Tuesday, November 26, 2013

The Process of Cancer Treament: Part VIII –follow-up with the surgeon

Nov. 25th, 2013

8:45 a.m. Left home. After driving towards the city to the hospital, 45 minutes into the trip, I knew we'd be early for the appointment. You never can tell! Rather than barrel into town, we stopped at a Rideau Canal lock. There were quite a few geese on the edge of the frozen river. A nice, albeit cold, walk to the river. It was bracing and a nice time for relaxing.

10:17 a.m. Arrival. We found a parking spot on the top floor of the parking garage. I took the wrong entrance, and realized I was hooped. The parking garage, under the shelter, was very full. We ended up on the 5th floor.
5th floor parking
Entering the elevator, we shared a laugh with a mom and daughter. It's amazing how being at the hospital allows one to embrace our humanity, treat one another with respect, not as total city strangers.

We'd forgotten where the Cancer Assessment office was in the bowels of the hospital. Digging out our files, and finding our info, we realized we had to go to the 7th floor. Rather than struggling, I found the main entrance to the Cancer Clinic, and spotted three volunteers who were happy to help us find the danged elevator! We wanted wing F, but were in the building with A, B, C, and D.

10:30 a.m. We made it to the correct office, checked in, and got the paperwork. There is a form, which is a self-assessment of pain and other symptoms. Hubby had a snack, and we grabbed some water from the cooler. The waiting room is nicely set up. They feature artwork by those who are managing cancer.

11:00 a.m. Our appointment was for 11:00, and we were ushered in, right on time, by the nurse. She collected our self-assessment form, and said that the doctor would be in when he finished with his previous patient. We could hear him talking to the other man.

Here are a few parking lot photos, 'you have a few minutes to wait until the doctor comes', explained the nurse. It is difficult to imagine how many people are being seen in the hospital right now, never mind the staff required to run the place.

We sat. Talked. Reviewed our paperwork. Planned. Chatted. Looked out the window. Reviewed questions for the surgeon. Time passed. We popped out to powder our noses. More time passed. Hubby began reading The Economist to me.
long halls, much signage

11:52 a.m.  In marches our surgeon. He took his time with the guy next door. We could hear him. He took his time with us, as well.
His first comments, based on the three tests (Bone ScanMRICT Scan), said that the tests were very, very good, since there are no signs of distant cancer cells. The cancer cells have not metastasized, spread to the bones or other organs. It has spread to the surrounding tissue, fat cells.

He explained our options; the best treatment, based on tests, seems to be surgery, although that is only a 50 - 60% chance of eradicating the cancer cells. We were assured that the cancer cells are highly resectable, despite breakthrough into the surrounding tissue. It may require a multi-modal approach, but surgery is better for local control.

It all depends upon the actual test results of the biopsy of the cells the surgeon removes. The tests can only generally give us an idea of the spread of cancer cells. And who knows what will happen between now and the surgery date.

I took copious notes!
It will take 3 - 4 months after surgery, based on the pathology of the removed cancer cells, to determine if radiation is called for, and it could be lifelong hormone therapy or surgical castration, thereafter. Hormone therapy is most efficacious, as testosterone stops the cancer cells from spreading for about 10 years. If the lymph nodes are negative, he may not need hormone therapy.
Radiation would mean 20 treatments, if this is called for later. Median survival rates work out to 77 months, based on recent research.
Surgery will likely be around the 2nd or 3rd week of January, as he is high priority, with a fast-growing cancer (8/10).

There is a training session done by the staff, another 75 minutes trip into the city, before surgery, to explain post-surgery care. Our nurse explained some more, she gave us more reading and pertinent phone numbers.

Louring sky
12:15 p.m. We needed to go to X-ray, for a chest X-ray before to the surgery. That, magically, took 15 minutes.

12:45 p.m. Made it back to the car. Hooray for signage. Parking cost us $13 for the day. Save those receipts! This is tax deductible. I was anxious to get out of the city, and nearer to home, before we stopped for lunch.

2:00 p.m. A nice lunch at the pub. Hubby reviewed what he'd remember from the surgeon's conversation. Then home to happy cats.
Parking lot mysteries


Bison burger and salad!
lots of sheltered parking

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