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You are welcome to apply any part of this article to your own personal use. Please do NOT publish any part of the article or apply any part of it to any non-personal use without the express written concent of the author.
Namaste, dear readers.
While resting up from the last Nadir Days we've had a few medical appointments. A detailed review of the latest CT Scan by my Medical Oncologist revealed some encouraging news. The one-centimeter nodules have gotten measurably smaller. They are now about 70 millimeters in diameter, which represents a shrinkage of about 30%!
The Medical Oncologist is also recommending surgery to remove the lesions in my lungs. I've been a bit reluctant to have my body cut into, understandably, so have explored the CyberKnife option. Here's what I've found out.
CyberKnife has some wonderful attributes. It has the ability to send a gazillian low-dosage beams to the target area, each beam from a different angle. All these beams intersect at the target area. The intersection receives the net dosage from all those beams, creating a very specific region of very high radiation dosage. CyberKnife works very well on cancer masses that are in inoperable areas, and that are large enough to be seen with CT Scans or other similar diagnostic tools.
However, there are several problems in that alternative, at least for my case. First, sarcomas don't respond all that well to radiation, requiring much larger doses to have a significant effect. Second, if you can't see the lesion using a diagnostic tool such as a CT Scan CyberKnife can't attack it - in my case with the shrinkage of the lesions the success of this approach becomes problematical. Third, the long-term effects of CyberKnife aren't yet known. Lastly, and very importantly to me, there is a large element of not-knowing because there's no extraction of the lesions to examine how well the chemotherapy has done.
After talking with the thoracic surgeon some additional information came out. For my case his recommendation is for only a single surgery where previously there were to be two separate surgeries, one on each lung. He expressed many reasons. All the lesions except one appear to be near the surface of the lungs. One incision in the chest through the sternum would give him access to virtually all the lung material enabling him to investigate virtually all the lung surface and much of the deep tissue for anomalies. This incision has the fastest recovery as no muscles are cut. The surgeon has on many occasions found and removed lesions too small for the best diagnostic tools to detect. With sarcomas with the current state of medical technology the best chance to be cancer-free for the longest time is surgical removal of all detectable lesions. Only one lesion is deep in the lung tissue, and that one is in the smallest lobe which is easily removable and hardly noticeable in its absence.
This surgical option typically requires only about two hours on the table, three to five days in the hospital to recover, then about three weeks to get back to about 80% of normal. As with most major surgeries, that last 20% will likely take from six months to a full year or longer.
After evaluating all the options and considerations, surgery seems the best alternative for my case right now. So we've scheduled it for September 9, 2004, the earliest possible date. My focus now is to build up my strength for the surgery. The next dispatch will be posted a day or two after my return from the hospital.
What happens after surgery? If the microscope shows only necrotic lesion tissues (all dead cells - only somewhat likely) then maybe nothing more need be done beyond a standard follow-up protocol (periodic CT Scans, say every 6 months or annually). If there are a few cells found (most likely) then we'll consider doing Chemotherapy Cycles #5 and #6 with a more aggressive follow-up protocol, the specifics of the treatment plan depending upon the percentage of necrotic cells found. If there are a lot of viable cells found (highly unlikely), then we'll be exploring other ways of controlling the cancer. There's a fourth option that we don't want to consider, that of finding lots of lesions too small for the CT Scan to see - that will likely necessitate going back to the drawing board, especially if they're composed mostly of viable cells.
Obviously we're shooting for the highest percentage of necrotic tissues. We'll know a lot more after the surgery.
In other news, we arranged to thank the Angels at my hospital ward (Six Southeast) for all the good care they have given me over the past months. With the help of Windworks Sailing Center (www.windworkssailing.com) where we teach, several Thank You sails were arranged for Wednesday, August 18. To accommodate the various shift schedules we had one morning sail and one evening sail. Most of my personal Angels were able to participate, five with two guests for the morning run (one boat) and twelve with eight guests for the evening one (two boats). Two Windworks skippers, Captains Neil and Gene, volunteered to drive the boats. Meet my Anglels (to skip the photos, click here):
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Thank you Six Southeast Angels - you are all extraordinary folks. Thank you Gene and Neil for driving the boats, and thank you Windworks for providing them - you effortlessly enabled us to contribute a very special day to my Angels.
Namaste, dear readers, and fair winds.
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