Further to my last post, I have now been approved and scheduled for the sacral resection surgery. The surgery will take place over two days on Thursday and Friday, February 3 and 4. Overall surgery time is often over 12 hours so they have recently broken the procedure into a 2-stage approach.
Day 1: Anterior Incision
On the first day the procedure will involve a removal of the rectum and any other cancerous soft tissue from within the pelvic cavity. I will be fitted with a colostomy at this time. In preparation for the second day, the arteries feeding the sacrum will be clamped off and a "flap" of abdominal muscle will be cut to eventually fill the void created when the sacrum is removed. I'll go into recovery following this procedure.
Day 2: Posterior Incision
On the second day the orthopaedic surgeons will perform an en bloc resection of my sacrum. The intent of this procedure is to fully remove all of the sacral tumour, leaving clear margins all around. In my case it will be a "sub-total resection". Most of the S1 vertebrae will be retained, which should preserve the structural integrity of the pelvic girdle and spine.
Recovery
I'm scheduled for the hospital for 2 weeks. Whether it takes longer will depend on the surgical outcome, complications, and mobility issues.
Future Mobility
I have been told that the left sciatic nerve will be lost in the surgery and that I could be "wheelchair bound". Having spent much time with my dear paraplegic Aunt Shirley, I have very few qualms about this. We really won't know what mobility issues there are until after the post-op assessment.
I will have a few appointments with various doctors and clinics over the next week as I get ready for the surgery.
Curative vs Palliative
Cancer treatment is often classified as either "curative" or "palliative" depending on whether the intent is to eliminate the cancer and cure the patient or to alleviate symptoms and provide comfort. I've been told that there is not a large enough "population" of this particular procedure to deem it curative. But there is no doubt that "cure" is the intent of the doctors performing the surgery and of us going into it. We would not undertake a procedure of this scale if there were not a reasonable hope of a curative outcome.
That said, we will not know for several months as to whether the operation successfully excised all of the sacral tumour or not.
That is about it. We are of course very excited and hopeful. But not without some trepidation on my part! We have the best of surgical teams and are in good hands. We will do what we have done for the last 6 years, forge ahead and hope for the best.
By for now...
Rob; in Vancouver
