“Deny, deny and deny” was my first reaction. Who would ever think that a simple surgery to remove a 12.5 cm x 8.6 cm retroperitoneal cystic non-enhancing mass in 2004 would turn out to be a one in a million rare form of cancer baffling to surgeons and oncologists in Manila and New York? Since the cancer was encapsulated in the center of the mass and had no stems to speak of, I was not given chemotherapy or radiation. After subsequent Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) scans, and eventually two video-conferences arranged by Dr. Ana York-Bondoc for a second opinion from Sloan Kettering Memorial Center in New York did we learn that the psudomyxoma peritonei possibly came from my appendix that had burst 26 years earlier, but was removed only after a week of my being asymptomatic.
In 2006, I was devastated to learn that the cancer had transferred to my omentum and it was considered stage 4. My heart-rending conclusion “I am going to die soon” was dispelled when my oncologist explained stage 4 could also mean the cancer had transferred to another location and not necessarily a time to say poignant goodbyes.
After another surgery, my oncologists and surgeon in Manila informed me they could do no more to help me control my cancer as my adhesions from previous operations for ovarian cysts, appendectomy and hysterectomy would make future surgical procedures very dangerous that may damage other vital organs.
Sloan Kettering suggested we check out the website of a well-known surgeon in a hospital in Washington, D.C. who specialized in psudomyxoma peritonei. We learned that the procedure would be “a meticulous cytoreductive surgery prior to the intraperitoneal chemotherapy instillation in order to reduce the tumor burden to its lowest level. Chemotherapy begins in the operating room and may be continued for the first five postoperative days. Only patients with minute-sized intraperitoneal tumor nodules with limited distribution within the abdomen and pelvis are likely to show prolonged benefit.” Sloan Kettering further stated that “Aggressive intraperitoneal chemotherapy treatments directed at large nodules of invasive intraperitoneal cancer will not produce long-term benefits, and are often the cause of excessive morbidity or mortality.
“Occasionally, patients with low-grade malignancies such as psudomyxoma peritonei survived for several years, but all end-result reports have shown fatal outcomes.”
It was time to bombard heaven with prayers, particularly Our Lady of Lourdes, Guadalupe and Manaoag, and hope for the best. My brother in San Francisco contacted Dr. Harry Oberhelman, head of the International Medical Services of Stanford Hospital and the latter arranged a consultation with the Gastrointestinal Board, made up of eight members from the medical, radiation, pathology and surgical oncology, and one from general surgery.
They said they could do a general debulking surgery without significant complication. If surgery is not possible due to adhesions, they would recommend a systemic chemotherapy treatment over intraperitoneal, if and when the time came. I was advised to return after six months for more tests.
Meanwhile, my husband Mike and I transferred to Honolulu to be near our two daughters and Stanford. We drastically changed into a less stressful lifestyle and concentrated our efforts to do more exercises. I did—and still do—the stairwalker, elliptical and bicycle in the gym daily and so far, my cancer markers have gone down.
My mother, still healthy at 92, perpetually warned me that I was digging my grave with my spoon from eating all the lechon, oxtail kare-kare, pinapaitan, etc. that we Filipinos love. Now, and for the past two and a half years, I have been on a diet of fish, vegetables and fruits. I avoid sugar and white flour and successfully eliminated coffee and sodas from my diet (except for an occasional indulgence of a mocha frapuccino from Starbucks). The best advice came from my nutritionist who told me to take two tablespoons of flakseed oil with cottage cheese daily, drink wheat grass with carrot juice.
Although my cancer markers have remained low, and my visits to Stanford are now down to an annual basis, my CT scan results last September showed “the disease appears to be stable to slightly worse.” Stanford recommends a continuation of the “watchful waiting” unless the signs and symptoms suggest a worsening of the disease. I have a ticking time bomb in my body, but with God’s help, I pray, I can defuse it.
(Edna Reynoso Anton, 66, used to write a weekly lifestyle column in Sun Star Baguio and had contributed to Inquirer’s Élan section. While fighting cancer, she’s in Hawaii writing a restaurant 101 book in collaboration with her niece, Rosanna Gonzalez.)
