Thursday, July 17, 2014

Drumroll, please...

On June 30th, I wrote a post referencing that, in addition to the removal of Omar the Tu-Mar, Dr. G had sighted and pulled Thing 1 and Thing 2 out during surgery.

My original post-up visit was on July 1st with Ms. D (Dr. G's surgical assistant, whom I love). She walked in, gave me a big hug, then chatted me up while she took out my seemingly excessive amount of staples... and then she ushered in Dr. H in to share the path report and give me a status report on The Plan for Laurie's Life. Now, Ms. D wasn't in my surgery this time (and H never is), so there were some details I could only get from Dr. G. Thus, the delay in giving the "full" report until I could get in and meet with him this week.

Below, I give you... Wolverette, re-purposed to show the location of all friends (aka: foes) removed from my being on June 19th, and verbiage straight from the path report.

First, we have Omar the Tu-Mar:

Omar, as expected, tested positive for "well-differentiated liposarcoma, sclerosing type, consistent with recurrence, with extension to the resection margin"

No big surprise there. We knew what Omar was before Dr. G went in.

Now, we have Omar + Thing 1:

Thing 1, I am sorry to say, was a tumor that had adhered to the inside of my skin/abdominal wall. The path report states Thing 1 is a "well-differentiated liposarcoma with involvement of the biopsy margins".

Moving on to a representation of Omar + Thing 1 + Thing 2:

Thing 2, halle-freakin-lujah, was nothing more than an "infarcted epiploica". Which is, basically, free-floating fat. (If you want to gag, look it up online. I'd tie a link but I don't want to force anyone to get pukey here.)

*The size of Thing 2, you asked? 11.3 x 3.4 x 1.2 cm. That's roughly the size of a Twix bar, kids. SO GROSS. (And yeah, I totally just compared my giant, free-floating, chunk of fat to a candy bar. This is how my brain works. Don't judge.)

And then there's Omar + Thing 1 + Thing 2 + The Henries (aka: the hernia sac)

While there were multiple Henries, Dr. G sectioned the entire sac and sent it to the path lab as a whole.

The hernia sac, I am sorry to say, was chock full of sarcoma.

As per the path report, "Consistent with hernia sac, with focal involvement by well-differentiated liposarcoma"

If you'd like to read more about hernias/hernia repair (and/or find out exactly what a hernia sac is), click here.

Now... let's talk about what all this means.

In short, in means that Dr. G went in to fish out one tumor and found... more than he was expecting to. He pulled out two tumors, a chunk of fatty tissue that was most likely causing pain and discomfort all on its own, and a hernia sac that was also full of cancer.

And there were positive margins.

Which means... as much as G took - and he seriously dug in there -  he couldn't get it all, and there are cancer cells still living in my body.

In long (as in, the opposite of "in short"), it means, in Dr. G's own words, that I am "defective".

Heh heh heh...

"Focally defective", that is. There appears to be a mutation in my genes. (Judy and I have discussed this and feel that it's safe to say, based purely on the number of family members on that side that have fallen to the C word, that this is probably "from my mother's side of the family". Bless them.)

Also, I appear to have what is called Occult Carcinoma.

At first, I thought he'd said I had "a cult carcinoma", like unto Waco is happening inside my guts. But then I realized he meant "occult". 

Which, I'm not going to lie to you, made me laugh out loud. (Who'd have ever thought one could use the word "occult" in relation to the cancer?)

Upon further questioning, he corrected me, and explained that Occult Carcinoma is a real thing. (And the internet agrees.) 

Mostly, I take it to mean the same thing as the second definition of the word occult: beyond the range of ordinary knowledge or understanding; mysterious.

So, basically... I have defective genes that are multiplying into cancer cells in a mysterious manner, which makes me very hard to treat.

That said, the good doctors H and G have two different ideas for what they're going to do with me on a go-forward basis.

In my initial appointment with H, he advised that he and G had a three point Plan for Laurie's Life:

1) I am to heal, regain strength and get as healthy as I can in a relatively short period of time.
2) They will resume scanning me every 3 months, with the next scan to take place the first week of September.
3) Once they have a scan that shows clear pictures of where the cancer is, they'll target the tumors with chemo.

Dr. H's reasoning for moving to chemo is that I, in my current state, am inoperable. My body has been through four major surgeries in just less than four years, and they have taken their toll. The state of my abdominal strength (or lack thereof), combined with the knowledge that there were positive margins in multiple areas, says that chemo is my best bet.

Dr. G's version of the three point Plan for Laurie's Life is slightly different:

Step 1 remains the same.
Step 2 remains the same as well, with the exception of moving my next scan from September to October. (I am fine with this. That gives me another month to heal, and it gives the cancer another month to grow - which increases the likelihood of something showing up on that scan.)
Step 3 has a slight variation, in that, if the scan shows a localized recurrence (one, solitary, tumor - outside my current surgical line), he might go in and pull it out. Or he might watch it grow, and wait for two or more scan cycles so he can track growth and make sure I don't have more "occult" growths coming up.

At this point, we/I can't be certain what the treatment plan will be. We'll need at least one, if not more, scans to show the progression of the disease before they can take action.

My money? It's on chemo. Given how many places the cancer was when they opened me up last month, I have a hard time believing that I'll have a localized recurrence. Chemo is scary - not so much because of the side effects, which I know are horrible - but more because I've been told that sarcoma doesn't react well to chemo. I don't want to have a repeat of radiation, with 6 weeks or sheer and utter hell, with nothing to show for it, cure-wise. But what I know is that surgery hasn't stopped the progression. So, chemo is the next logical step.

For those of you who are reading this, esp any who may be hearing (okay, seeing) for the first time that they didn't get it all... let me assure you, I am fine.

My body may be falling apart. I may have defective genes, and something along the lines of a cult trying to take over the left side of my body. (I asked Dr. G if he could just swoop out the entire left side of me, from the ribcage to the spine... he said no. Dangit!) The cancer may be running rampant. But I assure you that I am fine.

This isn't what I wanted, but it is what I've got. So, I'll deal with it the best way I know how. Day by day. With the strength that comes of hope, faith, and knowing that I have the most incredible people in the world as my support system.


Genevra said...

I love you Laurie. And as always, I hate, hate, hate that you have to go through this. Thank you for sharing this update. Thank you for being you.

Melissa said...

Lots of love and healing to you, Miss Laurie!!