At my last appointment Dr. G raised the idea of surgery at some point in the future. What surgery would this be? Amongst the initiated, it's known as "tumor debulking", to remove manageable spots of active disease. It's generally undertaken only when the benefits outweigh the risks. And what risks might there be?
First, the risk of surgery itself: My last surgery in January 2004, a partial liver resection to remove the first liver metastasis, resulted in life-threatening abscesses and an 8-month recovery. My dear H was elevated to sainthood through tending me during that recovery, the first 4 months of which involved daily dressing changes on an infected incision. For "daily" you can read, for the first 3 months, thrice- or twice-daily dressing changes. And for dressing changes, you must understand that the process involved not just popping on a bandage, but cleaning an open wound and applying medications, all the while trying to maintain a sterile field around the wound. Caring for the abscesses necessitated my wearing a bag at my waist attached to an internal drain for 4 months. Between the infection and the abscesses I was hospitalized 4 times and could easily have died twice. When additional liver lesions showed up in October 2004, every surgeon and doctor in my coterie lined up to rule out surgery as an option. No matter my general health, even now, would I be prepared to face that kind of risk again? Maybe if my lesions weren't in my lungs and liver I'd feel less worried about the idea.
Second, the risk of "waking up the baby" (as Dr. G put it - clearly he has a young child!) That is, adding stress to one's system may provide just the opportunity needed for cancer to re-assert itself. Would that happen to me?
For now I think we're more than content to keep the current medications and routines in place. It ain't broke, and perhaps there's more to be learned from pushing Nexavar to its logical limits. As Dr. G pointed out, I'm clearly responding to and receiving benefit from the drug, no matter the dosage. I'd like to see how long I can stay at this level before it stops working for me.
Side note: Saturday I noted the beginnings of the return of hand/foot. So I'm off Nexavar until at least Thursday. It took six months this time.
Labels: appointment results, hand/foot syndrome