Monday, April 6, 2009

Answers (Part 2) And A Big New Question

I'm finally back from Centenary Hospital with some "good" news and a dilemma.

The good news is that the cancer has not spread and is still localized in my esophagus. My lungs are clear, my Lymph Glands are clear, my liver is a thing of beauty. The Cancer is a stage 1 or (at worst) stage 2a out of four. The Surgeon will have to spend more time with the CT Scan results to be sure.

The dilemma is that, because it isn't as severe as they originally feared, I now have the option of going straight ahead with surgery immediately instead of going through chemo and radiation and then the Surgery. Surgery alone will involve 2 months off work, the addition of chemo and radiation would involve a further 3 months off.

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 higher than for surgery alone. However, this approach destroys my immune system.

The benefit of just going with surgery alone is that it will be over quickly (if you can call two months 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 have two days to decide or the Surgeon will be referring me to an Oncologist at Princes Margaret Hospital, because this is an aggressive cancer and he can't wait around for a decision. So I need to make my mind up before Wednesday.

Reading between the lines of our talk, the surgeon seemed to be opting for going straight to surgery (but then he is a surgeon).

Decisions. Decisions.

And not one I want to get wrong.