The Reality

I was certainly hoping to be sharing better news today, but instead I'll be sharing with you reality. Are we disappointed? Yes. Are we going to let this bring us down? Heck, No!

We spent the day at Dana Farber yesterday, going from appointment to appointment. The state-of-the-art building seems so familiar now and we can make our way to wherever we need to go with such ease. Of course it brings back many memories of the painful and scary days we spent, Scotty being so weak I'd have to push him around in a wheelchair, loading our hands up with anti-bacterial cleanser around every corner, fearing any germ we came in contact with. This time we act like our usual selves, sitting close, teasing each other and making each other laugh uncontrollably. It seems to make the unknown not so scary. I still look at others around us, brittle, weak, bald heads, and my heart hurts for them reminding me of when cancer was consuming Scotty, when the future was unknown, and I just want to tell them that everything will be ok... but will it? Scotty is a rare case. He is strong, he is determined and his body is so healthy, cancer didn't stand a chance. Even the worst poison they could possibly pump into his body (Chemo in the form of VIP) he was able to make it through with strength & grace. But everyone is different, every cancer is different, and unfortunately no one can tell them that everything is going to be ok. That is reality.

After getting his blood taken at 2:30 as planned, we headed up to the 11th floor: Dana-Farber's Yawkey Center for Cancer Care. Scott's appointment with Dr. Steele, the Urologist was set for 3, with a meeting with his Oncologist, Dr. Pomerantz, at 3:30. By 4, Dr. Steele finally showed up and sat down to review his scans. The hour sitting in the exam room waiting for him, seemed to take like 4 hours... and when he sat down to review Scotty's past, I felt a little frustrated that he showed up an hour late and hadn't already reviewed the case. I guess when you're one of the best Urologists in the world, that's how it goes. Two things came from his mouth that although I had heard before, keep ringing in my ears. "The difference in your scans from June to now is absolutely incredible. And after looking at the size of the original tumors, you are extremely lucky to be alive." How's that for reality? The scans he showed us were also very real. It is amazing that Scotty's body was able to operate, and at somewhat normal levels for so long, when tumors were taking over some of his vital organs. It also is a reminder of how long the cancer was in his body before the pain started affecting him, and finally went to the doctor. A lot of people would have died before even receiving chemo, due to the severity of their tumors, and many more are not able to make it through the side effects of chemo.

After reviewing the scans for quite some time, Dr. Steele's told us his recommendation is for Scotty to have Post Chemotherapy Retroperitoneal Lymph Node Dissection. This procedure is common with those who have Testicular Cancer and is a major surgery. Because cancer was badly staged in his body and the size of the tumors were so large, they shrunk significantly, but not enough and because they don't know what's left, the best option for Scotty is to have them removed. He has a large one in his liver that sits on the major vein, as well an enlarged lymph node close to his aorta and if they continue to grow, Scotty could be in some serious danger. Dr. Steele broke it down like this: he believes there is a 20% chance that the tumors could still contain cancer, yet not enough to show up in tumor markers in the blood. There is a 40% chance that they could contain teratoma, and 40% chance that it's scar tissue. Taratoma would ensure that the large dangerously sitting tumors will grow eventually making for a very dangerous situation. Dr. Steele said he was going to discuss with Dr. Pomerantz but he'd want to do the surgery in December.

Next up was Dr. Pomerantz and Scott and I were pretty deflated at that point. He was very optimistic saying he wanted to share his thoughts about the situation. He believes the chances of it being scar tissue due to Scotty's reaction to the chemo topped with his "pristine" blood markers, is over 50% but still wants to discuss pros/cons with Dr. Steele. He is definitely leaning towards the surgery for the reason that the "residual disease" could be potentially dangerous. We also learned Scotty will be closely monitored for years to come and that although there are no signs, his chances of getting cancer again in his 50-60s is much higher due to the chemo he had to endure. Scotty was informed that he is extremely healthy, his scans show he has no vascular fat, but it is essential to change his eating habits. Dr. Steele had said that just one salad a day significantly reduces the chances of cancer. Although he doesn't eat "bad," there is so much room for improvement, so I'm taking it on as my challenge to find ways to incorporate new healthy foods into his diet. I just don't think I'll ever live to see the day where I will find Scotty making himself a salad for lunch on his own. :)

So basically, Scotty's situation is very rare and the best situation is not 100% clear. Both doctors want to discuss and make sure they agree on every level. The surgery will most likely take place in December, between Thanksgiving and Christmas. The surgery will take 4-6 hours, he'll be in the hospital for about a week, and it will be a 4-6 week recovery period as he will have had his whole stomach cut open. There is the chance that because of where some of the tumors are that they will not be able to get it all, which Dr. Pomerantz wants to discuss to make sure it's even worth going in then. But, even if they were able to get most of it, and deemed it to be scar tissue, then it would be a huge relief. There is always the option of waiting and constantly testing to make sure that cancer is not growing, or even taratoma, but that is like waiting for a ticking time bomb to go off and a higher chance of having to go through chemotherapy again. Scotty feels better than he has in 4 years, and although would prefer not having the surgery, he wants to be able to go on with his life, not worrying about what might or might not be happening in his body because of the tumors. The Doctors were going to discuss and be in touch with Scotty on Tuesday, and the three of them are going to come up with a game plan.

We wish we had better news, but this is what reality has given us, so we're going to 'chin up' and take it as it comes. Scotty was told that this surgery is nothing like what he went through before... so as long as the actual surgery goes well, he'll still be feeling as good as he does now. There are a few possible complications, like bleeding due to removing tumors that are sitting on other structures, and reducing any chances we might have now of having children, but he's going to be in the best possible hands when it comes to this surgery and not many hospitals or Urologists even perform it. Dr. Steele works closely with the best Vascular Surgeon he knows, and together they make an amazing team. Knowing that surely helps.

So thank you all who have been thinking of us, praying for us, and surrounding us in love. You all mean the world to us and help keep us strong in these times of struggle and uncertainty. Please continue to pray for Super Scotty and that whatever happens will be a piece of cake for him and so he can FINALLY move on with his life! I can't say it enough, but he is an amazing guy and truly deserves the best. I was told recently that "Reality isn't unfair. It just is." Every situation is made to be an opportunity to grow and it is up to us to be aware and look for that lesson. Scotty will be an even better person after going through this and instead of wallowing in the negativity of the situation, we will focus gratefully on the lessons that life is offering both of us.

I will update you with the game plan once that is finalized this week. In the meantime, be well, be blessed, and much love...