Topic: Had appt w/ Surgeon Today in Prep for SBRT
I was at Memorial Sloan all day today. Met with the surgeon and then had surgical pre-testing done. An exhausting day!!! Here's what's happening...
The radiation oncologist wants to have a "spacer" put in between my stomach and liver to prevent the SBRT from hitting my stomach and other clean organs. I met with the surgeon today - Dr. Sam Yoon at Memorial Sloan. He actually invented this procedure when he was at Mass General in Boston. He came to Memorial Sloan last year. The procedure involves putting this "spacer" - which is made from cadavers (ugh!) - in between my stomach and liver - it will also protect my bowel. This is a relatively new procedure and has only been done on about 30 people - with good results in protecting the clean organs. The "spacers" will stay in me even after I'm done with SBRT.
The radiation oncologist also wanted the surgeon to put gold seeds in the tumor at the same time (this would further help with hitting the tumor directly with the SBRT). But the surgeon told me today he doesn't think he'll be able to get the seeds to do that. He said he is capable of putting the gold seeds in but the interventional radiology area do not like the gold seeds leaving their area. They like to put them in themselves in their area. Supposedly, these seeds are very expensive and if they're inserted in the operating room then interventional radiology does not get reimbursed for them. The surgeon said it's a lot of red tape - he didn't seem to be happy about it but doesn't seem to know any way around the bureaucracy. So I will probably have to have a procedure to have the gold seeds put in after my surgery for the "spacer".
Anyway, I'm having the "spacer" put in on Monday, 3/25 and will have to stay in the hospital for a day or two. The hope is to do it laproscopically but sometimes that's not possible if there is a lot of adhesions (which I have) from other tumors that have been radiated. So it's possible he may have to make a larger cut to put the "spacer" in and then I may have to stay in the hospital a little longer.
I'm hoping this will help. I'm doing pretty good right now with very little pain but I'm afraid something will happen with the surgery (like infection) and I'll be made worse.
The surgeon said that he's seen the SBRT work with good results but their is a high significance of tumors showing up in other areas. Didn't sound very optimistic but I'm trying to stay positive.
Background for those who aren't familiar with my situation - I was diagnosed with adenocarcinoma - unknown primary in 8/2011. Had 12 cycles of chemo - 5-FU, oxaliplatin and leucovorin from 10/2011 through 10/2012. In between that I had 28 radiation treatments in Jan & Feb 2012 (no chemo while I was getting the radiation). In 10/2012, my scan showed that the chemo wasn't helping any so they switched me to gemcitabine. Started gemcitabine in 11/2012 and was scheduled to have it 3 straight weeks then off a week then back on again for 3 cycles. Unfortunately, I was never able to get 3 straight weeks in because my counts would go so low. They tried lowering the dose but my counts still plummeted. Also, the tumor wasn't shrinking so this was stopped the end of January this year. This is when they decided to try a different kind of radiation. Since I already had traditional radiation, I wasn't a candidate for that because this tumor is too close to the tumor they radiation last year - so it would be too much overlap of the same area. So now I'm hoping to start the SBRT soon after my surgery next week and hoping it will be successful!!!
Sorry for rambling but I think it helped me to put it all in perspective.