Thursday, September 29, 2011

Biopsy Results "As Expected"

I received a call from my surgeon's office and they said the biopsy results were "as expected." The mass is malignant and in lay people's terms, is Colon Cancer, which means it is metastasis, which I believe is better than a diagnosis of liver cancer. And regardless, there's nothing really better, one verses the other.

All data is being faxed to Sloan Kettering today. I will receive a call back from Sloan Kettering when they are ready to schedule an appointment.

The reason I'm getting a third opinion is because I want doctors who are among the best in the world in their fields, to give me their surgical and post-surgery treatment (i.e., chemotherapy) recommendations. I've received some conflicting post-treatment chemotherapy recommendations, which I'm not going to elaborate on right now, and having a third opinion may provide me more clarity. Or less. But that's the rub when it comes to multiple opinions. The choice is ultimately up to the patient; they can engage in the decision making or they can be apathetic and simply do what's recommended, as some patients are, due the overwhelming nature of such a diagnosis.

So, that's the scoop. And I have a picture of the liver biopsy (which I took with my phone) if you want to check it out ; )

Friday, September 23, 2011

Surgery Postponed for 3rd Opinion

I have postponed my surgery date in order to obtain a third opinion from the doctors at Sloan-Kettering and I'm currently in the process of scheduling my third opinion appointment.

As this week began and my surgery date got closer, I became very clear that I do not want to have any regrets about the choice I made. I also distinguished that I was not getting a third opinion because of the "inconvenience" it would be to do so. It's funny how such an absurd thought can still show up even with all I have already been through.

Friday, September 16, 2011

Surgery is Scheduled

On Thursday September 22nd I will be at Guthrie for pre-surgery admission and to meet with my surgeon about the process and recovery. His office will also do the leg ultrasound that same day.

My surgery is scheduled first thing in the morning on Tuesday September 27th at Robert Packer Hospital (a part of the Guthrie Clinic in Sayre, PA). My doc will remove the mass and make the final determination if it is cancer or not (he doesn't question whether it is, but it must be proven before the diagnosis is certain). He doesn't want to biopsy it first because he has a concern about if it were missed and what would be a positive test, mistakenly came up negative. He also added that on the "very unlikely chance" that it is not cancerous, he recommends removal anyway.

The doc anticipates me being in the hospital for up to a week, followed by a four to six week at-home recovery. I've always had a lot of laughs with the staff at Robert Packer Hospital (I've had a few stays there) and I'm looking forward to a few more...laughs, that is!

Tuesday, September 13, 2011

Living Space

People have been asking what I need. I'm seriously considering moving to a studio/efficiency apartment that has space outside to play. Without question I would need an affordable rent. When I say affordable, I mean I'm looking for a landlord who, like many employers who are committed to paying a living wage, is committed to charging a "living rent." I don't know if those landlords even exist.

I'm not ready to move. I might stay where I am. I don't know. I've got a lot of thinking to do before I make my choice, but it's percolating... If you have any thoughts, please message me.

Monday, September 12, 2011

My Decision Has Been Made

On Friday I met with a surgeon, Dr. Schoniger, at Strong Memorial/The Wilmont Cancer Center. He said he would take the same approach as Dr. Vandermeer, the surgeon I met with at Guthrie in Sayre. They are both respected surgeons, so I will be going with Dr. Vandermeer at Guthrie Sayre because he's closer to my home. I want my family and community to be able to support me through this surgery with as little travel time as is necessary. So, I spoke with Vandermer today and asked him his availability. He said he will likely be available on the 27th or 28th of September. He will have one of his staff call me tomorrow for scheduling.

As soon as he provided me those dates, I realized that's 15-16 days from now and just wanted to cry. So, perhaps later this evening or tomorrow when I get a free moment to myself, I will. I'll let it out and then get my shoulder back to the wheel. This isn't like last time. I don't have a committed partner by my side 24/7. I will be doing this...well, not alone, I know I have my family and community, but far more independently than I did the last time around.

Prior to surgery, I will get have an ultrasound procedure called a Duplex, during which my legs will be scanned for any blood clots. This is because of the massive pulmonary embolism I had following the last big surgery I had. Dr. Vandermeer wants to vanish as much risk of a repeat as possible. At the beginning of the actual tumor removal surgery, he will do an interoperative ultrasound (IOUS) with which he will scan my liver for any small tumors or cancer growth that CTs, PETs & MRIs can't locate, and to determine the location of blood vessels so he can navigate the surgery in the safest manner possible.

I will have about a week in the hospital following surgery, then a four to six week recovery at home. While recovering my doctors will put a microscope over the tumor cells and determine the best chemotherapy treatment. I'm looking at six-months of post-surgery chemo [insert frustration based profanity here]. And I'm committed to staying focused on being loving and grateful for my life and all that comes with it. We get what we get. And I have so much to be grateful for. In fact, my little man is the greatest motivation in the world. He's more precious than words can express and I'll do whatever I have to do to be here for him.

Thursday, September 8, 2011

Never Thought I Would Be Posting This

On Friday September 2nd, my oncologist diagnosed me with metastasized cancer. I have a 2.4 cm diameter tumor in the right lobe of my liver next to my gall bladder. I have to admit, I was convinced I would never be diagnosed with metastasis. I was certain the cancer was gone for good.

What's in my favor is that the five prognostic indicators used to determine risk are all in my favor.
  1. tumor size - small
  2. number of tumors - one
  3. less than 12-months since original treatment - it's been three years
  4. if lymph nodes were positive for cancer at original diagnosis - none were positive
  5. CEA aka cancer markers less than 200 - my CEA is 6.5
My doctor also believes the metastasis is likely a result of cancer cells that traveled from the (original) rectal tumor, through the vein that goes from the colon to the liver, and once the cells got to the liver, they stayed there for three years. And in the last six months the cells grew into a tumor large enough to be detectable. The plan is to surgically remove the tumor followed by six months of chemotherapy.

If my doctor's diagnosis is accurate, I have a 70% chance of being cured. And cured is defined as five years cancer-free. I'm getting a second opinion on Friday September 9th. If the treatment recommendation is the same, I'll schedule the surgery immediately following the second opinion.

In the mean time, Bert Scholl & Friends is scheduled to perform on Friday September 9th at O'Toole's in Auburn, NY. We likely won't have anymore gigs until after I recover from surgery. So Friday is going to be a fantastic night. And it's going to be exactly what I need.

And one last thing. For those of you I haven't contacted directly, I've got SO MUCH to manage and just haven't had a chance to call you yet. But I love you all the same.