Monday, 28 May 2007

Last Supper

Steak for dinner - on the NHS (well it is a private ward). I'm nil by mouth after midnight, ready for 8am start. That means I'll be the surgeons first operation after the bank holiday - doesnt he need some practice first?!?!

Wednesday, 23 May 2007

Checked he had a steady hand...!

Met the surgeon today. As ever they tend to exhibit a confident, almost arrogant, belief in themselves - something easy to loathe in anyone but a surgeon (and Stu), but its exactly the feeling you want from them!

Quick cut here, persuade the ribs to open up and your in. Whip out the tumour and surrounding tissue, have a rumage around for anything else while I'm in there and we're done!

We reviewed the results from CT scan earlier that afternoon and the tumour was there for all to see (about 3 o'clock on the image above). More concerning was the fact that there were two other tumours on my right lung. One had been there ever since my first scan two years ago - its never enlarged or showed as active on the PET scan and can be seen at approx. 11 o'clock on the scan above. The other one not shown on the above slice is approx. 5mm and appeared to be new addition to the family, although it hadn't registered as active on my recent PET scan. So that means there may be the option of having further surgery on the right lung, before chemo?

PS. the surgeon had steady hands, but a dodgy eye! Not sure which is worse?

Monday, 21 May 2007

What are you doing this afternoon, sir?

Who says the health service can't move quickly?

After prevaricating for 6 weeks over which treatment to have I receive a call from Michael Dusmet, surgeon at the Royal Brompton hospital. "I've been asked by the Royal Marsden to take the tumour out of your lung, what are you doing this afternoon?" he asked.

I liked his style but not wanting him to rush into things (and the fact that I didn't have my toothbrush on me) I settled for meeting him on Wednesday, with surgery scheduled for the following Tuesday 29th May.

This at least fitted in with my plans to visit York for the weekend and visit some old friends (yes Nigel and Jerry, you are old!). Might be the last beers I have for a while!

Saturday, 19 May 2007

What's the plan?

In advance of High Dose Chemotherpay (HDC) I was prepared for a stem cell harvest which involved my giving myself nightly injections of growth factor for four days and then being connected to a centrifuge harvesting machine. Two sessions allowed them collect enough stem cells for one HDC cycle, but not quite enough for two, but they can try and collect more after my first course of normal chemo.

After much confusion I was finally scheduled to commence standard chemo cycle on 24th May, though the consultant, after some prompting did advise that they would discuss my case in more detail, particularly in relation to the surgery option. Having HDC first may mean there is nothing for the surgeon left to find; surgery first may simply delay the inevitable and increase chance of cancer spreading elsewhere.

Frustration!!! The standard treatment regime doesn't seem to extend to a second re-lapse, thus there is no standard approach - more of 'seat of your pants' type of approach, not helped by seeimg three different different consultants at the Royal Marsden (RMH) each of whom appeared to have only just picked up my file, did little to instill confidence in the decision making process!

A phone call at 8.30pm confirmed that after discussing the options the RMH team had decided that surgery first was the best plan of attack. It was decided that in the absence of being able to confirm whether my hip area is cancerous (a follow-up PET scan was inconcluisve) removing the known tumour surgically would give me a chance of not having to go through HDC - they would assess my AFP tumour marker after surgery and if it continued to drop as expected they could review the HDC option. If it didn't then it's HDC as originally planned, but with the risk of chemo not fully killing off the lung tumour removed.

Well at least there is now a plan!!!