January 27, 2012: Downs and Ups

When you ask me how Stella is doing, I might answer you.

Or I might turn my back on you and scurry away.

Either way, you will have my answer.

So now I probably confused everyone.

Didn’t Stella have the miracle operation? What happened to “She will be cured, she will be cured……(breathe)?”

Yes, that IS still the hope. But it’s a bit more complicated than that. Let me explain.

As you remember, in June Stella was diagnosed with stage four gastric cancer. The cancer had spread outside her stomach so the standard response — removal of the stomach — was not under consideration. Instead, we embarked on an aggressive schedule of chemotherapy. The hope was that the chemo would slow the spread of the disease.

But it did more. In November a scan showed that there was no more active cancer outside the stomach. Stella’s situation was re-assessed and it was determined that she would be able to have the operation after all. If all the cancer had been killed by the chemo, then there was a chance that the operation would result in a cure.

On January 1, Stella had the operation. When the surgeon saw the extent that the cancer had spread, he elected to perform the “most radical” surgical operation. Stella’s stomach, spleen, gall bladder, and over forty lymph nodes were removed. The tissue that was removed was then sent to the lab to see if any active cancer cells had been “hiding” from the scan.

The report from the lab showed that active cancer cells were indeed hiding from the scan in the tissue outside her stomach. This means one of three things.

Either the cancer is still present in her body and just as cells that were removed in the operation had not been revealed on the scan, she still has more cancer still inside that didn’t show up. This possibility gets the unhappy face.

A second possibility is that there are again more active cancer cells inside her body, but they represent the last remnants of the cancer. Since chemo successfully killed all the rest of the cancer, it makes sense that continued chemo will kill any remainder that is still there. This option gets a neutral face :I

A third possibility is that the cells discovered are the last vestiges of the cancer and since they were removed in the operation, she no longer has any cancer inside. This option, of course, gets the happy face

The problem is that there is absolutely no way to determine which of the three possibilities is the true one. As our Doctor said, Stella’s case is really “outside the box” as far as stomach cancer in concerned. She managed to have an operation for which there had initially been a zero percent chance. So now, the statistics can be thrown away, and we can rewrite the medical journal articles.

Where that leaves us is with a return to chemotherapy. The chemo is either going to kill active cancer cells that are still in her body, or it is simply a precautionary step to make sure that all the cancer is dead. Regardless of which option it is, we will resume the battle where we left off. Although this time our odds are better. Hey, the Giants are only three-point underdogs to win the Superbowl. That’s a hell of a lot better than they were a month ago, right? (If you don’t understand, ask a football fan.)

And so the battle continues. Right now, Stella gains strength every day, but it is not without occasional set-backs. She is trying to eat and drink, but it is difficult. She still has pain from the operation and some days she is not up to “visiting hours.” (So always e-mail before coming over.)

As for me, when she is not doing well, I am not doing well. When she is feeling better, I am feeling better. Catch me on a good day, and I will talk football or biking with you. Catch me on a bad day and I might spit on you. (No, I wouldn’t do that. But I might just turn my back on you without answering the customary “HowzStella?” greeting.)

Chemo will not be fun. We know that. Just when Stella’s hair has grown back and some of the other side-effects from chemo have disappeared, we have to renew our membership in the club. Once again, we will be spending days at Shaare Zedek and will have a number of “rough patches” coming up.

But we do have a possibility of a cure and THAT is what we must focus on. The big party will have to wait, and we will once again call on Stella’s Army to don your battle gear and jump into the fight.

In the TV show “24,” just when it seemed like all the bad guys were dead, the plot would turn and more bad guys would show up. But eventually it was just Jack Bauer and the last remaining bad guy. And we could all get stoked as he showed no mercy and sent the final villain on his way.

I have this dream where Stella finally confronts the very last cancer cell with her chemo gun loaded. And she kicks its ass. (If you didn’t get the Giants reference, you probably didn’t get this one, it’s a (mostly) guy thing.)

So we have no choice but to accept the situation and tell those cancer cells that their days are numbered. (Yeah, I’m in a bit of a rah-rah mood today.)

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