To Cut or Not to Cut...That is the Question

I just returned from my appointment with Dr David Rice, who is the radiology-oncologist that has been treating me thus far. I brought the CT Scan and PET Scan photos with me to the appointment. Dave's view was pretty much the same as mine; that I had about as good a response to the treatment as one could hope. The question now is what comes next.

What I learned from Dave is that there appears to still be metabolic activity within the primary tumor, but thus far it does not appear that the cancer has spread. (Dr Thomas Fabian, the radiologist who did the CT and PET, will be providing a report with a more detailed analysis, but that is Dave's best (albeit cursory) read from the pictures.)

Dave believes that the course of action to give me the best long-term prognosis would be to remove the remaining tumor, if that is possible. While I was there Dave called the thoracic surgeon, Dr Lary Robinson, at Moffitt. I am going to have another appointment with Dr Robinson ASAP and have him look to see if his view (about surgery) has changed. From Dave's conversation, it sounded as though the option of surgery still remains in considerable doubt. The issue appears to be the location and size of the tumor and now scaring. The fact that we did definitive radiation (7 weeks) vs a less intensive 5 weeks makes surgery more difficult. If we are going to do surgery at all we have to do it soon; otherwise scar tissue (from radiation) will be the deciding factor.

Dave's opinion was that I may currently be a borderline surgery case, so it is worth pursuing. We are going to set up an appointment to see Dr. Robinson ASAP. If he decides after all to do the surgery, we would do it right away right at Moffitt. In my case we might have to remove the entire right lung, rather than do a partial re sectioning. Removing the entire lung, according to Robinson, is high risk with high mortality from post-operative complications. (Although that is mainly true for patients who are elderly and have complicating medical conditions.) Moreover, surgery would entail a prolonged (two or three month) period of recovery (assuming you survive the initial trauma!) and would result in significantly reduced breathing capacity.

The other thing Dave said was that, they could go in to do the surgery and decide, after seeing what's what, that it can't or shouldn't be done! Then I would have to go through all the pain and recovery for nothing!

Frankly, all this does not get me excited to run out and have surgery, especially since I am feeling so well right now! Dave believes that, whether I have surgery or not, I should proceed with the consolidation chemo. The only problem I have with that recommendation is that I wouldn't want to be in a rundown condition (i.e. anemic or prone to infection) when I go under the knife. I would want to be in excellent shape, which I think would rule out consolidation chemo until we have a final decision on surgery.

Anyway, where we left it is that I will make an appointment to see Dr Robinson at Moffitt ASAP. My appointment with Dr Lunin is next week. I would like to see Dr Robinson after I have seen Scott so I know what questions to ask.

We should have some answers shortly about where we go from here. In the meantime, I am going to relax at home, eat, read, and generally enjoy my current good health! I definitely want to wait on proceeding to next steps until after the Giants beat New England on February 3rd.