The cancer journey is never easy. There are always questions of whether you should do this or do that. At the very beginning of the journey that begins with the diagnosis of cancer, the first question that arises is – do I really need surgery? What if the tumor that they found isn’t cancerous? Tom Marsilje's article, "Stage IV Life: Taking charge when medical teams disagree," brought back some of my initial thoughts when I was first diagnosed for cancer. www.philly.com/philly/blogs/diagnosis-cancer/Stage-IV-Life-Taking-charge-when-medical-teams-disagree.html In my case, a tumor was found during a colonoscopy. The colonoscopy was performed because there were symptoms that indicated something wasn’t quite right – in my case, a dangerously low red cell count. The surgeon assigned to my case didn’t want to do a biopsy; rather, she wanted to do a resection and remove that part of my colon where the tumor was located. She didn’t want to do chemo or radiation to shrink it. She wanted to remove the tumor and only after surgery would it be biopsied determine if she was right. But first a choice had to be made and it was my choice. However it wasn’t a straightforward choice. Because my surgeon then said: “You know, Robert, you can get a second opinion.” I looked at the drawing she did depicting the area to be resected. If her medical assumption was wrong, then a portion of my body would be removed based on a guess. I could get a second opinion that would perhaps recommend against surgery. But would a second opinion merely be an exercise to, hopefully, hear what I wanted to hear and that I didn’t need surgery? I looked at my wife and asked her: “What do you think?” And she said: “It’s your decision.” Drawing by my colon surgeon, Dr. Genevieve Melton-Meaux. When she drew this, she laughed and said she wasn't an artist. But she made her point. The area below the X is my cecum, and the tip is my appendix. Three polyps are shown - one on the left and two on the right. One of the polyps on the right is the tumor; the sketchy lines are lymph nodes, and the triangular object is my liver. Of course, getting a second opinion would mean finding another health provider to assess my situation, all of which would mean expending more time – and time was critical, especially if my surgeon was correct. And, of course, there was the matter that a second opinion would verify the first opinion. In other words, a loss of time when time was of the essence.
With that thought, I didn’t hesitate to sign the permission/release forms to move ahead with surgery. The point I’m trying to make is second opinions are an option that should be considered. In my case, the thought of a second opinion didn’t enter my mind until my surgeon suggested it. And therein lies a potential problem. Some doctors don’t suggest second opinions. They want to forge ahead with surgery. And sometimes surgery isn’t necessary. What they think may be a cancerous tumor or lesion may not be cancer all. Or other methods can be used – chemo or radiation. Most importantly, second opinions are valid should one’s cancer progress. Tom Marsilje’s Stage IV cancer is an example of that. When it comes to second opinions, take Marsilje’s excellent analogy to heart: “A good analogy I have heard is that as a cancer patient, you are the general manager and head coach of your care. As general manager you hire your players (medical teams) and draw advice from all of them. After all of that (sometimes opposing) advice is given – you as head coach (and patient) need to be the one to make the final decisions based upon what is most important to you.”
2 Comments
7/18/2016 10:32:10 pm
Miigwech. Thank you for sharing. Your blog is interesting and informative. Your epidemiology from the last installment was helpful, too! I'm guessing you have additional information from a cancer antigens count? Early symptoms are less likely when the tumor is on the right side of the colon say the text books. Your surgeon hopes to disrupt the tissue as little as possible so no biopsy until the surgery? The diagram would suggest removal of that segment rather than a resection? Prayers for you and your caregiver. Please tell her I am praying for her, too.
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Robert DesJarlait
7/19/2016 12:57:29 pm
My understanding is that resection is defined as the partial or full removal of an organ. In my case, the section of my colon called the cecum was removed.
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Robert Desjarlait
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