Oncology 19.0

I have been holding off on updating people on my latest CT scan as there has been a plan brewing about what to do with it. I had the scan about 4 weeks ago, and it showed that the liver lesion has increased from 2 to 2.5cm in the intervening 3 months. The retroperitoneal and mesenteric nodes remain stable, and there is the possibility of a new lesion in the right apex of my lung, this one is very slow growing, and hard to interpret, so it also could easily be non-malignant.

This result is consistent with the slow rise in my CEA, a tumour marker used to monitor activity of cancer. Putting this all together it basically means that my liver lesion is no longer responding to chemotherapy, whilst the remaining lymph node lesions appear to continue to fit the criteria of stable disease.

Over the past few weeks, there has been planning afoot as to how we will address this solitary liver lesion. It looks as though the best way forward is radio-frequency ablation of the area affected. This can be achieved by one of two ways. It can be done percutaneously, where they access the lesion via a small incision in the abdominal wall, or it can be done via laparoscopy (key hole surgery). I had an ultrasound last week to determine how accessible the lesion was percutaneously, and it found that laparoscopic will be the best way to go. The lesion wasn’t able to be easily identified via USS, it was also not well circumscribed, both of which are criteria for safe, effective percutaneous ablation. Another confounding factor is that it is located in segment 7/8 of the liver, which are posterior and up against the diaphragm. Percutaneous intervention would mean risk of frying a hole into the diaphragm as well. So the best way to access this lesion is going to be keyhole surgery.

I dont have a date yet for the surgery, but it is likely to be sometime in the next couple of weeks. It will mean a skipped round of chemotherapy (for which I am more than happy about), and a few days to maybe a week off work.

All things going well, it means the liver lesion is eliminated from the equation, and I continue on with chemotherapy which at this stage seems to have kept the rest of the disease in check.

Of course all of this happens in the context of our recent news that Hannah is pregnant. It has served to remind me just how fragile life is (both the new and the older), and how I need to maximise the time that I have. I now have a new survival target which is to be around for the birth of our child in January. Subsequent to that, I want to be around for as long as possible to be a father to this child. I realise that this time is likely to be limited, so I will count every second of it as a blessing. In the interim, I will keep trying to stay alive if not for myself, then for the sake of my future son or daughter.

Until next time….