Posted by: cg00n | June 17, 2008

Decisions, decisions

In the previous posting (An Interesting Case) I described how I was happy that the general surgeon had a handle on how to determine which lymph nodes (if any) to excise next by looking at an MRI scan. I ran this by a pathologist friend of mine asking if she agreed, and she said:

Sorta. In the sense that, if I knew that to be true, I’d vote for it. There is another school of thought that says our tumours spread all over the body before we are really aware of them, the seedlings may or may not catch hold, and that it isn’t really all that sequential. The sentinel node data, on the third hand, suggest that in most but not all cases, the linear sequence holds.

She went on to explain why I might want to leave the lymph nodes alone to let them do their job, sopping up the drainage from the foot surgery. All this money over all these years spent on cancer research and they don’t even know how it spreads?! I am so disappointed. During my appointment with the plastic surgeon (remember him? he was the one who reconstructed my foot) I commented on the difficulty of making any kind of sensible decision when the data is so unreliable. He agreed and added that any progress over the next few years is likely to be incremental rather than revolutionary. Probably I will stick to my decision to have faith in the general surgeon and her interpretation of the MRI scan, but this whole process is beginning to feel more like religion than science.

Today’s appointment did yield positive results however:  the plastic surgeon seems very happy with the way everything is healing.  His nurse cut away some scab material finally revealing that there is a small part of the “patch” that still has some way to go but overall things look good.  I asked about putting weight on the foot and riding my bike and he said “go ahead”, so I will.  Pretty soon I should be able to lose the crutches which will be a major step towards feeling back to normal.

Next Thursday I get to have a bone scan, an ultrasound, and my orbits (eyeballs) X-rayed to make sure there are no bits of metal in them, which would be a Bad Thing during an MRI.  All good fun.

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Responses

  1. I googled cancer and metaphysics … and look what I found. Perhaps the Australians who developed some outside the box approaches may have read this 🙂

    http://www.what-is-cancer.com/papers/cancerandmetaphysics200.html

  2. I don’t even want to ask why there would be a possibility of metal in your eyeballs!!

    Meanwhile I heard that there would be a piece on CBC Radio this Friday evening, on White Coat Black Art, about positive thinking and cancer. From the web site it appears as if the program will be discussing a couple of other issues, too.
    http://www.cbc.ca/whitecoat/2008/02/lets_go_positive_on_this_weeks.html

  3. Very interesting small article in today’s newspaper, about a case where a man’s advanced melanoma was essentially cured with a transplant of his own stem cells. I’m sure it’s more complex than that, but the article said the melanoma had spread to his lymph nodes, and now there is no sign of it.


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