It turns out what we had hoped was only scar tissue, wasn't even scar tissue at all. It was all cancer. This means the chemo was ineffective against the cancer. Which also means there's pretty much guaranteed to be more cancer other places inside of Karen; we just haven't noticed it yet. Which also means cancer is not likely something she will overcome. The doctor said to think of it as a chronic disease you live with, like high blood pressure or diabetes.
It appears to be a slow growing cancer, so that should give us more time than a faster growing cancer would, but no one can yet say how long. The doctor explained that the first one to three years will be the biggest indicator on how fast things will progress. If things are going to go bad quickly, then it should become apparent during this time. If we make it past those first three years or so without the cancer popping up anywhere important, then another five wouldn't be unreasonable.
During the surgery all the cancer from the site on the left was removed, but some from the site on the right was intentionally left behind due to the proximity of the tumor to the stoma. The doctors performing the surgery decided that it was more important to protect the integrity of the stoma than it was to remove the rest of the tumor. It's horrible to think that cancer was intentionally left in you because taking it out would cause more pain and suffering than removing it would. That's how sure they are that there's more cancer. The doctor said when it does become painful or cause problems with the stoma, he will do another surgery to remove that tumor and any others that have shown up on scans by then.
It was suggested that Karen start maintenance chemo in four to six weeks, once she's fully recovered from the surgery. But we'll know more after we've seen the oncologist. There's not much of a rush to see him because they want Karen to recover from the surgery first before starting with anything else anyway. The goal of maintenance chemo would be to have enough chemo in you to slow the growth of the cancer, but not enough to give you side effects that affect your quality of life.
Karen's not one to give up, and seems to be willing to give full strength chemo another go, even with as much as she hated it the first time. But the doctor we spoke to today didn't seem convinced it would be any more effective a second time, even if we changed things up. This will be something we talk to the oncologist about on our next visit. For now we're just going to stay as positive as we can.
