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Waiting Game

Hatshepsut's picture
Hatshepsut
Posts: 340
Joined: Nov 2006

My husband appears to have cleared all the hurdles for his Monday surgery. Blood tests are in. EKG is in. His cardiologist is signing a clearance. (I was a little surprised by the requirement that my husband have a note from his cardiologist to permit his surgery. I don't remember this happening in prior surgeries. On the other hand, maybe I was just out of the loop. Have you been required to get a cardiologist's --or any other specialist's--clearance?)

The CT scan indicates that the tumor recurrence is confined to my husband's abdominal wall. Our oncologist indicated that this meant the surgery would be much less invasive than previous surgeries. The surgeon, however, gave us the dire warnings about all the possible complications, particularly in light of the fact that my husband is 91. Our cardiologist, when I talked to him, was supportive of our decision to remove the tumor (the CT showed no signs of cancer anywhere else in my husband's body) but he, too, was a bit guarded, I thought. I think ( hope!) that this is simply a lot of "liability insurance speak." The same dire warnings are certainly there on the surgery consent form that is printed up for everyone to sign, regardless of their age. In my husband's case, because of his advanced age, people seem to be especially prone to hedging their bets. My husband, by the way, is a very vigorous 91. (He rows on his rowing machine most days. He is mentally very alert --he was a university professor. And, he has a lot of spunk!)

When we talked to the surgeon, he indicated that he is going to proactively do a hernia repair on my husband's abdominal wall because he anticipates removing a good bit of tissue (along with the tumor) from that area to be sure that he gets all of the cancer cells. Removing that much tissue, he says, will weaken the abdominal wall and make my husband prone to getting an incisional hernia. After I got home, I got to wondering if a CT scan can, in fact, distinguish between an incisional hernia and a tumor. Does anyone know the answer to that question? It may just be wishful thinking, but it would certainly be good to find that this is an incisional hernia from the previous surgeries rather than a tumor recurrence.

Again, my questions:

1. Is it routine to ask other doctors to sign a clearance prior to a surgery?

2. Can a CT Scan distinguish between an incisional hernia and a tumor?

Thank you in advance for those of you who are keeping my husband in your thoughts. I find myself feeling increasingly emotional as Monday's surgery approaches. I pride myself on being a strong person (and most days I do pretty well), but my husband's battles with colon cancer have absorbed every ounce of my emotional strength. I particularly appreciate those of you who have taken me under your wing and given me advice and comfort as our particular cancer experience has unfolded.

Hatshepsut

coloCan
Posts: 1956
Joined: Oct 2009

tho it really doesn;t answer your questions as for #1, part of my preop clearance for colostomy was my lung doctor"s ok tho surgeon operating was aware of my lung problem. Hoping all goes well for the two of you.....Steve

grammadebbie's picture
grammadebbie
Posts: 431
Joined: Jun 2009

Dear Hatshepsut,

I'm sorry that you both have to go thru yet another surgery, glad to hear it is confined to the abdominal wall. I can imagine the emotional roller coaster you must be on. It's all part of the cancer journey. No matter how strong we are it still can be overwhelming at times. You are in my thoughts and prayers.

As far as the cardiac clearance, I have to have that with every surgery as I have had some heart conditions. I also know that as we get on in years (I'm 57), they watch us a little closer.

As far as the CT scans are concerned. I have had very poor results with diagnoses/readings from CT. After my hysterectomy the pain was horrible (worse than before the surgery) they did a CT scan and said it was an lemon sized abdominal hematoma from the surgery. Still not better after 6 weeks another CT...it was now a Partial uterus...what...6 weeks later 2 specialist another CT..it was a rare form of cervical cancer...NOT All this just to let you know that I don't put much faith in the CT scan as far as diagnosis. After 1 year and 2 more surgeries ..the pain was all in my head. After 2 trips to the emergency room and emergency surgery they found 2 complete blockages and a cancerous tumor the size of a lemon. Stage IIIc colon cancer, resection, chemo. Anyway, all this to say that I'm with you and hoping that it is a hernia. That would be great. We'll keep thinking that way till proven otherwise.

You keep that fighting spirit going. Sounds like you have a wonderful husband and he has a wonderful wife. Please let us know how you are doing.

Be Blessed,

Debbie (gramma)

TLG320
Posts: 168
Joined: Oct 2009

Hi Hatshepsut,

Have the doctors taken a biopsy of the tumor that they're going to be removing on Monday? I would think that if they had any doubt about whether or not this was a tumor, they would not be proceeding with a major surgery. I do know that both scar tissue and tumors appear on CT scans, but don't know whether or not one can differentiate between the two.

You and your husband are in my thoughts and prayers!
Tashina

Fight for my love
Posts: 1530
Joined: Jun 2009

You and your husband are in my prayers for sure.I am just hoping everything goes well and your husband will have a very speedy recovery.Take care.

Sundanceh's picture
Sundanceh
Posts: 4408
Joined: Jun 2009

Hi there

I am hoping things go well for Monday's surgery for tumor removal and abdominal repair.

On the first question you had, I have never had anything from the surgeon that he had to sign, that I knew about it - though maybe there is something he does that I don't know.

The closest thing I had was I had to get clearance from my oncologist to give to my vascular surgeon to have a port removed.

And for #2, I would think they can distinguish between a tumor and a hernia. A tumor would show as a mass and would be highly visible on a CT scan. I have not seen what a hernia looks like on a scan, but I'm sure there is a physical difference.

As always, doctors are never sure until they open up the cavity and eyeball it in person - but the surgeon appears to believe that a tumor exists that he wants to take out of there.

You and your husband are in my thoughts and I wish you all the best and look forward to hearing all about it.

Thank you for your kindness and generosity to me on a personal note, L.

-Craig

donnare
Posts: 266
Joined: Jun 2009

Hatshepsut,

I don't have any answers or advice, but I wanted to say hello, and let you know that I will be saying extra prayers for your husband, and you too, on Monday.

Be well,
Donna

PGLGreg's picture
PGLGreg
Posts: 741
Joined: Jul 2006

I passed some sort of age threshold last year that requires me henceforth to get a blood test for kidney function before I can have a CT scan with contrast. (I'm 67.) So I'm not surprised that a 91 year old would need to go over some special hurdles before surgery. But I don't know anything specific.

It's pretty encouraging to us older folks to know it's possible to reach 91 and retain vigor enough to face surgery with some equanimity. Of course, he has my best wishes.

--Greg

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

Before I had my colon resection I had to see my heart doc and go thru a stress test. Heart doc had to sign off on me saying my heart was healthy enough for surgery. I am 52 but WAS obese at the time which was their concern. Good luck to you and your husband.... I will pray for him.

Jennie

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