Left Field

Met with Dr W today (gynecological oncologist). Very sweet gentleman. He referred to my demographic as "ladies". Going into the appointment, Zack and I most wanted to understand a) what the heck is going on, b) what piece of the procedure moved from a laparoscopic surgery to an open surgery and c) is that piece of the procedure worth the additional recovery time and muscle damage.

Turns out, the only part of the procedure that cannot be done laparoscopically would be removing the omentum (a fatty layer over the colon). The omentum tends to be a common site for ovarian cancer to spread. Zack and I decided that since I would only need to have the omentum removed IF they discover ovarian cancer, we could put off that procedure. So we are back to a laparoscopic, day surgery. Drs H & W will remove my ovaries, fallopian tubes, and uterus, and do a series of washes of the peritoneum. Pathologists will then test the organs and the collected fluid for cancerous cells.

Here's where we veer into left field. Our entire assumption of why we are doing this surgery was - well, not off base, exactly, but missing a key component. Up to now, we thought we were doing the oophorectomy to remove the major source of estrogen in order to keep from feeding any colonists from the breast cancer. That remains true. In addition, though, my BRCA2 mutation carries an almost 50% risk of ovarian cancer, and a small risk of peritoneal cancer. So, what Dr W will REALLY be looking for next week is a brand new primary cancer. And, unfortunately, the chemotherapy agents effective against breast cancer don't usually work against ovarian cancer, so it could have been lurking for a while. Given my history, if they find anything even remotely funky, we'll be right back to the beginning. Scans, chemo, radiation, and surgeries.

Strangely, we aren't despairing over this news. I think we are so excited about being able to negotiate back to laparoscopic surgery that we haven't quite processed the other piece. It was definitely an "informed patient" moment. We also are living in such a left field world right now that new, bizarre risks feel pretty inevitable. Right now, the surgery is tentatively scheduled for Monday, March 17 (the day after we return from our vacation in New York).