Here’s the Scoop

Today we went to see Dr. Osnis about getting rid of the last of my cancer, my last tumor, using “cyber knife” radiation or microwave ablation. He explained both procedures and we discussed the pros and cons. I’ll try to summarize…

The cyber knife would start with an appointment to set the fiducials, 3-5  little gold pieces, into my liver to mark the location of the tumor so the cyber knife could do its job.  I would then need to wait a week to let them “settle” and let the inflammation calm down. At that point I would get a CT scan to make sure everything was set and then I would have about 5 days of cyber knife radiation at about 40 minutes each. The cyber knife controls  the radiation better than regular radiation (at least that is my understanding) so there are no skin burns, etc. I could drive myself to the appointment and drive myself home, there are no negative effects that day. I would feel fine for a couple weeks and then a pretty heavy fatigue sets in for about 4-6 weeks. So the upside to cyber knife is that it is fairly painless, the downside is that it takes at least 7 appointments, over at least 2-3 weeks, just to do the procedures and then there is the fatigue.

During the microwave ablation they would take a fat needle, insert it into the tumor and burn it with microwaves. This is a one shot deal, that is the big upside to this procedure. It will not drag on for weeks (given no complications, of course, anything can happen anytime, with either procedure, I am aware). The down side has to do with the location of my tumor. If it was in the middle of my liver I could just be sedated and they could go right in, but my tumor is very near the liver wall. Because of this location they will first try to expand the space between the tumor and the wall by injecting saline solution. This may or may not be effective (sometimes the saline just keeps rolling, as water does, to the lowest point), but either way, because of the location there will be more pain. He said it could be up to two weeks of me needing pain killers (there are worse things, right?).  

Both procedures have about the same positive outcome of 85-90% effective. With either procedure if they don’t get it all (it is tricky with tumors in the liver, it is easy for cells to creep along and spread) they can try the other treatment…so if the ablation is not 100%, they could go back in and do the cyber knife procedure and vice versa. 

Dr. Osnis would not give us an answer to the question what would you do. He said they were both good choices. Mike and I left the office and on the count of 3 we both said, “ablation.” We were able to sneak in to Dr. Vermeulen for a few minutes to bounce our thoughts off of her and she totally supported that decision. She also said she had talked to Dr. Kaplan and he was fine with either decision.

So…ablation it will be. I think even if I wasn’t trying to meet my back to work schedule I would pick ablation. I can handle pain ok (knock on wood) and would prefer fewer appointments. I know there will be follow up appointments for either procedure. I’ll be going to extra doctor appointments for a very long time, I am aware of this. All the more reason to condense this part of the treatment.

They are currently seeking approval from the insurance company, then we’ll get the procedure scheduled and get on with it!

That’s the latest scoop! I’ll keep you up to date as I know more!

love and more love to you all…

janet

P.S. A reminder to keep August 21 as a possible save the date…but now, so much depends on scheduling the ablation…