Well, today’s appointment with Dr. Sarmiento did not quite go the way MaryBeth and I would have preferred. According to the CT scan, there was no appreciable change in the size of the tumor or any of the other things assessed by the CT (meaning that there is STILL no evidence of metastasis nor is there evidence that the cancer cells have invaded the lymphatic system). While the latter of these is good, we were very much hoping the size of the tumor would have decreased and, in particular, lead to a disentanglement of the tumor with the portal vein and the mesenteric arteries. Unfortunately, the portal vein is still surrounded (about 180 degrees) by the tumor and, in the words of Dr. Sarmiento, the tumor is “kissing” up against the arteries.
After all is said and done, though, Dr. Sarmiento believes it makes sense, given my age, to go ahead with the surgery, because it is the best bet I have for beating this cancer. To refresh your memories, Dr. Sarmiento will perform a ‘Whipple Procedure.” During this procedure, the surgeon will remove: (a) the head of my pancreas; (b) my bile duct (no more ERCPs — YEAH); (c) about 18 inches of small intestine (including the duodenum); and (d) about 40% of my stomach. I should be in the hospital for 7-10 days (though, it could be longer) and then at home on bed rest for another 2-3 weeks.
My preference right now is to have the surgery here, as it would be incredibly inconvenient to have it up in Baltimore; however, I am going into my meeting with Dr. Cameron with an open mind and will wait to hear what he says.
I’d be lying if I said I was not stressed about the results today. I really (REALLY) would have liked the doctor to have said, “Your tumor is MUCH smaller and surgery will be a breeze.” Instead, he talked about the increased risk associated with the fact that the tumor is still all mixed up with blood vessels in my abdomen.
One potentially positive note is that the CT was unable to determine which tumor tissue was dead (from the chemo and radiation) and which tissue was still alive. Dead tissue is MUCH easier to resect than live tissue, so perhaps tissue around the veins and arteries will be dead!
I’m on the road tomorrow to Baltimore. My older brother, Isaac, is taking tomorrow off to hang with MB, my Mom, and I in Baltimore and then Diney is coming down to have dinner with us and then go with me, Mom, and MB to the doctor’s on Wednesday. I am very lucky to have such a supportive family.