Left up to me...

The dilemma: So, I've been done with chemo for over a month now. I had my follow-up visit a couple weeks ago with my doctor (who had been on maternity leave) where I was hoping to get more answers and direction on my continued care. When she told me my CA-125 had gone down to 28.5 (last time it was 47) I shouted "hurray". My number had dropped 20 points in a month! That seemed pretty good to me considering my numbers had been flirting back and forth in the 40s the last few times. She burst my bubble when she responded that it still isn't good enough. Unfortunately, the fact that it has not gone down to normal is still baffling. She indicated it should be in the 10s or lower following chemo. 

Knowing this, she presented me with a couple options- either we keep me under observation checking my blood monthly or we go in for a "second look" laproscopic surgery. In bringing up the surgery, she said that statistically, a second look doesn't improve prognosis. This used to be the standard practice following chemo but since it didn't improve outcomes, it was discontinued. I asked her if she would recommend it for me. She said it was up to me. I asked her if she believed the elevated level could be due to endometriosis as her colleagues had suggested. She said it's hard to know but it's possible. My doctor also mentioned that we never had a baseline for me before the surgeries and chemo so perhaps this is or approaching normal for me. 

Back to the surgery option I asked what she would advise me to do. Again she said it was up to me but, she said, with me being so young, she would do everything she possibly could to make sure the cancer was gone. So I thought that was my answer. She asked which option I was leaning toward. I said the surgery. Then she said she had to warn me that, with the previous surgeries I had had and having just finished chemo, my body might have more scar tissue around my abdomen. This becomes a problem if there is too much and she can't get the scope in turning my simple laproscopic surgery into a full vertical incision major abdominal surgery. That would bring the unwelcome consequences of a 6 week recovery, not being able to lift my daughter again for that time, increased risk for infection, etc. That threw me for a loop. I asked if she thought I really would have a lot of scarring and again she couldn't say until she was in there.  We left it for me to decide and let her know if I want to do the surgery. 

The thought process: So I left and called Ammon to discuss. We came to the decision to proceed with the laproscopic surgery but if it would need to switch to the full incision then to stop. That seemed ok. 

Then in speaking with my parents, my dad asked a good question of what the harm would be in waiting another month. Could a new tumor really grow that fast. I remembered back to that same issue when I was to have my surgery after my tumor was removed. It was very difficult to get on my doctors surgery schedule and she told me if we needed to wait 3-4 weeks to get me in, that my cancer was not going to grow in that time. She said it was fast growing cancer but not that fast growing. 

 

Another thing to consider is if I have surgery and residual cancer is found, I'd need to wait 3 weeks to recover before starting chemo or whatever treatment that would follow, plus however much time it would take to get in to even have the surgery. But if I waited and my counts go up then I'd be out 4 weeks from my last doctor's visit before starting treatment, if it was needed. For either choice, the time frame would be about the same.

The decision: Considering that I had a negative CT scan, a significant decrease in my CA-125, the other factors spelled out above and after praying about it, I feel the risk is too great to do the surgery now. I made that choice and then had a conversation with someone else whose husband has cancer that helped confirm it. She communicated to me that it took awhile for his number to come down too. Granted he had a different type of cancer but it seems right to think it might take awhile for all of that chemo to work through the cells of the body until they show in the blood work that they're healthy again. So, I've decided to wait on surgery...at least until the next time my blood is drawn. If it's still not low enough, then I'll probably go through this same thought process again...