From the beginning (back in May) of Susan's cancer ordeal, we've heard the same thing:
Surgery to remove your esophagus and some part of your stomach is, according to available statistics, your best chance for long-term survival.
They told us this before Susan was staged at Stage IV, with tumors in her esophagus and stomach, plus in some local lymph nodes, plus in one distant lymph node. When they discovered that her cancer had metastasized (spread) and she was, therefore, not a candidate for surgery, that sounded like a death sentence to her. They also told Susan that she was not eligible for radiation treatment, statistically the second best option. She was only eligible for aggressive chemotherapy. We were starting out with what was, statistically, the treatment least successful in leading to long-term survival. But, it was our only option, so she did it.
In July, after her 8-week chemotherapy regimen, they did new scans and, quite unexpectedly, none of the tumors showed up. They were, evidence suggested, gone. At that point the options of radiation therapy and surgery came back into play. The tentative plan became: Susan would undergo six weeks of combined radiation and chemotherapy, take a five week break, and then get new scans. If the scans were still clear, we would plan the surgery. This was a relief to us because, even though the surgery was daunting and the life-changes it would bring were scary, it was, as far as we had heard, her best chance of long-term survival.
So, Susan did the (grueling) six weeks of radiation and chemotherapy. We waited five weeks, and then we went back early this week for new scans. They were clear. No sign of tumors. Then we met with her oncologist and he said, once again, "The surgery is going to be your best hope for long-term survival." Even though the cancer is gone, you see, there is only a 30% chance that it will not return, leaving a 70% chance that it will return. We knew all of this already, and we went from that meeting to a meeting with the surgeon.
The surgeon made several points in his discussion with us:
- People with metastatic cancer aren't usually candidates for major resection surgery like this since treatment of the primary location won't help in the long run when cancer is, potentially, all over the body.
- Susan's unusually good response to the therapy (no tumors) has caused them to consider her for the surgery where usually they would not.
- If the cancer does come back, it could come back anywhere, not just in her esophagus and stomach
- If they remove her esophagus and stomach and the cancer comes back elsewhere, what was all the suffering and loss of quality of life for?
- If the cancer comes back in her esophagus and stomach only, they can always do they surgery at that time.
So, in spite of everything we've heard to date, the surgeon recommended against the surgery. This was a surprise, but it was a welcome surprise. Susan was not excited about having stomach and esophagus removed, believe it or not. The surgeon's logic made perfect sense to us, expressing thoughts we'd already discussed and questions we had pondered together.
They're meeting next Tuesday with a large team to discuss Susan's case. They'll come to a consensus and let us know what they recommend at that time. For now though, here's what we know:
- The scans showed no tumors. (Hooray!)
- There's a good chance Susan will not have surgery, a wondrous new possibility for us. (Hooray!)
- We'll go back for monitoring scans in two months, and then every six months for five years. If we ever find anything, we'll start over. If not, then they'll call her cancer-free after five years.
Thanks for your positive thoughts, your hope and your prayers.
Hello, friends. I hope you're well. Are you?
Later. Love.
