Post Surgery Update

Figured I should probably let everyone know how it all went. Sorry about the lack of communication. I confess I’m just a little over this cancer thing. I’m sick of being sick. And let’s not even get started on the slippery slope I feel like I am now on. I haven’t been in the greatest of headspaces lately. Anyway…

Surgery went ok. We were told the surgery would likely take up to 5 hours. It ended up being 8.5 hours. Apparently there was a huge amount of scar tissue from my previous surgeries to get through which complicated things. Luckily they did manage to do it as laparoscopic (keyhole) surgery. So, rather than another massive cut I ended up with 3 small incisions and one larger one - which was only cut larger to actually get the liver out. It was a complete hepatectomy - they took the whole right side of my liver out. The gallbladder was also in the way, so they took that out too. They’ve never done this before but this time they actually gave me photos of the surgery. Here’s the liver they took out.

The chunk of liver they cut out of me

The chunk of liver they cut out of me

Because the actual cut was so much smaller, recovery has been nothing like my 1st big surgery. It’s been a million times easier. I was in intensive care for a couple of days and then on the ward for four days - so home less than a week after the surgery.

Unfortunately nothing is ever straightforward. I was recovering really well at home. I’d come home with a drain - a pipe in my side draining fluid into a bag that I emptied regularly. That came out after a few more days. However it seems all is not as it should be inside. I started having fevers and experiencing sharp pains on my right side. I’m on antibiotics at the moment and I’m booked for a Cholangiogram tomorrow (basically a specialized CT scan). The theory is that there might be a ‘leak’ internally which has created a pool of fluid in my abdomen which has become infected. Worst case I’ll need to have another drain inserted - basically they give you some local anesthetic and poke a hole in your side to create a drain. I’ve had this done before. It’s not great, but it’s also not too terrible in the scheme of things - especially if it brings relief from the abdominal pain.

Pathology also came back. Turns out the tumour - initially sized at 2.5cm in the PET scan - was 4.8cm. It’s a little scary that a 5cm tumour can just appear within such a short space of time. You can see it clearly in this slice image from the pathology report.

I slice of liver used by the pathology team for testing

I slice of liver used by the pathology team for testing

I’ve also arranged - at a cost of $3500 to me personally - to get a much more comprehensive gene panel done on the tumour at the Peter MacCallum Cancer Centre in Melbourne. This is pretty standard practice in the US but doesn’t really happen in Australia much (for good reason, which I won’t go into here). It’s a total long shot that the results will inform alternative treatment decisions but I figure it’s worth it. For example there is a 3% chance that I might be able to use immunotherapy, which would be a game changer.

I see my oncologist on Wednesday this week to discuss whether or not we do another round of chemotherapy. I know there are opposing views within my medical team. I’m not sure what I think. On the one hand the thought of doing chemo again - with all the awful side effects - turns my stomach. It would also have a huge impact on my ability to get back to work, which I’ve been keen to do quickly. On the other hand, there is obviously cancer floating around my system still for this tumour to have formed. I don’t know how I feel about doing nothing about that if we elect to do no chemo at all.

And so the cancer show trucks on.

It’s been funny doing this all a second time round. People’s reactions - family, friends , colleagues, medical folks - are very different to the initial diagnosis and treatment phase. You try not to read too much into some of those reactions, but that can be hard. Anyway, that’s another story.

To chemo or not to chemo ?

Treatment plan update