Decisions, decisions!

I have been struggling with contradictory input from doctors. My preferred oncologist is at IU Health in Indianapolis. No doubt. 

His analysis differs from the doctor at Dana Farber in Boston (part of Harvard). Maybe it is the fact that my undergrad degree is in statistics, and he goes to the white board at some point during every appointment, laying out information in graphs and charts that make sense to me. Or maybe it is that he cares about my happiness. And he made a chart about the importance of happiness in increasing our life spans. 

When I told him I was going to quit baking because I was too exhausted, one would have thought I had told him I was going to jump off a bridge! He said that I needed to be happy to make t-cells, and those t-cells were just as important to my healing as Gleevec, the kinase inhibitor a.k.a. chemo-by-pill that I was taking every day. I was taking a very high dose. So he cut the dose back.

The next day, I bought a pontoon boat. I live on the river, getting a boat was on my list, and I thought, "What am I waiting for?" I named her T-Cell. If happiness makes t-cells, then I am definitely making them when I am on the river. 

On the river with T-Cell

The oncologist at Boston was terse, insisted that the tumor was aggressive in spite of tests that said otherwise. I called his office later and he was good enough to call back. I questioned his diagnosis about how bad my tumor was. He said it was "high risk." I told him that I had looked at a chart that says, by size, 1 to 4 cm tumors are low risk, 4 to 8 cm are medium risk, and more than 8 are high risk. Before the Gleevec, mine measured a little under 6 cm. I asked, "Doesn't this mean mine is medium risk?" Paraphrasing, his answer was basically, "No, because I said so. That was just one chart."  Chart was from a reliable source, by the way.

I don't think he liked the little old lady questioning him. Ego.

My oncologist at IU was willing to listen to how the Boston doc thought my dosage should be changed. He had me taking half a pill one day (200 mg.), a whole pill the next (400 mg.). The Boston doc said that the half pill days would allow the malignancy to get a toe hold. He said I should take 300 mg. per day. My oncologist changed my scrip. No ego cropping up there -- although he did make a chart on half life of my medicine, and showed why he didn't think the change in dosage was going to make all that much difference - in fact, probably none. But at least he didn't just reject it out of hand. And his explanation made a lot of sense to me. 

On to the surgeons. Wow! From the first surgeon at IU telling me it would require a complete gastrectomy (that is, total removal of the stomach) plus the removal of the bottom quarter of my esophagus to the Boston doctor telling me he would do a resection (i.e. take out a triangle of stomach wall), not touch the esophagus, and I would be lifting weights in four weeks. These two diagnoses were based on both doctors looking at exactly the same test results. The IU doc said that if the chemo shrunk it a good amount, perhaps he could take just half the stomach and a smaller part of the esophagus. But he never discussed resection.

When I questioned the IU doctor about why his diagnosis was so different from Boston and asked if he would call the doc in Boston for some conversation, he told me two things. An emphatic NO that he wasn't going to call the Boston doc to argue with him (would it have to be an argument?), and that the Boston doc was just marketing to me, was telling me the story I would like the best in order to get my business. Wow again!

My inclination was to go to Boston, but the IU surgeon saved my son-in-law's life (removed an islet cell tumor from his pancreas over five years ago, and he is still doing fine). Eight hours on the table. Tricky business. And he is at the same hospital as the oncologist whom I dearly love. However, his specialty is pancreatic issues, not GISTs.

What to do? I am not a prayer person, but my daughter is. I told her I thought I was going to have to pray. I just didn't really know what to do, and the Boston surgeon had yet to call me back to talk about next steps should I decide to go out there for the surgery.

I called on Athena, the Goddess of Wisdom and War. Who else should I call on? Here were these warring doctors, and I needed some help. Then I forgot about it.

Later I suddenly thought, "If Dr. Wang hasn't returned my call, why not Google some Dr. Jiping Wang reviews on the internet?" Duh. Thanks for reminding me I have a brain, Athena! That was the "wisdom" part of her input.

Wow yet again! Dr. Wang is highly regarded in this specific field, and he does a lot of these. In reading through his creds, one of them mentioned that he specializes in performing least invasive surgery. That would explain why he is so sure that he can do this without removing my stomach - or even half of it.

I have made my decision. Now to make sure that I am not setting up any road blocks by using an oncologist from IU Health and a surgeon at Dana Farber Cancer Clinic at Harvard. Here goes - ONWARD AND UPWARD!

Thanks, Athena.