My Decision AndWhy I Made It

After my last visit to the surgeon, I was left with a very difficult decision to make. Go immediately to surgery or wait two weeks to see an Oncologist who might recommend tacking on chemo and radiation treatments.

The benefit of adding on radiation and chemo before the surgery is that it shrinks the tumor and and may mean less radical surgery (ie only removing half my esophagus along with half my stomach). Survival rates for those who have radiation, plus chemo plus surgery are slightly higher than for surgery alone. However, I would have to wait up to two weeks for the appointment and this approach damages my immune system.

The benefit of going with surgery alone is that it will be over quickly (if you can call two months in recovery quick); the survival rates, for the stage of cancer I have, aren't much less than for those who opt for the addition of three months of chemo and radiation. But it will mean removing all my esophagus and rebuilding it with half my stomach. However, it will leave my immune system in tact.

I was given two days to decide.

Although this is an aggressive cancer and Linda's first impulse (like that of the majority of bloggers comments I received) was to just get it out of me as quickly as possible, I decided to wait to see the Oncologist first.

A risk, I know, but everything to do with this disease is a risk. However, I intend to survive this and so I have to balance the quality of life I will have after treatment against the slightly increased risk of waiting to see the oncologist.

With chemo and radiation there is even a chance that this alone will eliminate the cancer and I might not require surgery at all. But even if I still do need surgery, it will be less radical.

Of course the wait could kill me. So trust me, a lot of thought went into this. I consulted with my family doctor who recommended waiting to talk to the oncologist. My sister-in-law is a nurse and she discussed my situation with one of her doctors, who is the brother of one of the most respected Oncologists in the States, who sent his brother a copy of my blog to describe the situation. His brother said I definitely should wait to discuss this with an oncologist.

Friends have also put me in touch with two people who are also fighting the same disease, and both recommended chemo and radiation.

Chemo is no longer as harsh as it once was. I won't loose my hair (what little I have) and the impact on the immune system is no longer as great.

If I have the chance to keep my digestive system in tact, I'm going to take it.

I've also decided to have a procedure next week to widen the closure in my throat to make it easier to swallow food. It is day surgery under a general anesthetic but it will improve the quality of my life while I wait for chemo to do its thing.

Although another unhappy wrinkle in this grand scheme is that the Oncologist could decide I'm not a good candidate for chemo or radiation and recommend going back for surgery. In which case I will have waited two weeks for nothing.

Decisions are never easy, but this one was the worst.

It was my call and I hope I got it right.