Well I am two and a half weeks from surgery and things are going pretty well. We had a follow-up appointment with my surgeon yesterday and they were pretty happy with how well things are going. I am so happy we came here for this - Dr. Reardon and his staff have been great to us and I am lucky to have him as my surgeon as there is nobody with more experience than him when it comes to removing cardiac tumors (I think I was his 30th resection).
The pain has abated significantly and the incision is healing (though it’s still a little sore). Right now the worst part is the limited mobility (I threw a toy for my dog yesterday and it felt like someone stabbed me in the chest) and discomfort sleeping but it seems to get better every day. I am hoping to be able to walk a mile (I still get short of breath easily) by sometime next week and maybe two miles by the time I am four weeks out of surgery.
We’ve received the operative report and the pathology report and overall I think the news is pretty good. As we knew all along Dr. Reardon was able to resect 100% of the tumor. While I was on the operating table the checked the margins and the part of my heart where the SVC artery comes in didn’t have clean margins, meaning there were still traces of the tumor in the heart tissue they cut out, so he cut a little more away from my SVC and was able to get clean margins all around. Though the recurrence rate for these tumors is very high, the fact that he was able to get clean margins weighs heavily in my favor. We talked to him about the decision not to remove the sternum and he reiterated to us that it looked healthy and he didn’t think removing it was nesissary. We talked about the possibility of either treating it with radiation or removing it in the future if scans ever show the cancer I have (or had?) in that area to be active. I was concerned because in July, when the Taxol chemo stopped working, my sternum lit-up on the PET scan indicating active cancer cells. The hope is the AIM chemo killed them (we’ll get a better idea of that in February when I get scanned again).
The pathology report didn’t deliver the news I was hoping and since we haven’t met with my oncologist yet I am not sure how to take it. The tumor in my heart was 90% necrotic (dead) when it was removed meaning the chemo killed 90% of the cancer cells in my heart. Though 90% is a high number, 100% would be much better as this would show a complete response to the chemo. In theory, I think you can apply that 90% to all the active cancer cells in my body which means it’s unlikely the chemo alone was enough to kill 100% of the cancer in my sternum, spine and rib (hopefully the radiation took care of the rest in my spine and rib).
So the big question is what’s next? Though the primary tumor is now gone (which really puts my mind at ease) the fact that the cancer was metastatic means I have to stay vigilant and aggressive. The possibility that the cancer exists in other parts of my body but is too small to show on scans will always be there. When all is said and done I will be off of chemo for 10-12 weeks and if nothing happens (meaning I get clean scans) in that time I feel that means very good things. In my talks with Dr. Ravi it’s apparent that we are going to stay aggressive in combating this disease which means I will likely have two more AIM treatments (which will put me at my limit) and then move on to another chemotherapy to keep killing the cancer cells we can’t see.
I go home next week and I can’t wait to get back to Syracuse and the two feet of snow that’s there because something just doesn’t feel right when it’s January and there is no snow on the ground (though I am enjoying Houston a little!). I've had a lot of support from family and friends while I've been here and I am so thankful for everyone who came or helped out at home. Shana and my mother have been here since 12/22 with me and are taking such great care of me and I hope they know how much I love and appreciate them for everything they have done and all they have sacrificed (same goes for my dad, who went back to Syracuse last week). I can’t wait to get back to work and back to normal (at least what I think of as normal) sometime in the next few weeks.
I am working on getting the video and pictures from the surgery - still mulling over whether I will post them here or not, but I am anxious to see them. Thanks for reading my blog and thanks so much for all of the messages and support. I thank god everyday for all my wonderful family and friends and the messages, emails, texts and phone calls really keep me going. I am a pretty lucky guy.