The value of a second opinion

7 Feb

First posted 18 Jan: http://community.macmillan.org.uk/blogs/b/kaths_cervical_cancer_blog/archive/2013/01/19/the-value-of-a-second-opinion.aspx

I’m slightly hesitant to write this, as it feels like tempting fate, but on Friday there was what could be really good news from a second opinion.

My new doctor sent my biopsy report to a more senior pathologist, and he had a different opinion.

A diagram to help:

 

As mentioned, I have squamous cell cancer, but it was also determined that it had passed through the basal membrane (see above), and therefore it was no longer local, but was invasive cancer.

Once the cancer is invasive, the risks of it spreading increase massively, and that is why the treatment is so aggressive. Either fairly widespread surgery to remove the whole area at risk, and/or chemo/radiation.

However, this latest pathologist thinks that perhaps it hasn’t gone through the membrane.

That would be a massive difference. If that is shown to be the case, then the treatment is very different. It means they just do a much more extensive cone biopsy – which would remove a larger part of the cervix, but not radical (ie, not the surrounding tissue) and I wouldn’t need the lymph nodes removed.

I only got this info yesterday on the phone – while I was in a place where I couldn’t really discuss it, so I don’t know much more. The doctor said he will discuss it further in a MDT (multi disciplinary meeting) on Tuesday, and would let me know the outcome of their discussions.

I don’t know if the fact that the MRI found there was a little more tumor to remove could change the opinion – how do you know it hasn’t gone through the membrane when you don’t have all the tumor? – but maybe there are chemical markers they can see as well as the physical transfer through the membrane.

Nothing will be known for sure until the next operation, but I may come out of that operation with a very different diagnosis to the one I went in with.

Incidentally that operation has been moved to 4 Feb. I’ll update in another post all my various appointments yesterday, and all this week.

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