Today, Laurie and I met with my surgeon. We are planning surgery to remove the large tumor in my liver. The last scan places its size at 6.3 cm. For comparison, a tennis ball is about 6.7 cm.
About this time last year my injections to treat the disease were increased from every 4 weeks to every 3 weeks. They basically stopped my symptoms for a short while. Over the past 6 months my seratonin blood levels have been slowly increasing and have been outside the normal range over the last 4 months. My symptoms have been increasing very slowly over the past year. Alternating diarrhea and constipation is worse than it has ever been. The evening chills are nearly as bad as they were two years ago when I was diagnosed. The night sweats occur pretty frequently. My oncologist fears that the sandostatin injections may have something to do with the atrial fibrillation that I had last year so she does not want to increase the dosage.
On February 21, 2013, I saw an outside oncologist at the University of Colorado Cancer Center. His opinion was that I should not have chemoembolization at this time but should pursue surgery. The reason for this is that studies show that it is likely that both survival time and time to progression of carcinoid tumor are greatly enhanced (on the order of 3 to 10 years) by removal of the tumor. Odds would be even better if they could also find and remove the primary tumor, but we will not address that right now.
The surgeon is checking with my cardiologist to make sure that I am healthy enough for this “medium/large” surgery. I may need to have an echo cardiogram to ensure that I can take it.
The surgery, if it progresses normally, would include removal of the large tumor, removal of my gall bladder, if time and conditions permit the surgeon may ablate (cook) a smaller tumor as well. It would take 6 to 8 hours and I would be hospitalized for 6 to 10 days afterward. They project recovery time of 2 to 3 months.
My gall bladder would be removed because I have developed gall stones. This is a common side-effect of the sandostatin injections that I receive every three weeks to treat the cancer. Many carcinoid patients have their gall bladder removed for this reason.
I will report as soon as we know that surgery is good to go and schedule it.
My thanks to all for their good will and support.