Tuesday, January 16, 2007

An Unwanted Journey: Day 0419 - Another Tumour Board

After the fact, it seemed entirely predictable. The CT scan was "suspicious". The MRI was "suspicious". But neither were definitive. And so my medical oncologist is taking my case to the gastro-intestinal tumour board for review on 26-Jan-2007. The board will then decide what the most appropriate next step should be, but it is highly likely that their opinion will depend on what the surgical oncologist recommends. He has already told me that he wants to do a flexible sigmoidoscopy at the end of March, almost one year exactly after the low anterior resection he performed on 28-March-2006. But the board may suggest he perform the scope test sooner and may also suggest that multiple samples be taken for another biopsy.

Waiting is now what I'm faced with yet again. There's nothing I can do. There's very little anybody can do until this diagnostic phase is complete. But I have lots of experience in knowing what waiting is like.

Even the CEA test will require waiting for about ten days, since the results require sending the sample outside the Grand River Hospital to another lab in London. I know what my CEA was like just before I began treatment last January and I know what it was like near the end of chemotherapy in September. Although it's not a definitive test either, it sometimes helps determine the threat of cancer. In my case, it was at its highest in January 2006 just before treatment and at its lowest at the end of the treatment cycle.

Am I frustrated? Yes, you bet. But I have to keep coming back to the excellence and thoroughness of my medical team and the fantastic resources available to take me through this medical maze.

But I'm also nervous and a little anxious. If we go ahead with another biopsy from multiple samples, and should the pathologist's report determine that I have recurrent rectal cancer, that means more surgery, a colostomy for sure, and the end of natural function in that part of my body. That's regrettable, but it's not what sets the hair on the back of my neck standing. What leaves me cold and frightened is the prospect of a large cancerous growth at the site of the anastomosis within 8 months (30-Nov-2006 was the date of my surveillance colonoscopy) of surgery. That would mean that whatever few cancer cells survived radiotherapy, surgery, and chemotherapy grew wildly. That would mean that my long-term prognosis would be poor - at least that's the way this medical layman sees it.

But, like I said, there's nothing I can do except wait. In the meantime, I will live my live "normally" and hope, yet again, for better times ahead.

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