January 5, 2021

I am near the hospital – stopped for some coffee. My pre-op appointment for the stent surgery is in an hour.

I have a little more clarity this morning. Here’s the situation:

My tumor is in my pelvis. There is also a cyst (almost as large as the tumor and sits next to the tumor) which may be cancerous. Each started out at about 7.5 x 6.5 cm. They are now 3×4 and 3×3 cm. If I have surgery, both would be removed. They are both irregular in shape and have invaded the pelvic area (left side). Therefore, if I have surgery, I have been told that my ovaries and uterus would need to be removed and it is possible that my bladder would have to be removed if the tumor is touching it.

My bladder is 100% healthy. I am opposed to my bladder being removed. I cannot be completely disemboweled. I need to have quality of life. Can they sew me back up once the procedure has begun if the bladder is involved?

I would like to save my ovaries because they produce hormones. Can they save one or both? I don’t know. I expect to lose my uterus because the tumor is contiguous with it and, apparently, my uterus is enlarged so something is going on. Does the cervix come out too?

What about my ureter? The last scan says it is “encased” by the tumor? What happens if the tumor is wrapped around the ureter rather than just pushing against it? Does that implicate my bladder and kidney both of which are healthy?

What happens if the tumor is still attached to my peritoneum?

How many hours does a surgery like this take?

How long will the recovery be? What are the risks – potential problems re surgery, recovery, complications, additional surgeries, permanent medical problems, etc.?

I cannot evaluate the situation until I speak with the surgeon and understand the surgery.

That’s the pelvis.

I have two lesions in my liver and they are located in an area that cannot be surgically removed. They have shrunk in size by 70+% but they are still there and could grow again if I have surgery because I will be off chemo during my recovery.

I have two lesions in my lungs that have shrunk by 50+% and are now very small. I have additional lesions (5-6 or so) that have shrunk and are tiny now – would not even cause a radiologist to make note unless he/she knew the history – and it is unknown whether or to what extent they are cancerous. They cannot be removed given their tiny size and scattered location. If cancerous, any of them could grow again if I go off chemo due to surgery.

Typically, they would want to remove all the cancer (pelvis, liver, lungs) during the surgery but, in my case, they cannot. In other words, the surgery itself will not cure the cancer (because some cancer will be left behind) and it is a big surgery. Therefore, they are not sure whether having the surgery makes sense. For that reason, the tumor team will review my case two weeks from yesterday.

If I have surgery, it is unlikely that the cancer will grow back in my pelvis; it is possible that the cancer will grow elsewhere (lungs, liver, other); and there is a remote chance that I can ultimately be cured of cancer (i.e. if chemo kills the remaining cancer).

I would have access to the full range of chemo drugs post-surgery because my tumor is not yet resistant to them.

So that’s the scoop.

Just had my pre-op for the stent surgery. Went well. It seems that maybe I did gain a little weight – not sure because I had eaten a small breakfast. Now I have an hour and a half until chemo.

Oh, I tried the pimientos – they were fine – I liked them – but I prefer buying grape tomatoes and roasting them in a little olive oil. Sweet and delicious. I scatter them on top of chicken – very good. I haven’t tried the pimientos with the lentils but don’t think that will change my mind.

I’m in oncology now waiting to be called for chemo. I want to go home and climb into bed. I’m tired and I want my Sweet Pea.

Love, Molly

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