What do you mean by NO exactly?

• Appointment with Dr. G at Barnes West County

It's funny to be in Dr. MM's office but seeing another doctor. (There are probably 10 doctors that see patients out of this office, but for some reason it still feels weird.)

It's a short wait before Dr. G comes in with one of his fellows. It's a good discussion. I like him. But. He does not feel like cytoreductive surgery, with chemotherapy put directly into the abdominal cavity afterwards, is a good option for me. The candidates for this surgeon are chosen carefully. It's a major surgery. They take out all the cancer they see. So that could be the rest of my large intestine, it could be portions of the small intestine, pieces of the abdominal lining, etc. (Often the appendix and ovaries come out, but hey mine are already gone!) If they see a tumor, it comes out. That's the idea, removing all cancer and then washing the abdomen with chemo directly, to get anything that can't be seen with the naked eye. But there's no decision making with me during the surgery about what to take or not take. Everything goes.

It's THE surgical option for peritoneal mets. And he's saying NO. To really treat all of the cancer, he believes that the best option would be a stronger chemotherapy. My eyes are getting a little watery, he sees it, I feel it. (Chemotherapy is never going to be a cure, so it's hard to hear this surgeon say that chemo might be the best option. Don't surgeons love to cut?!) Based on what Dr. C saw during my last surgery, Dr. G feels like my disease isn't advanced enough to advocate doing this surgery. (It's about quality of life. Three little words that I love to hate.) He thinks that maybe the surgery could be an option in the future. Hmmm. I ask Dr. G... since we can't see these peritoneal mets on any scans, how would we know when the surgery might be an option? When I start having side effects? Couldn't it be too advanced at that point?

Dr. G takes a moment and recalls a surgery that he did last year for someone with a case similar to mine. He did do the cytoreductive surgery and then at the same time, installed a pump (HAI pump) that put chemo directly into the liver. I can feel the wheels turning in his head. He concludes that the best thing is a discussion with the rest of my medical team and that I should expect to hear from Dr. T's office soon.