The pouncing update
This morning I had a follow-up appointment for my recent CT scan. It’s not good. One of the tumours has doubled in size, 2 others have stayed about the same, and another has increased marginally in size. This is in relation to the last scan I had 7 months ago before I started the oral chemo. Clearly, that drug didn’t work and I’m glad I stopped taking it.
The nature of the beast
The big tumour which was previously on the diaphragm wall was actually on the adjacent peritoneum (the membrane that separates the abdominal cavity from the pelvic cavity). It’s now spread to my liver (also close to the peritoneum). I know when I hear this about someone else, I wince, because when the disease is in their blood, that usually (in my limited knowledge on the topic) means time to pack your bags. My disease is serous and not in the blood. If you’ve ever broken or cut a wart, the inside isn’t made up of fluid; it’s tissue and it sits on top of your healthy skin. That’s kinda what my disease is – solid mass.
It’s morphed through that membrane and attached itself to the liver. How did it do that? Well, as I move around, tiny bits of the original tumour can break off and deposit themselves elsewhere. Because cancer cells can mutate and imitate healthy cells, the body thinks they’re normal “extra”peritoneum / membrane cells and “extra” liver cells.
The danger is that the liver regenerates by replacing damaged cells with brand new ones all the time. In fact, when liver transplants are performed, even a 25% portion of liver can successfully regenerate into a full-size liver relatively quickly. Because of this regeneration and the fact that sneaky cancer cells can imitate healthy cells, there’s a risk that part of that regeneration will be of more cancer cells and not of healthy liver cells. Sigh.
It’s my pelvic cavity that’s stuck together with adhesions/scar tissue and can’t be operated on. This new development is in my abdominal cavity. The most effective way to rid this type of tumour, is to debulk/physically remove it and not through IV chemo. Enter the surgeon.
Facing up to the dragon with multiple weapons
I won’t receive IV chemo. The plan is to insert an abdominal port during surgery so that chemo can be injected to “wash over” the topical layer of those organs in the cavity. (It sounds ghastly and I wonder how sick it’ll make me.) It’s reported in literature to be more effective than IV for this type of tumour though not many doctors perform it because it’s new. I’m not afraid of new methods and it’s about damn time that I had a specialist who has some balls too! (Even though she’s a woman). Fine, then. “Intestinal fortitude”.
The oncology-specific DNA testing the oncologist suggested will not only help determine which drugs my body will respond to and which it’ll resist. It’ll also report on mutations, some of which can be kerbed with simple medicationand help the efficacy of the chemo.
Medical aid hasn’t yet responded (after 2 weeks) to the doctor’s letter of motivation to cover the cost of oncology-specific gene testing. Enter my fight mode.
Attack at will
I have an appointment to see the surgeon’s partner next week. Wouldn’t you know that the recommended surgeon is on leave for 2 weeks. Bugger off, Murphy. I can wait. He’s not old school like my previous surgeon and has done this operation for 2 other patients of my oncologist.Replacement army – woohoo!