8/16/06 Improving Odds and a Course Correction

Family and Friends,

Gen and I met with Dr. Douville (surgeon) today and were given a lot more to think about. We learned of a new option that looks like it could improve my long-term chances of remaining cancer free, and also changes the anticipated timing for my surgery. That option is to have two courses of chemotherapy before the surgery. With surgery alone, there is a 20% to 25% chance of getting cancer again. Those chances are CUT IN HALF by doing this preventative chemotherapy. WE LIKE THOSE ODDS!

Each course consists of having an IV of chemotherapy for one day. We then wait about a week for my white blood cells to regenerate, and then have a second course. (Fortunately it’s only a two course meal.) After my white blood cells have regenerated again, I have the surgery to remove the tumor. Only 2-3% of people get very sick using this form of chemo, and usually don’t lose their hair. However, I’m blaming any future hair loss on chemo.

Dr. Helen Ross is the oncologist that we will be seeing. She came with very high recommendations from both Gen, who works in Rehab at Providence, and our friend Rebbecca, who used to be the cancer unit head nurse at Providence St. Vincent. Dr. Douville says that Dr. Ross is a nationally recognized specialist in lung cancer, that her patients love her, and that he very highly recommends her. We are trying to schedule an appointment with her to get her opinion and to begin chemo if it sounds as positive after talking with her. She’s out of town this week, so Dr. Douville recommended that we take whatever appointment with Dr. Ross that the scheduler has available, then get Dr. Ross to squeeze us in sooner when she comes back next week.

The surgery itself involves removing the upper lobe of my left lung, along with the lymph nodes. The surgeon told us that the surgery usually lasts about two hours, and I will probably be in the recovery room for about an hour, and will likely spend the first night in the Coronary Care ICU. I should expect to be in the hospital 4-5 days, then go home and need assistance for a day or two. I should be able to get up and down stairs as soon as I am home. I will likely be at home through about the third week, return to limited activity within 6 weeks, and have almost 100% of lung functioning and be pain-free in 8-12 weeks. There is about a 10% chance that my vocal chords could get nicked while removing the lymph nodes, which would leave me sounding constantly hoarse, but there are solutions that lead to a very good chance of full recovery from that side effect. There should be no other long-term complications to my health. “The only change you would see in your functioning over the long run is that if you were a marathon runner, you would probably run a little slower.” I think I’m safe there.

Skip the next paragraph if you don’t want to know the gory details of the surgery options.

There are two ways that the surgeon recommends to perform the surgery. The method this surgeon uses for the surgery is to cut the breast bone and spread the ribs. This has a shorter and less painful recovery period than the more traditional method of entering from the side and spreading the ribs, which he does not recommend. The other option that he recommends is to make a small hole to insert a camera, and two more small holes to perform the surgery. Recovery time appears to be quicker with this method and there are no known increases in risk. He does not perform this surgery, but his partners do, and all have outstanding reputations. The only down side he sees is that there is a much shorter history of research on the effectiveness of this method (seven years). We will give these options further thought.

Now for the statistics. There is about a 2% mortality rate after this surgery. An extremely small (“infinitesimal”) percentage of that is from patients who die during surgery. The rest are patents who die of complications after surgery due to pneumonia, infection, heart attack, etc. That being said, Dr. Douville says that my chances are MUCH better than that because I’m in the top 5% of the patients he sees as far as condition prior to surgery: I’m young (no wise cracks – It’s all relative), healthy, exercise regularly, have an excellent diet, a great support system, and have a great attitude. I would add to that list all of the people that are praying for me, sending positive energy, or thinking dried prunes. Once again, we appreciate the love, support, and prayers that you are sending, and we strongly believe it makes a very big difference.

Overall we are very optimistic but drained after the appointment today. We were gearing up for the possibility of surgery as early as this Friday, and we’re having a post-meeting crash right now. However, I’m enlivened by one other upside to this new turn of events… There’s time for GOLF THIS WEEKEND!


Dann and Gen