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!!!