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Jay Lake
Date: 2010-08-11 16:16
Subject: [cancer] Having met with the liver surgeon...
Security: Public
Tags:australia, calendula, cancer, health, new zealand, personal, travel
calendula_witch and I met with the surgical oncologist today regarding the lesion in my liver. He had a very strong and reassuring chairside manner.

The surgeon expressed his sympathy for what I'm going through. He is quite clear on believing this lesion to be metastatic colon cancer of the liver, despite the ambiguous PET result. There are several other possibilities, but he finds them all low probability. The proof of course will be in the post-operative pathology report.

We talked about the possibility of a biopsy, but in this case he's strongly in favor of going straight to a resectioning. I agree with this completely. Whatever this thing is, I want it out of me. The plan is to take about 45% of my liver out -- the left half, more or less -- via laparoscopic surgery which will leave entry wounds in various decorative places about my abdomen, including in the existing scar from my colonic resectioning of 2008. I can expect the liver to regenerate to about 95% of its original size within four weeks of the operation. The surgeon says I will feel lousy and tired for about six weeks afterwards, even with the relatively minimal surgical wounds. I pointed out that having just gotten off chemo, I was no stranger to that.

Assuming the pathology report bears out the current opinions, I'll go back on chemo 4-6 weeks after surgery. This will be another six-month course of twelve biweeky infusions, this time FOLFIRI-Avastin. We did discuss the possibility of chemo prior to surgery, but he felt that was not indicated in my case as the lesion is singular and fairly accessible.

The main variable now is the New Zealand-Australia trip. After some discussion, we all agreed that if the lesion is fairly stable in size and presentation, the surgeon is comfortable postponing the surgery until after the trip. Currently it is scheduled for 9/16. However, he did order a CT scan which was done this afternoon, to check on possible growth of the lesion. If it shows evidence of continued development, we will cancel the trip and the currently scheduled surgery and instead have surgery as soon as OR time can be secured. I hope to know on Thursday or Friday which path we're taking.

One of his more revealing remarks was his comment that cancer treatment is a process of controlling the disease over the long term. He called it "eminently manageable", given my apparent tendency to present with one tumor at a time. I remain concerned about the apparent increase in aggressiveness as this journey continues, but we treat what's in front of us.

I'll know more by the end of the week, hopefully, with respect to dates and planning. For now, suffice to say it's falling out about as my medical oncologist said it would, and as I have been expecting.

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User: talekyn
Date: 2010-08-11 23:20 (UTC)
Subject: (no subject)
Just knowing there's a plan must be a some relief, even though the plan is "we're going to cut you open again, it's just a matter of when."

Continued good thoughts hurtling your way from the wilds of New Jersey.
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User: cathshaffer
Date: 2010-08-11 23:25 (UTC)
Subject: (no subject)
I wish you didn't have to wait so long for a definitive answer on that thing. I am feeling discouraged. :-( At least you can still go to worldcon.
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User: zellandyne
Date: 2010-08-11 23:50 (UTC)
Subject: (no subject)

I'm sorry you have to deal with so much suckiness.
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Allison Lonsdale
User: caprine
Date: 2010-08-12 00:06 (UTC)
Subject: (no subject)
Totally inappropriate mental image: the "we're here for your liver" scene from Monty Python's Meaning of Life.

May all go smoothly with the surgery.
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Twilight: BlackBloodRose
User: twilight2000
Date: 2010-08-12 00:10 (UTC)
Subject: (no subject)
A plan is something to hang your hat on at least - it's a start. Hope the end of the week gives you more particulars!
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User: deza
Date: 2010-08-12 00:15 (UTC)
Subject: (no subject)
At least now you know. Knowing is always better than fearing.
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Chris McKitterick: just Chris
User: mckitterick
Date: 2010-08-12 01:10 (UTC)
Subject: (no subject)
Keyword:just Chris
I'm glad you have a plan that you feel comfortable with. Thinking of you.
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User: madrobins
Date: 2010-08-12 01:15 (UTC)
Subject: (no subject)
You have a roadmap. That's a good place to start. I hope that gives you a little bit of calm in all this suck.

