Update from the Surgeon

My heartfelt thanks to all who have commented or otherwise messaged me to rejoice about the news of my being in partial remission. I went back and read the report from my January PET scan, and the difference between that one and the recent one is indeed huge.

The unexpected degree of this good news was to some extent overshadowed last week by the fear that I would now be told I should have a very major surgery. Alternatively—which was perhaps worse—I feared that some of my doctors would say I should have the surgery and some would say I should not, leaving me with a terrible decision to make.

It did not in fact turn out that way.

On Friday I saw the surgeon, and he says the "pleurectomy and decortication" surgery (P/D) is not for me, partly because of how well the treatment has been working and partly because of where my tumors are or were. So I do not have to have major, mutilating surgery. Whew!

Instead, it may make sense for me to have a much smaller "debulking" surgery, which would aim to reduce the size of the remaining tumor—if an initial exploratory look confirms that it could be done pretty straightforwardly. The surgeon also said that because of my unusually good response to the treatment, which is based on an immunotherapy drug (Keytruda) which has only recently been approved for mesothelioma, we are in a "data-free zone." In other words, we are pretty much making this up as we go along. That could be disconcerting, but it is for such good reasons that I am taking it well.

We'll go see the specialist at Johns Hopkins next week and see what she says about the debulking surgery and any other steps I should be taking other than continuing the Keytruda on schedule.

Meanwhile, I had a quiet but happy Mother's Day yesterday. It was so good have positive medical news to celebrate and to have Gita (and her cats!) with me for the occasion. (For anyone who wants to know more about our trip to Chincoteague and Assateague, Gita has a lovely blog post on the subject. And for anyone who is interested in going there themselves, bring bug spray! The mosquitoes were legion.)

So grateful for Gita on Mother's Day