So Many Decisions

Tuesday August 8, 2017
We had an appointment scheduled for this afternoon to discuss the radiation portion of Dan's treatment plan.  Since Dr Pickron is recommending surgery only, Dan called Dr. Fisher (radiation oncologist) to ask if he should come to the appointment.  Dr Fisher said he would really like to see us so we can talk about all of our options and know all of the information.
Dr Fisher, like Megan Grunander, is incredibly kind and caring.  He gave us a ton of information today about the MRI.  He explained to us that if the tumor really is a T2 then surgery is definitely the right plan of action.  However, there is a 30% chance that the tumor will be upstaged to a T3 at the time of surgery.  In that case, we would definitely wish we had done chemo/radiation path.  The MRI is the best way to stage the cancer, but it isn't 100% accurate.  The only sure way to know is to do the surgery.  Dr Fisher also informed us that Dr Pickron (who is the surgeon that will operate on Dan) has notes written all over the MRI that he feels there is a fairly good chance the tumor is will end up being a T3 after surgery.
I feel like my head is going to explode!  So much up and down.  One minute we are crying out of fear and the next we are crying our of joy for the miracles we're experiencing... right now we are so completely and utterly confused.  We have no idea what path we should take.  Dr. Grunander called Dan personally.  She expressed her deep concern about his well being and said she truly wants what is best for him.  She said if it were her husband she would definitely want him to do the chemo/radiation plan before surgery. She said it is not worth the risk that the tumor could really be a T3.
Everyone agrees that T2 = surgery and T3 = chemo/radiation.  The debate is over whether or not we trust the MRI results.  I'm usually okay with taking reasonable risks.  But not with Dan's life! I feel like the safer way is to do the chemo/radiation plan.  I know it is much longer and harder but it's the safer way to go.  There is a 97% cure rate if we go with the chemo/radiation plan.  If Dan has surgery and the tumor is upstaged to T3 his survival rate drops to 75-85%... which is still pretty good but when we're talking about his life its a HUGE difference.
Dan's mom feels strongly that we have been given a miracle and we need to trust the Lord going forward.  She feels we should do surgery as soon as possible.  The tumor size appears much smaller on the MRI - it is now estimated it to be 3 cm.  The original size was measured at 10 cm.  This is an absolute miracle!  Because the tumor hasn't metastasized into the liver or lymph nodes and it's a T2 tumor, it is being categorized as Stage 1 cancer.
Dan has a friend from medical school who became a colorectal surgeon, Mike Pendola. He talked to Mike and he told Dan the MRI reading is so so important! Mike wants to look at the MRI himself...Dan is going to Fed Ex the MRI images to him tomorrow morning. He said if it truly is T2, then we can feel very confident going forward with surgery.  But if there is any question at all, we should definitely do the chemo/radiation first.  So much is riding on the MRI.  And a resident read the MRI at Huntmsan! :) In all fairness, a physician signed off on it.  But, oh so much is riding on the correct interpretation of the MRI.
Dan also talked to Matt Peterson who is our infertility doctor and the U of U and our friend.  He is one who originally got Dan an appointment with Dr. Pickron at Hunstman.  We told him all of this information... he is also going to make some calls and get another radiologist to over-read the MRI.  So we will have two other opinions about the reliability of the MRI in staging the tumor as T2. If they agree with the current recommendation, Dan will have surgery on August 22.  In the meantime, Dan still has surgery scheduled for next Monday to have a portacath placed for chemo infusions.