Today was my day to discuss Chemotherapy with the Oncology department at the other hospital...I was back under the care of the original Onc team which I was glad about as he was aware of the problems I experienced back in June this year.
I was feeling quite apprehensive about this appointment as I seem to have far more questions than answers at times.
Anyway, to try to keep this as brief as possible I met with a lovely Oncologist who was part of Dr L's team. Bit disappointed when I realised that I wouldn't be seeing him (Dr L) but really only because he was aware of my 'history' with Chemo and Radiotherapy to date. However, I didn't need to worry as she was totally lovely and really clued up.
We discussed the build up to the op, previous treatment, how I've been since the op (did cry a little at this point but mainly held it all together - Sarah said I did brilliantly....:-))....) and other aspects such as the wound not healing yet.
She confirmed that Chemo could potentially give a 3-5% increase in the chance of the cancer not returning to a new spot - or even to the same spot. However she also felt that my chances of suffering a severe reaction would be far higher....
I explained that I was really frustrated that I hadn't been able to have access to my histology reports which would confirm the Stage, Grade, lymph node involement and aggresiveness of the tumour that was removed. She confirmed that they also hadn't received this from the previous hospital and without it she couldn't really answer my questions in full.
She then said she would ring the hospital and see if she could get the report faxed over.
Amazingly she got it within 5 minutes ! Brilliant.
We then continued with the meeting and Dr L also came in and took part. He said he was fully expecting me to be resistent to further Chemo and understood my reasons completely. I explained that I wasn't happy about the idea of poisoning myself 'just in-case' and he more or less agreed with me. He also said it was obvious that I'd thought things through properly and it wasn't a 'knee jerk' reaction....
I discussed with him that numerous people had done the Chemoradiation, followed by surgery, then followed by adjuvant Chemotherapy and still got mets to other places or a return to the original site - therefore with no guarantee's whatsoever it didn't feel like the right path for me to follow at this time.
At no time did either of them say 'You NEED to do this Carole' because if they had, I would risk it.
He confirmed that there would be, and could be, no guarantee's either way..in other words I could have the Chemo and it might never return, or maybe it would - or I could refuse the Chemo and it might never return or maybe it would.
On those statistics I decided no Chemo at this point in time.
She then discussed the histology report with me explaining that the tumour they removed was 3cm, poorly differentiated, Stage 3a, Dukes C, T2 N1.....(T2 N1 tells them that there was lymph node involvement) Apparently 12 lymph nodes were harvested and one was impacted.
In English she explained that this meant that the cancer could have moved to a new position via the lymph node but on the other hand may well not have done...so again, no guarantee's.
Then she discussed with me the diagnosis of 'poorly differentiated' and explained that this related to the agressiveness of the tumour.
A well differentiated tumour is one with clear borders and easily identified 'clear margin' around the tumour - mine is poorly differentiated which equates to them being unable to define the exact borders and shape.
So again this meant that due to this it could have moved off to find a new home or it may well not have done so....
Based on all the above, I've decided to play a waiting game until my 6 monthly check up in June. If there is any sign of it then we'll discuss Chemo - but not now. They are perfectly happy with my decision and so am I.
I don't want anyone to think I've taken this decision lightly - because I haven't. I've taken what seems to me to be the best possible choice for now.
Sarah asked the Oncologist for her opinion on whether (in some people) the actual Chemo could cause new tumours.
Oncologist said that she didn't think that was the case however it has been proved that Radiotherapy could and does sometimes cause new tumours later on down the line...so taking into account the way I burned during my treatment that could be a cause for concern at a later date I guess.
However, for now I'm just concentrating on recovering from the op - which is still going to take some time as I'm still very weak at times - and getting myself back to full health, returning to work and some kind of normality, eating well and continuing to support my immune system as best I can and we'll see what the future holds.
Tomorrow I'm off to the other hospital to see if the wound has healed enough for the stitches to come out. They've warned me that if it is ready it will be very painful now and to 'bring paracetamol with you just in-case'.....
Now call me daft if you like, but I would have thought that a hospital could supply me with painkillers on the day rather than expecting me to bring my own supply of paracetamol !!!
Fingers crossed for me that if tomorrow is stitches out day that it doesn't hurt as much as I'm now expecting it to :-((
