A Visit to the Surgeon Dr. G

I met Dr. G the GYN Oncology Surgeon for the first time yesterday.  He was so kind, gentle and showed great concern for me.  Dr. G doesn't actually see patients on Fridays, but he fit me into his schedule, away from the lab which typically takes up his time on Friday's.  I can't say we have a definite plan yet, but I did get some answers.  I am beyond amazed again at this physician. We spent nearly 2 hours discussing my case.  Earlier in the week I asked the nurse if Dr. G was good.  Her response was, "If he wasn't good he wouldn't be here."  I liked that response.

Ultimately the treatment I have won't be what they want or what I want but we will decide on what is best for me and what we as a group feel will help eradicate or at least keep the cancer stationary.  Dr. G told me to stop reading statistics on the Internet, because I'm not one.  The statistics that are out there are people who aren't like me.  Just like Dr. P said, I'm young, my cancer is low grade serous cell and he thinks that me being healthy is the best thing that is going for me, that I eat well and that I exercise make this an even better case.

Dr. G told me that we need to think outside the box on my care.  Typically in OVC they only do 1 surgery and then treat recurrences with other means, unless it is only in one area do they typically do surgery.  Mine is in 3.  But he said because I am healthy he would consider doing the surgery.  This is the issue...the main area of concern which was thought to be on the bowel, is actually on the anal sphincter which couldn't be in a worse spot.  Just saying the word gives me the chills and explains why my tailbone hurts so bad to sit or lay on my back.  For those of you who haven't been following me until now, when I was initially diagnosed the Ovarian Cancer was also on the sigmoid colon.  The cancer now is at the base of where the initial surgery was stapled off.  Dr. G discussed with me that everything that took place with my initial surgery and treatment is exactly what he would have done.  But this cancer is difficult to treat and is usually chemo resistant.

Dr. G said that if I do surgery it will involve another bowel resection which isn't easy and that I will have to have an ileostomy for 8 weeks.  I could probably handle an ileostomy for 8 weeks, but that's it.  Dr. G thinks the mass is 1-2 cm even though on CT it looked to be about 3 cm.  The other areas of concern will be easy to get to and given my lymph nodes were removed on the previous surgery, he isn't totally convinced the one area that was once thought to be a lymph node really is such.

The other option which sounds hopeful is the MEK Inhibitor which is a pill I would take twice a day for the next several years or unless it doesn't work and we have to resort to surgery.  This study that I would be in isn't a blind study so Dr. G could make it so that I get this drug, which is the only way I would do it.  I don't want to have to go through chemo again, which would be another option to do the same chemo regimen or a different one.  I really don't know if I could handle the intense bone pain that came from the same chemo regimen.  It's funny that Dr. Dan said they would only do IP (intraperitoneal)chemo once, but Dr. G said that because I'm healthy and was able to handle all the treatments we could try it again.

The MEK Inhibitor does have side effects like rashes, nausea, vomiting, diarrhea and it lightens your hair color (interesting).  With being on the MEK Inhibitor in the beginning, I would need to stay close to Boston for a few months to have my blood drawn on a very regular basis and to monitor how I'm reacting to it.  They would do a CT scan every 3 months to see how the tumors are responding.

Another option which is rare and again thinking outside the box would be to do radiation.  Of course this has side effects too.  Dr. G told me that he has been taking care of someone who has a similar case as I for 10 years.  That brought me hope. 

I will know more on Monday when the Tumor Board discusses my case.  Its crazy to think that nearly 20 of the best Oncologists and Radiologists in the country will be focusing on me and what is best for my treatment.  Dr. G will call me on Monday to discuss our options and what the board feels will ultimately be best for me.  There is no doubt in my mind that Heavenly Father has had His hand in my life directing me to this very point for many years so that I could have the best care.  I know that Heavenly Father will direct these physicians and me when we ultimately decide on what the best treatment will be.  I cringe a little thinking that as I sit here typing that I have cancer in me.  I'm a cancer patient, but I'm still a survivor.  It is my hope and prayer that the treatment I'm directed to have will give me many more years to watch my sweet nieces and nephews grow up, to experience all the joy and happiness around me and to be an instrument in Gods hands in helping others.

My initial plans are back on.  I'll work 3 shifts this week and then head back to Phoenix to work my 9 shifts for July, go to Idaho for my 20th Class Reunion and to eat snow cones and play in the pool with my nieces and nephews.  I'll be back to MVY July 21 and will start some type of treatment then.  I've decided to postpone my boards so that I can focus on getting well, even though I would like to have them behind me.

I had a call this week from EMP's VP (my Phoenix employer).  She was so understanding and let me know that my job will not be at jeopardy, that I have short and long term disability to use, that I will still have all my benefits and that they will support me in anyway they can.  This gave me some relief and more love for the amazing company I work for.