The Return

Back from Mayo. I guess I was secretly hoping that Dr, Hunter, one of the world's foremost experts on this particular type of cancer, would say positive things -- possibly make me feel better about the staging of my cancer... or that Dr, Ungawa had somehow overstated or exaggerated my condition. He didn't. The news is bleak, honestly.

Dr. Hunter's recommended course of action is more extreme and more invasive than Dr. Ungawa's. Dr. Hunter does laparoscopic surgery but wouldn't in this case as he wants to see and feel the lymph nodes in the area and the bladder. He's done about 100 bladder cystectomies (exactly the same kind he would do on me) this year alone, so he is definitely the guy for the job if I can get in to see him for the surgery. On another note, I am the youngest he's personally seen with bladder cancer, usually not even affecting lifetime smokers until they're 60 or more. He says whatever is going on with me is very aggressive so he recommends aggressive action to make sure it doesn't recur or spread.

The game plan changes somewhat after talking to Dr. Hunter: He recommends chemo *first* (3 to 4 months worth, the same regimen and drugs as the oncologist I met with) and then surgery *after*. Ungawa's current plan has me doing surgery first and chemo and radiation afterward. The chemo can be done wherever, and doing it at Mayo would be needlessly far away -- adding a 2 hour drive onto each side of a 6-hour treatment sounds pretty horrible to me. I'll just do it in Minneapolis at my oncologist's. Dr. Hunter doesn't recommend radiation at all, as that apparently permanently changes the bladder tissues, making any further procedures that might be needed impossible.

What this all means is that I will have time before the surgery (as much as 5 months) while I undergo chemotherapy, so I can do everything possible to get my coverage changed to a network (like UCare) that will cover Mayo. Even if this isn't possible (and I'm now worried about Dr, Ungawa's abilities based on the contrasting courses of action each had) I will follow Dr. Hunter's advice on doing the chemo first.

Though this was a sobering visit that put things into very clear perspective, I am extremely glad that I met with him. He was knowledgeable, personable, and patient.

I have some hard decisions to make, but at least I don't have to feel rushed into them.