Not What Was Expected

We went to Bellingham this morning to meet, separately, with a surgeon and with the GI guy who did Ed's colonoscopy.  The purpose was to go over the results from the biopsy of the mass that was found during the colonoscopy, to discuss the results from the CT scan, and to plan for the surgery to remove the mass in the colon.

The results of the biopsy were largely what we expected: that is, it is a 5 cm. adenocarcinomasarcoma which must be removed, because otherwise it will end up blocking the colon and that is not something anybody wants.  Nothing else problematic was found in the rest of the GI system.  (Last week included both a colonoscopy and an endoscopy).  However, the mass was determined to be 'infiltrating,' meaning it wasn't just sitting easily on the lining of the colon. 

The worse news was from the CT scan, which showed the cancer had metastacized to the liver.  This is the most disheartening news of the day, of course.  Confined to the colon, it would be pretty treatable/curable even.  The spread to the liver is not so treatable. (Incidentally, the liver is the most likely site for spread from the colon.)  We have neither of us done a lot of research about outcomes in this case, but without some kind of treatment, we are talking about a year, perhaps.  To get good information about treatment possibilities, we will need to talk to an oncologist.  However, surgical resection is not viable because the cancer is spread fairly evenly throughout the liver.  The two docs we spoke with both talked about chemotherapy as being a viable option with some chance of longer life, but with the downside of chemo, of course, and no promises about an additional year or two.

So, this is pretty disheartening.  There are some good parts.  The surgery to remove the mass from the colon can be done laparoscopically, which is a world of difference from open abdominal surgery.  (e.g., 4-5 days hospitalization vs. 5-8 days;  4-5 weeks recovery vs. 6-8 weeks.)  The surgeon has done lots of these...over 100 in a year, so we get lots of experience.  Although there are mets to the liver, the liver appears to be functioning normally, although this would change over time.  There is no way of knowing without an actual biopsy whether this is an aggressive cancer, so it could smoulder on without significantly affecting Ed's daily life for some time.

The surgery is set for 3 weeks from now (Feb. 17th, the earliest opening they had in the schedule for this surgeon).  Bellingham is awash with docs and medical centers and equipment and resources.  The docs say that the three-week wait is of no issue and that Ed can continue to go about his regular life until that event.  After the surgery, in which the surgeon hopes to be able to obtain a liver biopsy sample, we will talk to the oncologist about what, if anything, makes sense next.  Ed is not committed to any position on this, although neither one of us is inclined to want 'she/he battled his/her cancer heroically' featured in our obituary.

So, we are not where we expected and hoped to be today.  But we are where we are and understand pretty well what comes next.  We are working on clarifying what really needs to be brought to completion in the various parts of our life (other than medical) and a plan to get those things done as soon as possible, including turning some tasks over to others where it is necessary.  For ourselves, doing things that need to be done is infinitely better than drifting into thoughts of fearsome probabilities and possibilities.  So whether we are doing it ourselves or getting help from others, we are moving forward with a sense of purpose.

Given our ages, this note could as easily be a message that one of us had been diagnosed with dementia, or had a stroke with significant neurological impairment, or had failed to survive a heart attack.  So, in that sense, this is a lot better than it might be.  However, it is clear that the warning bell has rung, and we have heard the warning.  But what must be remembered by those of you far away, is that we are both fine.  Other than Ed's tiredness from the anemia (and he is taking plenty of iron to build up his blood count), we are as you saw us last.  And we'll be exactly that for some time now as far as I can understand.  And we have the time and the energy to get done what needs to be done.

There is a tendency to think that having what appears to be a terminal illness means that you are terminally ill.  But that's only what happens at the end.  And there's no reason to think we're very near that point at all.  I asked both doctors several times about this three-week interval: 'would it be okay for us to go up to the coast, e.g.?'  'Of course,' they said.  'Nothing is going to happen in the next three weeks.'  We all, at some point, will be terminally ill; but right now, we are fine.