32 Jars and Waiting

The promise of pathology results has been on my mind since my surgery.  I was in the hospital for a total of five days.  Thirty-two samples were taken out of me and sent to the lab for testing.  I still have a hard time contemplating thirty two sample jars filled with pieces from my body.  Every day my oncologist would come in, usually first thing in the morning and tell me there were no results yet and every day I would feel more and more adrift. 

Let me back track here and explain why pathology is crucial after a diagnosis of ovarian cancer.  The pathologist holds a lot of power because they determine the stage and grade of the cancer.  How fast is it growing?  How much has it spread? And what was at the forefront of my brain, how aggressive does treatment need to be?  Radiation?  Chemo?

On the day that I was discharged from the hospital, my doctors told me that they would call when the results came in.  So I waited…and I waited.  I did call and leave messages for them.  At one point on the phone, I was told by a nurse that my pathology came back negative, no malignant cells seen and I burst into tears because that would mean that I didn’t have cancer.  Five minutes later, she called me back, very apologetic to explain that had only been for one of the thirty-two samples, thirty-one were still pending.  So I kept waiting and finally my two week post op appointment with by gynecologist arrived and I was sure the results would be ready.  Everything I read online told me that this was when people usually got their results.  But no, still not ready.  There were two samples that had indeed come back clear, but the tumor and ovary were still pending.

Paul and I read everything we could find online about the different stages of ovarian cancer and just based on snippets of what the doctors had told us, we were pretty sure that I was early stage.   But I am a planner and I still felt like I had no plan and no way to even think about a plan until we knew exactly what had happened to me.

I will cut to the chase here, it took four weeks to get my results back and when they did come back, they weren’t as clear cut as I was hoping.  The initial lab couldn’t make a decision so they had sent the tumor to a cancer center for a second opinion.  That pathologist found that a great deal of my tumor was actually dead.  No one knows why or what was killing this tumor, but something was cutting off its blood supply and it was dying.  The living tissue of the tumor was Grade 1, Stage 1 which is amazing.  In normal circumstances that would mean no further treatment needed.  Surgery would be it and in 95% of cases there would be no recurrence.  However, because they can’t stage dead tissue, they couldn’t say that other parts of the tumor weren’t farther along grade wise. 

My doctor was very honest, he wasn’t sure which way to go and wanted some time to think about it.  But I was told I have three choices: 

1) do nothing 

2) do three treatments of low dose chemo 

3) full-blown chemo

The kicker came when he said, if recurrence happens, he was pretty sure we wouldn’t be able to cure it.  So this is where I am now.  Paul and I agree that full-blown chemo is off the table based on numerous factors, but most importantly with the living tissue being graded so low, we’re cautiously optimistic.  The choice is between the first two options.  I have a lot of questions about side effects but this is the decision that will be made on Tuesday. 

I don’t feel adrift anymore.  There is forward momentum and that is a relief but I’m still angry and I still get sad.  I’m scared but I’m moving along and that’s all I can do.