So I am back from two days of second opinions from the James in Columbus OH (ranked #20 nationally). I am locally receiving treatment from a center in Dayton.
As they say, you get what you ask for. Now I have some decisions to make- especially with regard to surgical options.
Liver mets:
My highly respected local surgeon wants to go with an aggressive resection and ablatement of my liver, and believes that he can do it in a way that will substantially limit the risk of it coming back.
The highly respected second opinion surgeon does not think it's possible to resect/ablate everything in one surgery, and believes that doing a partial resection and installing an HAI pump is my best chance to rule out recurrence. (note: I know that these have been discontinued, but they still have them in stock at the James).
Potential for Peritoneal Involvement/Spread:
(Background: The general surgeon who did my colon resection removed a single cancerous node from the peritoneum that may just be something that dropped from the colon. He says that he didn't see anything else, but nobody- including myself- is relying on this since this same joker confidently wrote off my liver metastasis as a hemangioma when there was clear evidence at the time to support otherwise.)
Local surgeon says that while he is in there he will take a look at my peritoneum and if he sees anything lay down a HIPEC application on the spot.
Second opinion surgeon wants to rule out peritoneal involvement before surgery. First with an MRI focused solely on the peritoneum, and then laparoscopically. If there is involvement, she can lay down HIPEC, but the HAI pump is not an option.
I love the simple, aggressive approach of the local surgeon. However, with the second opinion I am now afraid that it might be too aggressive or overly confident, and I am afraid of risk of it coming back. On the other hand I also worry that defaulting to the HAI pump is more of a "treat this like a chronic disease" versus a "cure" mentality. I am 40 and am not quite ready to give up on an approach that could potentially cure me and allow me to grow old and retire one day. Getting to 50 with a pump would be amazing, but I don't want to go down a road now that could limit my chances for cure long-term.
For those of you that have experience with either of these approaches, do you have any thoughts?