(And a liver regenerates that fast? Wow.)
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cathschaffstump: cathbooks
User: cathschaffstump
Date: 2010-08-12 01:39 (UTC)
Subject: (no subject)
I'm sorry that you're dealing with another one. This is rough news to come back to.

I'm glad that you're getting good medical advice. Hang in there.

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Little and foxy and sexy... what more do you want?
User: little_foxy
Date: 2010-08-12 01:41 (UTC)
Subject: (no subject)
Sending positive vibes your way.... hope that you don't have to cancel the planned trip though.
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ubiquitous_a: sheldon-comiccon
User: ubiquitous_a
Date: 2010-08-12 01:53 (UTC)
Subject: (no subject)
Am thinking many good thoughts for you. Should things not work out for the Aussi trip, you should seriously consider coming to Dragon*Con in Atlanta instead (I actually have a couple of rooms at one of the host hotels I'm casting off, FYI). If only because I would, selfishly, love to meet you.

That being said, it sounds like things are going as well as can be expected. And, btw please send me a mailing address via PM or my email address (which I believe you have somewhere) so I can send you hats. :)
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it's a great life, if you don't weaken
User: matociquala
Date: 2010-08-12 01:56 (UTC)
Subject: (no subject)

It's all I got, but I got a lot of it.
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User: scarlettina
Date: 2010-08-12 02:09 (UTC)
Subject: (no subject)
I'm glad there were no new surprises this visit, just a plan of action and agreement about said plan on all sides. I'm glad the surgeon wants to be aggressive; I read this and had the same reaction you did: couldn't agree more.

I knew the liver could grow back; I didn't realize how quickly it would do so. The human body is an amazing organism, even in the midst of full frontal assault.

I send love.
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User: leela_cat
Date: 2010-08-12 02:13 (UTC)
Subject: (no subject)
*hugs and love*

Here's hoping that things go the way that you need them to.
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Michael Curry: alton
User: mcurry
Date: 2010-08-12 02:35 (UTC)
Subject: (no subject)
I'm glad you've got a better handle on things now than you did when you woke up this morning, and I hope the results of the new CT scan are such that you can make the trip, both because I know you want to go and because it'd mean the lesion isn't being aggressive.

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User: (Anonymous)
Date: 2010-08-12 03:14 (UTC)
Subject: (no subject)
I am rooting for you.

I'd very much like to see you at Aussiecon!

Carrie V.
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User: quantuminsanity
Date: 2010-08-12 03:39 (UTC)
Subject: (no subject)
Wow, it's amazing to think the liver regenerates that much that fast.
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User: the_ogre
Date: 2010-08-12 04:11 (UTC)
Subject: ...
I'm glad you have a plan now. Much strength and love to you three.
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User: squirrel_monkey
Date: 2010-08-12 04:11 (UTC)
Subject: (no subject)
Hang in there. I know it's difficult, and I hope you won't have to cancel the trip.
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User: msconduct
Date: 2010-08-12 06:24 (UTC)
Subject: (no subject)
Liking those words "eminently manageable" and "long term".
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User: fjm
Date: 2010-08-12 07:22 (UTC)
Subject: (no subject)
Will be back in the UK next Wednesday. Will text for a call shortly after that, xxx
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User: goulo
Date: 2010-08-12 07:45 (UTC)
Subject: (no subject)
Sounds like you are in capable hands. Good luck to you!
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User: austspecfic
Date: 2010-08-12 08:32 (UTC)
Subject: (no subject)
Big hugs and lots of positive thoughts. Donna
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MEG: Baldy
User: djelibeybi
Date: 2010-08-12 16:24 (UTC)
Subject: (no subject)
I read this in the early hours of this morning and cried for your distress but couldn't put anything into words. Today's not much better but I wanted you to know that complete strangers (like me) are rooting for you through all this painful process. At least there's now a plan. It's not what anyone wanted for you after all you've been through, but it's marginally better than the waiting.

And you have wonderful people around you.
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Stone of stumbling and rock of offense
User: wordweaverlynn
Date: 2010-08-12 19:32 (UTC)
Subject: (no subject)
Keeping you in my thoughts.
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Kari Sperring
User: la_marquise_de_
Date: 2010-08-12 20:59 (UTC)
Subject: (no subject)
I will be hoping for the best possible outcome for you. Much love.
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