More Details from The Wizard’s Visit

Dr. Curly seemed to be pretty positive about the potential future possibility of maybe having a chance at thinking about performing a potentially curative operating procedure called a liver resection.  That’s such great news.  We’ve been told for so long that because Maggie’s liver was so consumed with tumors and because of where these tumors were that she’d never have this option.  Up until now our only real hope was chemo which served merely as a delay tactic for the inevitable given the seriousness of our situation.  Now, for the first time since this Great Cancer Adventure has started we’ve got a glimmer of hope of a life beyond the diagnosis.  And that just makes my heart leap with joy.

A liver resection is a conceptually simple operation.  The liver is the one and only organ in the body that can regenerate (thankfully, because of all the damage I’ve done to mine since this Cancer Dance has started!)  Its regenerative power gives doctors the option to operatively remove bad parts of the liver like those that contain nasty tumors.  Once those bad parts are all cut out, the liver will grow back to it’s normal size in about five weeks and everyone is happy again.  Except the tumors, of course.  But we never really cared too much about their feelings.  It’s true.

The chemo has been doing it’s job – thankfully!  (Although it’s questionable if it’s still working – see my entry “School Starts, MDA Calls, and The Cancer Grows.”)  But Maggie’s tumors need to shrink further before a liver resection is an option.  The maximum liver tissue that can be removed, and only in exceptionally ideal cases, is 75%.  The key to success is finding a good, tumor-free 25% to leave behind to grow back into a nice, healthy “new” liver.

Dr. Curly told Maggie that despite the obvious problems, her liver is in wonderful condition.  Her life of eating healthy, staying in good shape, and avoiding too much of the Devil water has probably given her this opportunity.  He said that if she was 50 lbs heavier that this would not be an option.  He also said that yes, chemo has been proven to pickle* the liver and thus make the surgery too risky but he’s seen this primarily in patients who didn’t abide by such clean living standards or who were older.  Maggie’s health and young age continues to give us fighting chances.  Attitude may have something to do with it, too.  😉
* pickle is my word, not the doctor’s.  Surprising, I know.  I just thought it was a nice visual.  🙂

He believes that oxaliplatin, a different chemo drug, will continue the process of shrinking up those stubborn tumors enough to where in January we may be able to have the surgery.  If not, he’s pretty sure that by March-ish we’ll be in good shape.

“Why can’t he just go take out as many tumors as he can right now?” you ask?  Good question.  So did we.  Apparently when the liver is in regeneration mode it releases an enzyme or protein as part of that re-growth phase which is what actually causes the growth.  Tumors loves this stuff and will grow very rapidly in response.  So, if they remove some of the tumors and leave some, when Maggie’s liver begins to grow back, the tumors that remain will grow aggressively, effectively canceling any benefit of the procedure, and likely leaving us in a worse position (few but bigger tumors, more percentage of the liver consumed… blah.)  So this is truly a go big or go home opportunity.

It probably doesn’t surprise you to know that turning 75% of someone’s liver into pâté isn’t a simple surgery.  What may surprise you (it sure surprised me!) is that it’s a pretty low risk procedure!  According to the few studies I’ve read, the risk of The Big Sleep is just around 6%.  Fantastic!  I had thought it to be much, much higher.  Of course, the hospital stay will be around 5 days (still less than we had in January when this mess began) and a complete recover takes about 5 – 6 weeks (or 2 – 3 weeks, Maggie time.)

The plan going forward is to change her chemo to oxaliplatin on Monday and work our way through a whole new set of nasty side-effects and reactions.  While it will be tough to re-learn our chemo dance (complicated by my extremely demanding school schedule), we’ve got a goal.  We’re going to make it through this so that in January weeeee’re….. (come on, sing with me now), weeeeee’re… off to see The Wizard, The Wonderful Wizard of Cancer (yeah, I know it doesn’t really have a ring to it – it’s the best I could do this early.)

7 thoughts on “More Details from The Wizard’s Visit

  1. I know I don’t post here very often (or ever) but I want to let you all know that I do read the site and all of your comments… even the ones that make me cry. I know I am going through a rough patch but I am one of the luckiest people I know, I have a wonderful husband, fantastic family and amazing friends all of whom have been more supportive than I could ever imagine. I wouldn’t wish cancer on anyone but if you have the misfortune to get sick this is the way to do it! I have seen so much kindness and selfless action from friends and strangers alike I don’t know if I would change things if I could (hmm, maybe). Any who, I love you all and I want you to know that your love and support has made this journey a much easier one to take.

  2. Dear Maggie,

    I was older than you when I had my colon and liver surgery at 43. I had most of it removed. Although it took me a bit to recover, I know you will come through with flying colors.

    I too ate healthfully and was in good shape. Because I do have a heart murmur, I was put in the heart ward. However, when they cut out your liver, where I was at, it was important that you eat as much meat as possible.

    So, I’m in the heart ward, where everyone is eating chicken and salad. I’m eating eggs, bacon and sausage every morning. Steak at night. I begged for a salad and I finally got one.

    I was concerned about my cholesterol. My onc told me to worry about that after my liver healed.

    Good luck, and thanks for the great news.

  3. Maggie,
    I had hesitated to post before this b/c I am one of Dr. Bottoms’ students…, obviously you don’t know me, but man, I feel like I know you! I have been checking this site daily for updates since the 1st time I saw it…………
    This update is fantastic!!! I started crying when I read it! When I see your pictures and that incredible smile, I can just feel your spirit and energy! If anyone can make it through this, you can!!! And you have one heck of a hubby there! I can just hear his love for you in his posts!
    Enough of the mushy stuff……….just wanted to let you know I am in your cheering corner and will continue to pray for you!!!

  4. Dear Maggie. All the love and good wishes in the world, and we are looking forward to January. 2008 is going to be YOUR year. You’ve earned it. OOOO’s amd XXXXX’s and prayers, of course. Meme

  5. I was so happy to read the great news! You are developing quite a following here! I understand how serious your situation is and liver resection sounds scary, but compared to what you have already been through, I am sure it will go smoothly. My cousin had a rare tumor roughly the size of a basketball growing from within her liver. It was benign, but over 50% of her liver had to be removed. Except for the scar, no one would ever know. She lives a completely healthy, normal life. I am so happy for the great news for you guys!

  6. I do not know you but I can see that you are a very strong and courageous person! God bless you and your family! I hope and pray that you will continue to fight this with all your might!

    My thoughts are with you. I will keep you in my prayers.

  7. Fantastic news!

    You sound much more optimistic than in your previous post. If I understood you correctly, the surgery is not just “a possibility” but almost a guaranteed thing if not in Jan, but in March.

    This is awesome!

    Maggie, you are doing a terrific job, we’re with you.

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