I met Wednesday with a surgeon who specializes in oncologic procedures. He studied the images takes of my neck and touched around on the nodule really good.
He is concerned about the lymph gland being physically adhered to the artery and vein (bigs ones, too) underneath it. He showed me on the PET scan and CT scans how the progression of the tumor is against the actual artery and vein on my neck. He zoomed in a bit and showed how there is a “tissue plane” between the lymph gland and the vessels. At one point, though, the tissue separating the two disappears and it looks like the lymph gland and vessels are connected.
He stated that his physical evaluation brings him some hesitancy also. He should be able to take the lymph gland, since it is right on the surface, visible, and easy to touch and feel, and move it around freely and independently of any other tissues. But he’s not convinced that is happening. He is not able to move the lymph gland independently, suggesting it is adhered to the tissues underneath it, which just happen to be the carotid artery and jugular vein. The other part of the exam that concerned him was his ability to count my heart rate by touching the lymph gland. It pulses strongly. Again, it is setting on top of the artery.
Therefore, the surgeon wants to do one additional test. We will get another CT scan, this time zooming in tightly on the affected area. The goal is to determine if there is enough tissue around the gland to support being able to cut it out safely.
The danger and risk are high. If the carotid artery or jugular vein is nicked or cut open, the result will be tenuous at best. Blood will fly across the O.R. (literally) and they will have an emergency on their hands, trying to contain and patch the opening.
So the goal now is to balance the risk with the need for the surgery. There is no strong need for the surgery, but rather, a recognition this could cause issues down the road. This is the original lymph gland that swelled up quickly June 2014 indicating I had Burkitt’s Lymphoma. Every time the lymph gland swells the slightest, which it did last week when I went into the ER for the stomach stuff, we are going to order additional tests to determine if my cancer is back. Continual testing and worry (on both my end and from the oncologists viewpoint) are the primary factors driving the desire to get this knot out of my neck.
My follow up CT is Wednesday the 25th of February. I meet with the surgeon about 2 hours after the CT is done and we will then make some kind of decision. I feel ambivalent on the subject, thinking the risk isn’t worth it until I look in the mirror in the morning and have to wonder if the lymph gland is growing again. It stares at me, mocking me, and reminding me of my frailty in the eyes of cancer. I’ll keep y’all posted.
Oh, what does a picture of Longhorns in Fort Worth, Texas have to do with this blog? Life must go on. After my stem cell transplant last November, recovery has been slow, very slow. I’m now starting to push myself physically a bit to build up my endurance. I spent the day with a friend and his children at the Historic Stockyards in Fort Worth. I really liked this picture, it is taken as the last cattle drive of the day occurs. Just as these steer move slow and steady to their destination, so shall I.