Well, the last few days have probably been the most difficult I've had in a long time. On Tuesday, the tumor review board at Methodist Hospital in Houston (where I will have the surgery) and a group of doctors from MD Anderson (Dr. Ravi's group) both met independently to determine whether or not surgery was reasonable. I'm not generally a pessimist, but I couldn't shake the feeling that this was going to be a repeat of what happened at Dana Farber in July, when their group of doctors determined that I was not a candidate for surgery.
I've been given the best Christmas gift ever as I will be on the operating table on Tuesday, December 22nd (time TBD). This surgery is my only chance at being cured and I am so happy, excited and grateful that I will be given this opportunity. I feel like everything I have gone through the last fourteen months (34 Taxol treatments, 6 AIM treatments that required 5 day hospital stays each, 20 days of radiation to my spine and ribs and a VERY painful surgery to drain fluid from the space around my heart) has been done with this as the ultimate goal. Given what I have, I feel very lucky to be in the position that I am in and I have got to be the only guy in the world that's actually looking forward to open-heart surgery.
My oncologist, Dr. Ravi, has been very stern the last few times we talked about the risks involved with this surgery. We talked at length about these risks and I accept them, and firmly believe that this is the right decision, no matter what the result. The primary risk is that there are cancer spots in my body that are too small to be detected by scans - this is something that I have been told is likely many times over the last 14 months. If there are, once I have the surgery, I am essentially defenseless against them. Given how aggressive this cancer normally is (though I don't think mine has been that aggressive) I can understand why they are worried about that. I believe I can go back on chemo (which I am going to do to stay aggressive) 5-6 weeks after surgery. Believe it or not, I am looking forward to seeing what happens when I am off chemo for 10 weeks as I will be for this surgery. This is something I have to do sooner or later.
The other risk is the surgery itself. I am sure there are many things that can go wrong with this surgery. Dr. Reardon gave us some examples, but I think my overall health, age and strength all give me advantages going into this surgery. On top of that, Dr. Reardon is one of the most (if not the most) experienced surgeon out there when it comes to tumor resection. When Dana Farber was considering surgery they consulted with him and if you Google the surgery his name comes up very frequently. Patients come to see him from all over the world, so I feel very lucky to have him as my surgeon. When you talk to him his confidence is very reassuring.
Here is what I know about the surgery. The surgery will be on 12/22 and I will be in the hospital from 8-10 days. There will actually be two parts to the surgery (not sure which order they will be done in). Dr. Reardon will remove my sternum (part of it anyway) which is the bone that connects your ribs and protects the organs in the center of your chest. This is because the cancer is there and we opted not to treat it with radiation because of the proximity to my heart. The major part of the surgery will be the tumor resection. The tumor is in my right atrium and is located on the outside wall. Dr. Reardon will remove the tumor and some of the atrial wall (I belive the tumor is about 3.5 CM right now) and then rebuild my right atrium using synthetic cardiac patches (I know they have a name but I can't remember them).
I know there are hundreds of people who have prayed for this and I thank you so much for all your support. I feel like a broken record when I say THANK YOU so much for all of your support but it means so much to Shana and I, and my family and you've all helped me get this far. I couldn't have done it alone. I will be sure to keep the blog updated as I learn more over the next 10 days or so, and I will ask Shana to update the blog the day I have surgery. Spending Christmas in the hospital will be interesting, but this is the best gift I could ask for (and hopefully it will be nice and quiet!).