The tone of the article is "back to business" because this week is one for me to take seriously but within my stride, regardless of what information comes my way.
Whilst I analysed many of the issues that were central to the diagnostic phase I did not delve deeply into the dynamics of surgery because I thought that it was an issue best left to a more appropriate time. There is only so much information that I think is good to take on both from an emotional and a mental stand point.
If we stick to basics, I was diagnosed as having a "regional tumour" i.e. it has grown through the oesophageal wall and has infected the local lymph nodes but has not metastasised to other organs in the body (i.e. there is no secondary cancer). The tumour has been staged as T3, N1, M0 - where T is the size from 0 to 4, N is the nodal infection gauged from N0 to N3 and M indicates the presence of metastasis either M0 or M1.
The following artical describes the classifications more fully (remember that I have the second type of cancer listed "adenocarcinoma"). Oesophageal Cancer Staging . So my cancer was at an advanced stage when diagnosed though, critically not metastatic.
Spinning to the bottom of the linked page a harsh truth is articulated and that is that, for the statisical sample that was taken, people with my level of cancer have a 20% chance of surviving for more than five years. I believe that these statistics were derived before the type of treatment I am having was in situ but, but whilst the reading still isn't pretty, I believe it to be closer to a 30% survival rate for 5 or more years. It should also remember that I am having the "wonder drug" Avastin, so it remains to be seen what impact that has.
There is a another factor, which is termed as metabolic resoponse. Metabolic "responders" have a much higher survival rate than non-responders. What I don't understand is whether I have been tested in this respect. From what I have read, metabolic response is determined by a PET scan a couple of weeks after the start of chemotherapy, but as my PET scan was performed before chemotherapy I assume that my metabolic response was not measured. That is something that I will ask.
Now base line statistics are always good to absorb because they tell you the wider picture and let you know where you are "operating from". However, it would also be a good argument to say that it is unwise to delve into this kind of information and just assume that you are going to be ok.
As I work as analyst my view point is to digest the statistics and information that is out there (and there is plenty of it) and then use it to your advantage.
There are many key factors to survival rates and these include how you respond to the initial phases or treatment, how much of the cancer can be removed at the time of operation, your general health, the quality of your care and your attitude are all good examples of factors that affect the equation. Given that I have a leading oncologist, surgeon, good general health, I am relatively young and that I am focused on returning to health, I believe that I have a lot going for me in this current predicament. The fact that blood counts related to the tumour were considered to be moving in my favour significantly is also a positive consideration.
The ability to remove all of the tumour is critical, as the following chart illustrates. R0 represents complete removal
The difference between R0 and R1 quite compelling. It should be recognised that the chart is not exclusively for my stage of cancer.
Regardless of any of the above the CT scan on Wednesday will present a picture of where I am now. Whilst I was diagnosed as having a stage III tumour we will know how well I have responded to the chemotheraphy and the surgeon will presumably have an idea (though I would imagine not definitive) of how successful surgery will be.
The CT scan will provide some hard facts, so by Friday I expect to be able to reset my expectations in a pragmatic way, whilst retaining my belief that there is much I can do to influence the outcome of my own journey.
My simple take on my situation has always been that if my "inner battery" is beyond recharging then it will fail; nature will dictate that. If it can be juiced up then I will succeed.
I don't need any motivation because my young family provides as much as I need and reservoir beyond that I can always dip into emotionally.
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