Nothing is simple...

I am getting ready to catch a flight back to Syracuse (in six hours) after a very long week in Houston. I spent 4.5 hours in an MRI machine between my cardiac and spinal MRI, had a very positive meeting with my potential surgeon (Dr. Reardon) and then a not so positive meeting with my oncologist (Dr. Ravi). On top of that, it snowed here (very rare) and the play we had second row seats to tonight got cancelled...because of like 2 inches of snow. Being from Syracuse, we obviously got a good laugh out of that. At least they refunded our money!

The meeting with the surgeon was very positive. We talked a lot about the surgery, his experience with Cardiac Angiosarcoma, the risks, the recovery, etc. We left his office with the understanding that if MD Anderson (and Dr. Ravi) felt strongly that surgery was the right thing to do, that I would be back here in 2-4 weeks for surgery. Dr. Reardon talked about the risks of this surgery, and explained that many of his colleagues would be against this operation because of those risks (and the fact that my disease is metastatic, which makes me a lost cause according to textbooks), but said that he's willing to be agressive and do it if there is a chance that it means I can live longer than I would without it. We left his office feeling VERY confident that this surgery was going to happen. The only hurdle, from his perspective, is him convincing the "tumor review board" at Methodist Hospital (in Houston) to approve it, which he said shouldn't be an issue if MD Anderson (the oncologists) was strongly behind it.

Then we met with Dr. Ravi. Good news first, all my scans were clean - the cancer spots we know about are "stable" and nothing new has shown up. But then he told us he has concerns about the surgery and is not sure if we should go to surgery or continue to treat me with chemotherapy. I trust him very much, which is why his doubts are so concerning to me. He relayed a VERY stong message to us today, and that's that this surgery carries a tremendous amount of risk with it. He said that I've aced everything to this point, but didn't want me (and my family) to let the success so far cloud the fact that this surgery could cause things to go very bad for me very quickly. The real question is whether or not we want to persue a curative approach (using the word "cure" very loosley). My only chance of being cured is surgery, and there is a very low probability (statistically) that they are able to cure me, and that approach comes with a lot of risk (high-risk, high-reward). Continuing on chemotherapy should buy me time (how much nobody can predict) but won't work forever and will not cure my disease (low-risk, low-reward). And the fact is, if I decide to have more chemo and at any point in that a new spot pops up, surgery is off the table. The only resaon they are considering it now is I've gone so long without any new spots, which is rare for a cancer this agressive.

I have had my heart set (no pun intended) on this surgery for 13 months and I have been very confident that it's the right thing for me. After our conversation today with Dr. Ravi, I am less certian and more scared than I've ever been, but as Dr. Ravi told us, it's his job to keep us grounded and not let us forget what we are dealing with. He is presenting my case to his peers on Tuesday night, at which point he will make a recomendation to me whether or not to have surgery. I worry that if his peers feel strongly that surgery is the wrong choice that I won't even have an option (exactly what happened at Dana Farber in June), so I am praying that they want to be as agressive as I do. I am willing to take the risk - I feel I have nothing to lose (but time) and I'd prefer to attack this cancer rather than sit around and wait for it to attack me.

I am expecting a call from him on Wednesday (12/9) to have the conversatoin that ends with me knowing definitivley what's next. I will be sure to post as soon as I hear!

Thanks to everyone for checking, emailing, texting, calling and all of your support. It means the world to me and keeps me going. Everytime I get down about this, there is another message (email, text, etc), phone call or card that picks me right back up and I really appreciate it.