This morning I met with my surgical oncologist to follow up about my latest CT scan and solidify plans for the operation going down in 2 weeks. I assumed the CT scan would show little to no change in tumor growth and that we would be pressing forward with the surgery as scheduled, so I was a little surprised to hear him offer me an option. Now, I’ve learned over the past year that no schedule is set in stone and to always expect changes, but after having made the appointment for surgery, get the vaccinations and go through all the little details leading up to the operation, I was definitely a little surprised that I was being offered the option to back out of surgery completely. The reason for this option to withdrawal is rooted in the confusion of both my type of cancer and my positive physical progress since the last surgery.
With each unchanging scan, my oncologists are encouraged and yet confused as to why I’m doing so well. They can point to the benefit of the HIPEC surgery, of course, but they can’t fully admit that chemotherapy is causing this stagnation. They both admit that patients in situations similar to mine “rarely ever” respond to the chemotherapy treatment and the tumors continue to grow, but for some reason that just isn’t the case with me…but they don’t know why. Both oncologists have said, “SOMETHING is working, we just don’t know what.” And so that leaves them in what they’ve also said is “unchartered territory”, and subsequently a plan of action that isn’t marked by defined outcomes. They aren’t sure what they are doing is working or not. That means NOT having surgery is an option.
Not having surgery performed means we would be in a “wait and see” scenario. Because this cancer is so slow growing, we would wait and wait and wait to see if it starts to reproduce rapidly and out of control, necessitating more chemotherapy and, ultimately, another surgery. However, we can also do the same AFTER a second surgery. What the oncologist could tell me with much greater certainty is that my type of cancer has a very high recurrence rate and the likelihood that it will come back even after surgery or waiting it out, is significantly high. I knew this and was prepared for it.
In the meantime, he is encouraged that I am “non-symptomatic”, meaning the cancer itself isn’t causing complications for me. I’m not experiencing intestinal blockages or other organ failures. The only thing that is taking away from my quality of life at this point is the chemotherapy. So the only thing I wanted to know in today’s meeting is if AFTER surgery, will I have to go back on chemotherapy? That is what I undeniably DON’T want. If cancer comes back, or if cancer starts to grow and cause complications…fine…we’ll deal with that. That’s expected. But if I can go a year or two or 5 or 10 without chemotherapy…then I’ll live with cancer. Screw it…I’ll enter the “fastest cancer patient alive” category if I have to. And should cancer come back, THEN we’ll deal with it.
Fortunately, my oncologist didn’t disagree. He also felt that a life without chemo would be best and that my medical oncologist will most likely agree that we should try the “wait and see” approach after surgery. To reaffirm my confidence in this approach, I outright told him that if we have to “experiment” through this process, I’m completely on board. Ultimately, what do I have to lose? If, by chance, chemo is NOT actually keeping my cancer at bay and it’s something else, than I want to try take that chance. And if we find out that, for whatever reason, I am responding to the chemo….then we go back on it. It’s that simple.
That still leaves the consideration about the immediate surgery on the table though and I had to make that decision. It didn’t take me long to decide, however, and before he left the room I committed to carrying through with the operation. Basically, I still fully expect cancer to come back sometime down the line and I can only hope that it’s VERY FAR down the line, but time…and strength…is truly of the essence here. Let’s say I wait out the cancer at this point and see if it comes back, only to have it cause severe complications in 5 or 10 years, that means my body is most likely 5 or 10 years compromised. I don’t want to risk undergoing this extensive surgery on compromised terrain. I’ve been building up and trying my best to prepare for this surgery, to make sure i’m ready to recover as quickly as possible, and so I feel my best bet is to undergo the operation as soon as possible, with a body that is as primed as it can be in this state, in the hopes that recovery will be quickened, cancer will be minimized and I can spend the next 5, 10, 15, etc. years free from complication and chemotherapy.
And then if I have to do it again…then I do it again.
But for now, I’m relying on developed strength and the hope that this surgery will offer me a chemo-free life much further into the future.
I want to run freely again. I want to go through the surgery, recover, avoid chemotherapy and slowly build until I’m running unhindered for as long as I possibly can, reaching for goals set previous to diagnosis and seeing how close I can get to them…one more time.
And that’s the plan. Despite the options he gave, my surgical oncologist agreed with my perspective, felt now was the best time to do surgery and promised he would do his best to get as much of the cancer out as possible…and then we’ll wait and see. I’ll go through CT scans every so often in order to keep tabs on the growth, but as it stands, we are not going to pursue chemo treatment after surgery (aside from the treatment that is part of the surgery itself). But hey…plans change.
To give some specifics, the surgery is the same as last time. A debulking process with the HIPEC treatment, possible spleenectomy, possible bowel and colon resection and partial stomach removal. The additional fun, however, (aside from the potential organ removals) will be a few days of continuous chemotherapy drips through 5 tubes left within my abdominal cavity. Then follows the long, unpleasant process of recovery.
With a hopeful trajectory.
Now it’s one week of vacation with my son, one more week of preparation leading up to the More Fire Run and then all systems go…or stop…whichever makes the most sense.