Brain cancer - NYE

It was a long day of waiting, various registrars coming in to chat. Finally a real doctor came - in fact, I got two. Dr Jacob Fairhall does plain, old-fashioned brain surgery, Dr Colin Chan does Stereotactic Radiosurgery (look it up).  

The plan is for Dr Fairhall to perform 2 excisions (one for each lump) during the same operation ... And that may be as soon as tomorrow (Jan 1) or the next day depending on if an OR will be free. An excision is basically a procedure where he makes a cut in the skull (2 places actually), shoves a needle through the brain matter down into the lump, and sucks out the great bulk of the lump. Sorry for the grossness. Of course I'm way over-simplifying the technique but I think that is enough detail. Such a technique cannot remove all tumor cells (which is what must happen) - so thats where Dr Chan comes in the following week.

Dr Chan uses radioactive lasers (again, over-simplifying) to kill what cancer is left at the cellular level. The machine basically takes a 3D model of the tumor, then aims the lasers at the tumor using the computer model as a guide. Amazingly, its done as a day procedure and I will be awake during the whole thing. If everything goes well, we may still be able to go on our holiday to Port Macquarie on Jan 12 (no, really!).

But things can go wrong. The excisions carry some risks: temporary brain damage; infection; it even has a small mortality rate. The Radiosurgery can do the whole job quickly and cleanly but: 

• without a prior biopsy (something the excision will also provide), they might find that the lumps are different cancers from what they are expecting (since the pictures are inconclusive) and the procedure may be a waste;
• while the cancer can be fully killed, if would remain as inert lumps in my head for the remainder of my life - thats OK if you don't have a choice, but I want those bastards right out!

The approach is pretty standard for thyroid cancer - cut out what you can and irradiate what's left. Its what happened 3 years ago. But if it turns out not to be thyroid cancer, things could get even more messy.

So, as you can see, its not cut and dried. But I've had almost two weeks to research options and weigh up risks vs benefits. So when the docs came to talk to me, it didn't take me as long to decide as I thought it might. I'm taking on an acceptable degree of risk to maximize the cure and minimize the chance of the cancer coming back later on. My previous job in IT risk has probably helped me come to terms with the grey areas quicker. Alas, there is no ideal scenario here.

What's more, everything will be paid for in the public hospital. Other than free TV and better food, the private hospitals cannot generally compete when it comes to serious and/or urgent treatment. I started this in the public system assuming I would eventually have to change over. But the doctors couldn't justify a change. Hooray for our wonderful public health system!

On a lighter note, I've had a great view of the Sydney Harbour fireworks and the Coogee fireworks.