It’s been a disappointing day today but with a very bright possibility in the dimness.
The surgeon I have been waiting so patiently to see isn’t the one I should have been seeing at this point. Dr Chung’s speciality is the liver and he says he won’t go anywhere near mine with a knife until the main tumor has been surgically removed. Even then he would want to see positive results from an IV chemo round before he can say liver surgery is an option. My oncologist thought Dr Chung would do both surgeries and do them at the same time. It seems that would run a very high risk of killing me on he table. Both of these surgeries are very serious, complicated and specialized. They can’t be done at the same time or by the same surgeon.
He says I am in an extremely unusual situation. For 90% of people with my cancer, he would not even consider surgery. Removing half a liver is very serious surgery with risks similar to open heart surgery and the potential benefits must be fairly certain before he will do it. We won’t know if it is worth he risk until the main tumor is dealt with and the metastases show good response to chemotherapy.
As I understand it, there is no point in cutting the liver if the main tumor is still there to cause further damage to the remaining liver tissue. It just creates a worse situation if the remaining liver is still under attack. So the main tumor must go first.
Secondly, the nature of the metastatic lesions must be such that they aren’t spreading on their own. If the cancer spreads from the lesions themselves, we have no way of getting all of it by slicing out the infected half of the liver. The Chemo will tell us the story. If the lesions respond to the Chemo by shrinking, or better yet, disappearing, then surgery becomes a good option. If they don’t shrink, or they get bigger, then removing half the liver is more likely to just speed up the spread.
He described my liver as an innocent bystander that is suffering here just for doing it’s job. It is meant to fight & filter the bad shit that circulates around my body. So far it’s been doing an exemplary job. That’s why the visible metastases are found there. The thing is, that bad shit still floats around and we need to know we can fight that stuff successfully with chemo before we take half the liver off the job.
1) eliminate what we hope is the source of the cancer by surgically removing the bowel tumor;
2) see if the visible metastases then respond to chemotherapy; and
3) if 1 and 2 are successful, we can then remove the infected half of the liver.
I asked Dr Chung if its true that the liver grows back. It can, he confirmed, but it doesn’t matter if it does or not, I don’t need a whole liver anyway.
It pisses me off some that I have to rewind this whole process and get a referral to the bowel cancer surgeon now when I should have been on that list weeks ago. It took over 5 weeks to see Dr Chung while I should have been waiting to see Dr Whoeveritisthatcutstumorsoutofbowels. Now the main chemotherapy will be delayed too. It can’t be done until I recover from the surgery.
So we need to get this show back on track!
I learned a lot today. More than I ever wanted to know. I bet you did too. Thanks for being here.