Cancer Recurrence – Part 2

Ovarian or Peritoneal Cancer – Meeting with the Gynac Onco 

Between all the doctor visits and surgery, I was experiencing continued burps to the extent that if kids or Robin touched me with a little bit of force on my shoulder, it would end in a burp. I cut down carbs and sugar entirely and made it a protein-rich diet to help with the abdomen swelling. The most painful part during this time was managing the bowel movement. I say this without exaggeration, but some days the cramping would be as severe as birthing contractions. 

I had not resorted to laxatives but would worry if there was any blood in the stools. Robin would check it out some days to ensure we are not missing anything. 

During the appointment with the gynac oncologist, he suspected ovarian cancer, peritoneal cancer, or nothing. However, he had to go in because of the ovary marker to see what was happening. He suggested we do a laparoscopic hysterectomy with bilateral salpingo-oophorectomy. Basically, a surgical procedure to remove the uterus, cervix, ovaries, and fallopian tubes. The option was to immediately go for it or wait a month to see if the ovary marker was changing. It was almost an instant decision for me and Robin to move forward with the surgery immediately. 

We were indeed taking a risk by taking out the organs, if there was no cancer, the bets were big, and it was at least an option to consider a decisive result rather than speculating and losing our mind not knowing the medical condition. My oncologist and other doctor friends were not convinced this was the best path forward, but the gynac onco was confident this was what we should be doing. He again told me, similar to the plastic surgeon, that if it was his wife, he would suggest the surgery. 

More than losing my organs, I was worried about peritoneal cancer. It is one of the rarest cancers and has a very poor prognosis. The doctor suspected this because of my symptoms of bloating and other things. That was the most challenging part – almost everything in the abdomen area shows similar symptoms making the diagnosis difficult. 

In simple words, the peritoneum is a tissue layer that pads and insulates our organs by helping hold them in place and preventing friction when the organs rub against each other. So it surrounds your abdominal organs. 

Laparoscopic surgery 

We finalized the date for the surgery within a week, and being an outpatient surgery, it was scheduled for the afternoon at 3pm, with the discharge on the same night. My elder sister decided to come down to help us out after the surgery. 

The plan was to conduct a biopsy of the peritoneum layer and fluid during the surgery. The gynac onco would also clean up anything seen during the procedure. We would have an outcome during the surgery- whether there is cancer or not. 

These days, I also noticed a random bruise on the lower lip, which was not healing. The paranoid me by this time also read about lip cancer – yes, it’s true and exists, and I thought probably that’s another thing that has come in my chart. Robin obviously did not want to listen to any of this, but the lip wound was concerning because we did not know where it came from, and no amount of antibiotic cream was helping in its healing. 

Anyways, the night before the surgery, I wanted to complete my 350th Peloton ride and decided to go big – conquer my cancer and ended up with a 14-mile bike ride that night.  

Although anxious on the day of the surgery, I kept my day busy with work calls till noon to avoid thinking about the surgery. 

While the nurse was preparing me for the surgery, I noticed something about anesthesia while signing the consent form. The way the tube is inserted into the mouth, it could cause a bruise. Immediately, I showed my lips which was covered under the mask to the anesthesiologist, who confirmed that it could have happened during the port removal surgery and usually takes about 3 months to recover. He also promised to work around it during this surgery to avoid further bruises. I felt instant relief when I heard this, and yes, my lips are fully healed 🙂 YAY, something was successful. 

When I woke up from the surgery, I heard the devastating but not surprising news that they did find cancer cells in the peritoneum layer and the onco cleaned up as much as possible, and the organs were sent to the lab for additional tests. My sister and Robin, who had already heard about it, were trying to stay strong in front of me. Knowing the prognosis of peritoneal cancer, my immediate question to my gynac onco was about my life span. He did not want me to worry about it and instead told me once the lab results would confirm the staging etc., he would have the treatment plan in place. 

Laparoscopic surgery uses 3 to 5 small incisions; through it, gas (CO2) is put into the abdomen. The gas inflates the stomach for the surgeon to be able to see the body parts. A small telescope is inserted into the belly button for the surgeon to see inside through the telescope. Long, narrow instruments are inserted through the ports in each incision to detach the uterus, cervix, tubes, and ovaries. The tissue is then removed through the vagina. The gas is then released, and the instruments and ports are removed. 

I liked this link explaining the laparoscopic process. https://www.hamiltonhealthsciences.ca/wp-content/uploads/2019/08/TotalLAPHysterBilateralSalpingoOophorectomy-th-PD6501.pdf

Post Surgery – Metastatic Breast Cancer Diagnosis

With the opioid painkillers, I managed well for the first 3-4 days; after that, I was still experiencing terrible pain. It is excruciatingly painful to pee even with the painkillers on the first day. They won’t discharge you from the hospital without peeing. With the cancer confirmation, my younger sister also came to spend the weekend with us. 

I resorted to walking about 2-3 miles inside the house without being unable to do the Peloton while healing from the surgery. Nights got highly challenging because I could not sleep on the flatbed. I am still unable to sleep on the flatbed, so eventually, we invested in the inclined mattress beds. The pain was from the surgery and cancer in the peritoneal layer. I eventually shifted to the couch to sleep. The inclined position gave me some relief, but I also noticed that the inclination had to change after every bathroom visit at night – lighter and less inclined after every peeing session. 

In the next few days, with the lab results coming, we realized it was not peritoneal cancer but the breast cells that had metastasized in the distant organs. It was time to share this heartbreaking news and everything that had happened with my parents. These family conversations are tough when you see everyone breaking down. 

With cancer in my female organs, stomach, liver, and back, I still managed to do a business trip, a 14-mile Peloton ride, etc., showing it is all a mind game on how we navigate with and without information.

We were at receiving end of one bad news after the other. The mutation results, the mutation prognosis to chemo medications, why cancer returned, and the next steps. I had to get the port back in for the chemo treatment to start again. A PET scan revealed the extent of spread to the liver, back, and some areas in the peritoneal layer in the abdomen. Although it is a tsunami of emotions that one goes through, it is a waiting game dealing with one step at a time and exploring all your options patiently.

I still experience discomfort in the abdomen – the healing from the surgery slowed down because of chemo, cancer still being there, and the side effects of chemo. Robin massages my back, and I look forward to it every day. My childhood school friends surprised me with their visit, and all my other friends and family worldwide continue to give their unconditional support.  

With Robin, I had never seen him being so vulnerable in the 29 years that I have known him. With recurrence, the initial few days were incredibly hard on him. His crying never stopped for many days, and when my doctor discussed the metastatic condition and asked him to start fulfilling my wishes, he was inconsolable. He avoided FaceTime calls with family, and even when friends came home, he couldn’t deal with it. After this initial downtime, I see him emerge way more robust than before. I always teased him, saying I loved him more, although he is more romantic. But how he has dealt with our situation in the last few months has earned him much more love, admiration, and respect from me. From checking my stool color to sometimes helping me poop, to massages, to driving me for appointments to helping me mentally and physically cope every day, and checking on my diet, the list keeps growing.

He is undoubtedly incredible!! We maintain our sanity by continuing to argue and have disagreements like any husband and wife 🙂

I will continue sharing my journey as the treatment progresses. For now, it’s going to be chemo and immunotherapy for a long time. I have put together a FAQ post to address the questions/concerns that are coming my way as a metastatic patient.