Ox Fall Down

When Step has questions I'm not being clear. Surgery/Dr. Yoon offers a change in strategy. All treatment in the past four years (chemo and radiation) was aimed at eradicating this tumor. Slowly. Neither methods worked fully. They did offer "wonderful disease control" as the reports from DFCI read. Disease control lately has meant keeping the same tumor in check. And clearly both are responsible for delivering the margin necessary to cut. Yoon's opinion is: Radiation and chemo haven't gotten rid of this tumor and they've had four years to work. I can cut this out of you now. And you'll likely get a few years off before the next tumor comes back.

Great. That's the reward. What's the risk?

As vaguely discussed the surgery might require a vascular bypass graft. That graft might not hold. Emergency surgery could ensue. All surgery is risky. You're open for hours. Infection. Anesthesia is dicey.

But, in the grand tradition of e-mail Dr. Yoon has written in with the definitive assessment:

"(S)urgical resection would be aggressive but not unreasonable."

Ok....that answers all of my questions. I imagine Officer Barbrady ushering off the onlookers...ok, you looky-looks, nothing to see here...

But, after some follow-up e-mails and phone calls aggressive-but-not-unreasonable seems accurate. Plus, three years ago surgeons in Boston, NY, London and Paris declined this surgery on this tumor. Maybe aggressive-but-not-unreasonable is half-full.

To that end I meet with Cambria on Monday. Special angiogram afterwards "to better assess the blood vessels in that region. This would determine if you would need a vascular bypass graft or not."

Great. Memorial and Dr. Brennan afterwards for the second opinion. Sleep well.