Beating the Odds

Today we celebrated Cinco de Mayo at Estrella's with the girls. In addition for an excuse to show them off in their traditional Mexican dresses, we were celebrating  an unexpectedly positive  pre-op consult with my liver surgeon. 

Today was the 3rd time I have met with my nationally-renowned surgeon, and these meetings usually fill me with dread as he is bound by law to discuss everything that could possibly go wrong as I go under the knife.  Today though, he began our meeting by saying that I looked much better than the last time he saw me, and his aura was bright and jovial instead of his usual intense and severe.  When I asked about the possibility of throwing a tummy tuck in, he just looked at Carl and said, "A tip to the male species; tell her she doesn't need it!"  He also said that I had a good shot at healing quickly, and that he probably wouldn't be seeing me much in the future, which would be a great thing. 

As we drove away from UCSD Moores Cancer Center, feeling more secure that nothing would impair the 2nd stage of my 2-stage liver resection, we reflected on all the odds we had to beat to get to this point in the journey.  Although we still have half the mountain to climb, it's worth stopping to take a look at the view from the half-way point.   

The following figure should help explain the points which follow.  The first section in the graphic below show that 47% at diagnosis have liver only metastases, which category I happen to be in:

  

• Among all people diagnosed with stage IV colon cancer, 47% have liver-only metastasis, meaning that 53% of those at diagnosis also have cancer spread to the lymph nodes system, lungs, or other vital organs. In order to qualify for a potentially curative surgery the cancer must be confined to the liver only.  Thus far, I have had 6 scans and MRIs to verify that my cancer has not spread elsewhere. 
• In addition to the cancer being confined to the liver, a patient must show a significant response to chemotherapy in order to qualify for the 2-stage liver resection surgery. Only 25% show a significant enough response. 
• 20% of those considered for 2-stage liver resection never actually receive the surgery because MRI scans reveal that the cancer is in millimeter-sized locations which CT scans do not detect.
• The first of the 2 surgeries is performed with a 10% risk of the surgery being stopped because additional cancer is found by laparoscopic cameras which could not be seen or detected by imaging (MRI and CT scans).
• After the first surgery is completed, there is a 20% risk that the cancer will re-grow or spread in the liver or other organs, thus preventing the option of a 2nd surgery.  

So, The combined probabilities are as follows:

47% x 25% x 80% x 90% x 80%= 6.7% chance of receiving a potentially curative surgery since diagnosis.  

AND HERE I AM, BEATING the odds, and fitting into the 6.7% that qualify for surgery!

Only here's the rub...the odds of the cancer not returning after the second surgery are only 10-20%.  But I have beat smaller odds already, so I have FULL CONFIDENCE I can do it again!

Besides, according to a scholarly and insightful article, The Median isn't the Message, by Stephen J. Gould, a late Harvard medical professor who outlived his own cancer diagnosis by 20 years, statistics should not be treated as a sentence.  Gould asserts that those with "positive attitudes, a strong will and purpose for living, a commitment to struggle, an active response to aiding their own treatment and not just a passive acceptance of anything doctors say"  also tend to beat those odds!

I join with the chorus of this optimistic song the odds are that I will be alright!