My “debulking” surgery was scheduled for first thing Friday morning at 7:00 AM. Due to my insomnia and misery, I was thrilled to be first on the list. Ovarian cancer survivor Susan Gubar, in her book Memoir of a Debulked Woman, describes the surgery as “grotesque” and “patently hideous” among other discouraging adjectives. To me, however, it only meant a chance to feel better now and in the near future. So after my initial reactions to the whole situation, I now embraced the “barbaric” opportunity to be debulked–I didn’t care what they had to do. The National Cancer Institute describes debulking as “surgical removal of as much of a tumor as possible. Debulking may increase the chance that chemotherapy or radiation therapy will kill all of the tumor cells.” The sobering message of this definition is that no matter how much or what they remove, there will still be cancer cells left.
Besides removing the cancer, another purpose of the surgery is staging of the cancer, or a determination of how far the cancer has spread. Stage I indicates that the tumor is pretty much localized, and stage IV means the cancer has spread to other vital organs such as the liver. With my symptoms I already knew that it wasn’t localized. Then finally, the surgeon makes a determination whether the surgery was “optimal” or “suboptimal.” Was there any visible cancer left? If not, it would be considered to be optimal, along with a better chance of long term survival.
Besides the delivery of my only daughter 25 years ago, this would be my first hospitalization. I arranged to have my brother Kevin pick me up at 5:00 AM to take me to the hospital. He is the only family I have close by, and he would prove to be my greatest champion and supporter over the coming ten days. He took the “before” picture above as I was waiting in the hallway to be taken into surgery and the “after” photo below so he could report to our sister and my daughter on the days progress. I told him to stop taking pictures and later asked him to delete them. Fortunately for this blog he doesn’t listen to me and you are able to see the good and bad of it all.
I was visited by the surgeon and anesthesiologist while I waited in the hallway, and it felt like a long wait. I was finally wheeled in to an ice cold surgical room about 7:30AM in a semi-nervous state. The next thing I knew, about 5 hours later, I woke in the recovery room with Kevin again snapping a picture. Pretty bad I know.
My pathology report indicates that my surgeon performed a radical hysterectomy with resection of the uterus, cervix, ovaries and fallopian tubes, excision of the sigmoid colon, greater omentum and right diaphragm. There were actually two small separate areas, referred to as “donut holes,” removed from my colon, with an anastomosis which means they just sewed the two ends together. I have heard of women who were not so lucky and had to have a colostomy performed (with an opening made to the outside of the abdomen), including the “Debulked” author above–she has good reason to be cranky about the surgery. I looked it up and according to Johns Hopkins Ovarian Cancer Center, only about 3% of patients undergoing debulking wind up with a colostomy.
My cancer was determined to be stage IIIC which means the cancer has spread or grown into organs outside the pelvis, but has not spread to liver or spleen or distant sites. The farther you get into the staging, the worse your prognosis is. At this stage I have a 41% chance of surviving for 5 years. I can’t find a written report of whether my surgery was optimal or suboptimal. I didn’t know enough at the time to even ask but I’m putting it on my list of questions for my next visit to the oncologist. I think it was optimal however.
I spent the next day and a half lying in a hospital bed, pushing a magic button that delivered a dose of morphine. I slept a good deal of that time, probably because I pushed the button every time I woke up. But hey, I didn’t feel much pain. They inserted a urinary catheter during surgery which meant I didn’t have to get up to use the bathroom and I liked that idea! That is until Sunday when they took the catheter out and the fun ended. Stay tuned!