May 23, 2011

Local mess, distant bliss

The Big Three confirmed again that my cancer appears to have not spread beyond the single tumour in my pelvis. Hip hip hooray.

The Big Three also showed that my tumour appears to have had its volume reduced by about 80%.

The surgery is a tricky one

And may require the removal of my right seminal vesical (likely) and bladder (unlikely). The trickyness is because the Big Three do not produce perfect images and so the surgeon will not be entirely sure what the tumour is touching and by how much until inside.

The surgeon has requested another big-wig to stand in on the operation so the two of them can assess the situation and bounce ideas off each other during surgery.

Cancer is one long exercise in percentages and risk 

You have a X% chance of living in the next Y years. If you have X therapy you are likely to improve these chances by Y%. You have a Z% chance of developing side effect A from therapy X. If side effect A develops, it then goes away in Y% of people. However, because you developed side effect A you have a X% chance of developing condition Y in the future.

These percentages are comforting because they allow patients to understand the big picture and the benefits of a therapy. But all rational decision making goes out the window when you are told there is a chance you could wake up from the surgery without a bladder.  The surgeon’s words become a blur and you simply here the phrase no bladder. No bladder. No bladder.

These moments pass though. Good doctors are able to recognise when a patient has become fixated on a particular side effect and then start steering them back towards the land of the rational.

The need to hide from it all doesn't last long

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