Abrub - update on recurrence

After surgery 5 weeks ago for my appendix cancer recurrence (after 9 years of NED), they determined that in addition to the defined tumor, there remain scattered malignant cells outside of the tumor margins.  With mine being a slow-growing cancer (and the new tumor identical in morphology and pathology to the original tumors of 2007) we don't really know if these rogue cells will ever do anything, or how long it might be until a recurrence.

We also don't know if the 2 days of Intraperitoneal Chemo I had after my recent surgery affected those extra cells.

My dr quickly called in all resources, consulting with his colleagues within the colo-rectal service, as well as calling in oncologic specialists in other areas (Interventional Radiology for possible ablation therapy, and Radiation oncology to consider brachytherapy.)  I just spent the week in appointments at Sloan Kettering meeting with many drs and having numerous procedures to see how we can best move forward.

At this point, we know that ablation therapy is not an option, because you need macroscopic cancer so that the therapy has a specific target.  There is nothing visible in my scans.  Brachytherapy via a vaginal probe remains an option, but my primary oncologist is concerned that if the radiation travels too deeply into the tissue (we're talking by a couple of millimeters here) that it could damage my bladder or ureter, which are physically lying against the affected tissue. He fears that he'd have to do surgical repairs.  Plus he noted that vaginal mets have their own way of moving about.  His other concern is that if I have the therapy and have a recurrence down the road regardless, then the surgery becomes more complex due to dealing with an irradiated vagina, which does complicate surgery.  And despite what he'd told me earlier, yes he would do surgery on me again, even with the complexity.

Barring some new information (can they really control the depth of brachytherapy?) our current plan is for me to have regular pelvic MRIs (every 6 months or so) and quarterly physical exams, under the assumption that a tumor should be able to be felt.

Thus, once I recover from this surgery (and yes, I'm still quite sore and limited in activity) I'll resume my normal life, and go back to living under the assumption that I'm cancer-free (while going in for those required checkups.)  So while I didn't get the outcome I hoped for, what I did get is still very positive.

Overall, I'm feeling quite positive.

Alice