What my CT scan showed

Many of you have been anxiously awaiting the results of the CT scan that I had this past Friday.  Obviously by the time of this post, the results showed that my lymph nodes didn’t shrink enough to avoid surgery.  My largest node pre-chemo was 2.5cm (not outrageously enlarged, anything above 1cm is on “the list”), and post-chemo it’s 2.1cm.  The Dr’s suspected that this would be the case, as the most likely type of cancer that I have (teratoma) does respond to chemotherapy, but typically requires surgery to remove the dead leftovers.  I know, that’s a little confusing.

Let’s allow a skunk be our metaphorical link to understanding.  Suppose a skunk rudely traps  himself underneath your house, and continuously blasts your dwelling with his nasty-cloud.  After he refuses your lovely invitation to leave, you launch poison grenades at him for a week straight hoping it will kill him, leaving you a light snack.  Well, the grenades work, but they only stop him from spraying your quaint residence.  That’s awesome!  But… he’s still in there, doing who knows what.  He could actually be dead, and he’d either fade away into the dust of the earth, or begin to rot and fester.  Or he may be slowly reloading, waiting for Thanksgiving dinner to bring out the big guns.  Just to be on the safe side, you use your chainsaw to tear open your living room floor, and you get rid of that jerk.

We’re removing the jerk that is cancer.  That’s the first analogy that came to mind, feel free to enjoy it.

That may sound like all bad news, but we didn’t find any new skunks… err, places where the cancer had spread.  It was pretty unlikely that it would have spread during chemo, but I’ve been riding the “unlikely train” for a few years now with cancer.  My lungs, spine, bones, and brain all look as wonderful as they ever have.

Why surgery is the next step

For complicated reasons, the lymph nodes behind my intestines are the first place where cancer spreads beyond the testicle.  Once there, Mr. Cancer has a lot more options for places to go, as he can travel by land or by sea (body fluid or tissue).  So to allow the him the opportunity to spread more is not good.  The RPLND surgery has been apart of the testicular cancer cure process for a long time.  It was on the table originally as an option during my first round of cancer.  But at the stage I was at, surveillance was the better option.

After this surgery, I have a 3-5% chance of relapse during the first 3 years.  After that the number drops quiet a bit, but I’ll still be having my blood tested and getting scans for the rest of my life.

What the surgery looks like

I’m scheduled to have the surgery in ONE WEEK.  Our appointment today was quickly followed with several rush pre-surgery appointments, which made things really hard for the kiddos.  We came back to our hotel and had lunch around 2:30pm, and miraculously we all took a much needed nap.  We go back in tomorrow morning for the final pre-chemo appointments in Seattle.

It’s best to do the surgery right after my body has recovered from chemotherapy.  They estimate that I’ll be in the hospital for at least 7 days, with the first in the ICU.  I’ll be off of solid food for 3-4 days following the surgery, as my intestines will need time to unscramble themselves.  The surgery is quiet intense, as there are a LOT of lymph nodes in the retroperitoneal zone.  Plus, my swollen lymph nodes are on my right and left side, which is unusual as I only had cancer on my left side.  I believe they’ll remove 50+ lymph nodes.

Below is a short (1-2 minute) video that overviews the surgery.  It isn’t over-the-top-brutal, but you may not want to watching while eating breakfast… it will give you a much better understanding of the surgery than I can describe.  The short explanation is:  They make an incision from my ribs to my waist, and go skunk-hunting.

What’s next and how are we doing

So after recovering from surgery (2-4 weeks total), I’ll likely enter back into surveillance mode, with blood work and scans every 2 months for the first year with decreasing frequency each year after that.  There’s a small small small chance that I’d need more chemotherapy (if they found active cancer cells in my lymph nodes, IE the skunk was fooling us all, and blasted us with skunk juice when we went to get him).

We are very much looking forward to being done with this.  It’s been a long few months.  We’re tired.  We don’t like cancer.  It causes to much anxiety, it’s ridiculously expensive, and it’s messing up our lives.  That being said, we’ve been blessed by our supportive church, family, friends, and strangers.  My wife is beyond a doubt my favorite person, seriously, she’s incredible.  We’ve had great care the whole time, and are in the hands of the top Dr’s in the nation for this surgery.  In rains on the just and the unjust, God is still God, God is still good, and cancer still sucks.

Speaking of tired, I’m going to bed without proof-reading this much, or confirming that it makes any sense.  :D