A Major Step in the Elimination Process

Last Thursday I had a PET Scan done to find out how effective the treatments had been.The scan also gave the doctors a current resource in order to make the decision of "what to do next".

Today we met with both Dr. H (oncologist) and Dr. K (thoracic surgeon).

Good News! Since we have started treatments the main thymic mass has shrunk 50% and the smaller thymic mass is non-existent on the imaging (!!!) -- which leaves just the main thymic mass at 3 1/2 cm. The liver mass has not changed in size whatsoever, however it has become less "reactive" to the scan injection. The fact that the mass has changed in reaction but not size confuses the doctors on what it might be. So the plan with the liver = keep an eye on it, but don't let it effect our decision making.

Even though chemo and radiation has shrunk the mass significantly, Dr. H does not recommend continuing with chemo as a permanent treatment for the thymic mass. Which I agree with.

Which leaves..... The Plan, although very serious, is to do surgery. My team of doctors will sit down once again this afternoon to discuss every angle of the surgery. If everyone is still on board and nothing unexpected pops up, we will set a date.

As I mentioned above this surgery is very serious.
The thymic mass lies under my breastbone and on top of my heart.
The surgeon will cut through my sternum (breast bone) to access the area.
There is no way to tell from the scans, but if the mass has grown into the Vena Cava (a major vein that drains blood from your head, arms and chest) they will have to remove any part of the vein that is cancerous and reconstruct the vein with a graft (a plastic piece). While they are working on the vein I will be put on a bypass machine, which runs the risk of additional complications. As I mentioned, this might not even be an issue; but we have to be prepared just in case it is.
Also in this area lies 2 nerves, these nerves are in charge of raising your diaphram when you breath. It is very likely that one of these nerves will be removed or cut during the surgery, if both nerves are in the cancerous area they will be forced to leave one there (with the cancerous tissue). Not having one of these nerves will cause shortness of breath and exhaustion. The muscles around the lungs will have to work twice as hard and adapt to this missing nerve; even with this compensation I am told that I will still have difficulties from strenuous exercise in the future [still better than having cancer]. So as you can see not having either isn't an option.

The surgery without complications should take "a few hours", the surgery with the complications mentioned above will take "a few hours on top of that". I will be in the hospital anywhere from 3 days to a week. From there I should be able to go home; however, the expectation is that I will recover at home for 3 weeks after that.

The list of possible complications that were listed on the consent sheet: bleeding, infection, stroke, death.
The list of possible benefits that were listed on the consent sheet: possible cure from cancer.

I am sure this is a lot for you to intake, I know that I asked a bazillion questions.
If you know my medical history, I'm sure you are just a degree below the nervousness than I am feeling -- but everything will be fine! I have a lot of living left to do.

I'll tell you the secret to my confidence... it's all of you (and some say I might be just a bit stubborn). Anyone who has called, text, IMed, Facebooked, Commented or Seen me in person is responsible for how well everything has gone. Throughout this horrific experience I have been reminded on a daily basis why it's worth it and how lucky I am to know such wonderful people. With John attached to my hip (and heart) every step of every day and all of you who have shown your support keeps our confidence and good spirits high -- Thank you.

When I know the date of the surgery or any other information, I will be sure to post it - but I can assure you that it will not be before Christina & Taylor's Wedding!!! ;0) (10/3/09)