After several calls with my gyn-onc and rad-onc at the OU Cancer Institute we've finally got some answers.
They did compare my CT scan with the PET scan from before treatment and the great news is that the mass is gone! The treatment is working thus far and certainly I need to take a minute to celebrate this news! However, there is still cancer in the vaginal wall on my right side. The doctor first called to say there was still an "enhanced ridge", which after hanging up I freaked out about. In my mind, I thought that sounded like the mass was still there and if that was the case how could the treatment be working? I called the rad-onc back to ask more questions and learned that what they see now is a thickening of the vaginal wall where the mass was previously growing. There are abnormailities present in the glands and tissue of that wall, which tells them that there is still cancer there. Regardless if there is or is not, the next step for the highest cure rate and the lowest reoccurance rate is still clear. I have to go forward with the Interstitial Brachy Therapy. The wall is over .5mm which means I am not a candidate for the cylinder type internal radiation. I've written about Brachy Therapy before, but here is my specific plan.
Monday; 3/21 - Arrive for pre-op at OUCI (OU Cancer Institute) - Be on a liquid diet all day.
Tuesday: 3/22 - Arrive at pre-op at 5:30 am; surgery begins at 7:00 am where they will place 20 needles into the vaginal wall while I am under anesthetics. Once I wake up they will take me for x-rays and a CT scan to ensure the needles are placed exactly where they need them. Next, they will take me to a quarantined radiation suite, as they call it, and the rad-onc will attach small cathedar size tubes that will begin to feed radiation seeds directly to the vaginal wall. They will give me a cathedar and some meds to stop my bowels. I will continue a liquid and soft foods (like Jello) diet for 49+ hours once I'm radioactive.
Wednesday: 3/23 - Continue to lay in the bed flat on my back radioactive. I will have a self-given morphine drip most likely through an epidural. Nurses will come in to check vitals and bring liquid meals. The rad-onc will come twice per day to check on me and ensure there is no infection. My husband will be allowed to come stand at the open doorway once per day for 10 minutes. Noone will stay in the room for more than 10 minutes at a time so that they are not exposed to the radiation.
Thursday: 3/24 - Late afternoon when 49+ hours are up the rad-onc will come in and remove the needles and the cathedar. I will be allowed to get up and shower and ensure bowels are working again.
Friday: 3/25 - I'll be dismissed and we'll begin the long drive home
The main decision I still have to make is whether to remove my ovaries at the same time they put the needles in for Interstital. I mentioned that the gyn-onc drew blood to test my hormone levels and the result gave me a result of 57 (FSH), whereas the range for post-menopause is 25 - 134. There are times during a given month that a pre-menopausal woman's hormone reading will cross over into the post-menopause range, but a 57 is low enough this is not of concern. We can safely say my ovaries on not functioning and releasing any estrogen. This is a good thing based on my particular situation, but there is a 25% chance that they can repair themselves and begin functioning at some level in the future. For my own peace of mind I need to have them out and to have a surgery more than 6 weeks after radiation is risky. The organs and tissues in the radiation path are not only fragile, but scar adhesions begin to form between the organs and this causes high risks. I can either go through both surgeries at once or I can have two surgeries over a 3 week period. I'm really leaning toward getting both done at once as of now.
A lot of information here I know, but want to keep many of you following closely up to date.
Please pray for peace of mind leading into treatment and during treatment; not only for myself, but for my husband and children, family and friends. Next week is Spring Break for my kids and I'll be in the hospital for four days where they are not allowed to come visit me. I believe that this is necessary for my long term well-being and I also believe that I won't really be alone in that room. There is One that never leaves me!