Docs, Lotsa Docs This Week

Remember in the last post how I said the new drain hurt? Well it never stopped hurting, and it was hurting in a completely different way from all the other pains that have come by to visit in the last month, like being branded from the inside out. It buried all the other pains.

It hurt so much I didn’t want to move from whatever position I could find that wouldn’t hurt. On Sunday I’d had enough. I called the on-call interventional radiology doctor and explained what was going on and he very nicely wedged me into the Monday schedule of CT scans and tube checks, moving it ahead of the Thursday scheduled date. Yay!

We found out that I still have enough fluid to justify the drain, but when we went to the table to check the tubes the doc suspected that the suture that held my drain in place was the culprit. He snipped the suture and asked me how it felt. Wow, that was it! 95% of the pain went away immediately. He replaced the suture with this neet stick-on pad with a tube clamp built in so the drain wouldn’t move and boom, I was good to go! >WHEW<

I had appointments with my oncologist and surgeon on Thursday. Talking with my surgeon, Dr. Rocha, I learned that I’m healing well. We agreed to leave the drain in for another 2 weeks or until it stops producing for a few days. Talking with my oncologist, Dr. Picozzi I learned many other things.

For one, we’re in unknown territory now. Pancreatic cancer is a little like breast cancer in that both will send little undetectable soldiers around the body to start new tumors. However, with breast cancer the recurrence after chemo & surgery is around 20% after a year. Pancreatic cancer is more like 80% likelihood. Of course those are nationwide stats, for stage-2 people who have had all kinds of chemo with different efficacy. I’m an anomaly in that I’ve responded so well to the drug trial, nothing was found in the lymph node & border tissue biopsies, and the chemo resulted in 85% inactive or necrotic cells in the tumor.

Those floating cells respond differently to chemo than cells in the tumor too. Since so few pancreatic cancer patients make it as far as I have there haven’t been enough cases to find out what that difference is, so there’s no way to predict whether they’re active, dead, or something in between, especially with my drug trial results, where I’m “making medical history”. Did it do a similar job of wiping out floaters? We just don’t know.

That means we still have to decide what to do post-op and post-recovery. Some combination of chemo & radiation? Just chemo? Just radiation? Mix up the chemo like we did in the drug trial? Do nothing and watch? For now I’m just healing. I’m sure Dr. Picozzi is going to research this like crazy, and we’ll meet again in a week or so.

He’s also ordered somatic testing on my tumor & germline testing to check for genetic mutations. There’s a lot of new insights being learned with those tests. Maybe the results can help steer us through effective decisions for all this. The costs are even being picked up by the new federal funding for pancreatic cancer research. You can learn more about this cool stuff right here – https://www.pancan.org/news/guidelines-advise-germline-and-somatic-testing/

Meanwhile I’m back to feeling a little better each day. I’m even putting some weight back on. I wish I could work out but that would be a spectacularly bad idea, and the little tugs and twinges in my torso remind me of that. Meh, we’re making real progress so I am totally grateful and satisfied with that.