Tuesday, September 2, 2014

Medical Oncologist

Well, it's been a little while since I've felt like typing. I haven't had much to say, and a dear friend of mine committed suicide two weeks ago. To be honest, I'm in the dumps. I decided to try and dig myself out a little bit to type this update. We'll see how it goes.

I went to see the medical oncologist at Loyola today. It was the first time I have met him, and the appointment went very well. He agreed that my sentinel node biopsy results are still "unclear". It seems that the node is likely "trace positive", although there are competing reports. In his mind, it seems best to consider the node positive. That having been said, he feels that the node is only barely positive, and it seems unlikely to him that the melanoma would have spread beyond that one node. Unlikely, but not impossible. Ugh.

These are the options he laid out for me today:

1. Full dissection of the groin nodes. He told me he would be against that option personally because the risks of lymphedema with a groin dissection are significant. Given the significant chance that the nodes removed would be negative, he would advise against the dissection. I fully agree.

2. Interferon.  I explained that I've done my reading on interferon and that I understand it could increase my recurrence-free time by a year or so (if I'm going to have a recurrence) but that it doesn't really increase overall survival. He said that was accurate, and that he could "go either way" on whether or not to recommend the treatment. Basically, if I said I wanted to pursue the Interferon, he would support me, but he said he didn't want to push me in that direction. He offered the option of a one-year course of treatment or a five-year lower dose treatment.

3. Do nothing and pursue the standard follow up regimen for my stage while keeping a close eye on the nodes, etc.

Given the options, I believe I'm inclined to do nothing. My exact question to the doctor sounded like "I think I would prefer not to do the Interferon, but before I decide to do 'nothing', do you think it would be in my best interest to pursue a second opinion?" He said that if it were him, he would get another opinion for peace of mind.

I admitted to feeling a little guilty about seeking another opinion. It's funny, because this whole process has really pushed me out of my zone as far as assertiveness. He said "You are the consumer. Don't forget it. You are the boss. You have every right to seek a second opinion, and I would advise you to do so before making a decision. Your lab results are not as clear as we would like them to be, so a second opinion is a good idea."

So there you have it.  I have arranged for my slides to be sent to Memorial Sloan Kettering in New York. I guess I'll be heading out for an appointment sometime soon. I hope that will help me to put this whole thing to rest.

3 comments:

  1. Okay, so what made you pick New York over another location?

    Thinking of you all the time!!

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  2. The reading I've been doing (patients on the MPIP board) suggested going to one of the "major cancer centers" in the US. I had 5 choices or so. My doctor said he would go to Boston or New York. I chose New York. They're looking at my file today. We'll see what happens next.

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