Change

Well, the bottom line is that Ed has an appointment at the University of Washington Liver Clinic on June 6-7: first, to have more complex CT scans performed in order to get a more accurate sense of whether surgery is possible,  and, second, to get more information about what the surgery entails. If they judge he is not a good candidate, then we don't need to know about the surgery's risks and benefits.

Over the past ten days, Ed has read much of the research on the effectiveness of liver surgery in advanced colon cancer cases. The standard of practice has been not to operate if there were multiple tumors in more than one liver lobe. Ed has multiple tumors in more than one liver lobe.

However, in recent years, surgeons have been altering their surgery criteria in an attempt to find the patients most likely to benefit and in various studies have begun to show median survivals of four years. There is not yet a single new standard for this selection criteria, but several research groups are getting these kinds of outcomes numbers.

That makes it look as if surgery is obviously a better choice as compared to further chemo, which is more like 24 months median survival. But, as Ed's medical oncologist pointed out, the studies really can't be compared because the surgery patients were accepted only if they met very strict criteria. Second line chemo is pretty much offered to anyone who survives after a first round.  Thus, after June 7, we will probably know more.

Additionally, Ed's return to chemo seems to have been less 'friendly' that it was the first time around.  He has had more of the side effects (foot and hand, mouth sores, nose bleeds, GI problems) and it has slowed him down much more.  That would make more chemo harder to choose.  The last chemo was two weeks ago and I'm hoping that the next week will see the diminution of these problems.  (Well, the foot/hand and mouth sores have already disappeared, but the nose bleeds, the GI, and the fatigue are still with him.)

(I will post the summary of the research in a separate blog post titled "Research Results" if anyone is interested in looking at it.  It will be only the four articles that Ed thought were most important.)