
This article appears in the winter 2016 issue of Cancer Care magazine.