The Unwinding of the Miracle - Julie Yip-Williams Page 0,97

so from the inside and that it is likely cancer. She said if my metastases were isolated to the ovaries, it would be an easy and obvious choice to do surgery, but since I already had lung metastases, it didn’t make sense to remove the ovary, unless of course I found the pain intolerable, in which case she would happily go in and remove that ovary and probably the other one, too. At that point, I didn’t think I had enough pain to justify surgery, but even so, after considering her statements for several minutes, I disagreed.

I went to see Dr. A.C. immediately afterward. I recounted Dr. B.’s conclusions and then said, “I don’t agree. I think this surgery could be an opportunity.”

“Exactly!” he proclaimed before I had a chance to elaborate.

It gratified me greatly to discover again that Dr. A.C. and I think similarly. He and I both view the probably cancerous tissue in my ovary—we won’t know for sure until the ovary is removed and the tissue biopsied—to be valuable. It can be used to update the genetic testing that I’d had done on my primary tumor, the bulk of which still sits frozen at UCLA. I needed to have the surgery as soon as possible so I could be back on treatment that much earlier to slow the growth of the lung nodules. I had also decided to spend my own money and have the live cancer cells implanted in immune-suppressed mice. Assuming the implantation was successful, we would then select the drugs to test on my mice to determine whether those drugs might have any cancer-killing effects when directed at my genetically unique cancer. A courier would be waiting outside the operating room to receive the tissue and drive it to New Jersey, where the lab and mice are. The scientists would implant the mice that night or early the next morning.

There’s also the possibility that further chemotherapy will have no impact on my ovaries. It is more likely not to work well in that area, just like on the peritoneum. I don’t want the things to get any larger and cause me additional pain, at which point, in order to have surgery, I would have to take at least four weeks off treatment. Surgery seems meant to be now, since I’ve already been off treatment for four weeks. The window of opportunity is open; I must take advantage of that. Furthermore, I can’t help but rationally conclude that it’s better to remove whatever cancer one can in order to extend life, particularly when the surgery is low risk and not that invasive.

Although the window of opportunity is open, it is closing fast. I’m convinced that the cancer will spread to my brain next. While we are dealing with my ovaries, the lung mets are growing. Dr. A.C. told me that the probability of the cancer going to my brain is very low. My response: “The probability of the cancer going to my ovaries was low. The probability of it skipping my liver and going to my lungs was relatively low. The probability of me even getting colon cancer at age thirty-seven was low. So I don’t fucking care about probabilities. They don’t apply to me. So get the surgery scheduled for me ASAP.” Yes, this is how I sometimes talk to my oncologist, who takes it all in stride.

It took a couple days of me exchanging late-night texts with Dr. A.C. and bugging him on his cellphone because of Dr. B.’s lack of response, but we finally scheduled the surgery. It will be a laparoscopic bilateral oophorectomy, which in the best-case scenario will take an hour, assuming minimal scar tissue from prior surgeries. Also depending on the amount of scar tissue, Dr. B. will be able to take a look around and see if I have disease on my peritoneum, and then depending on the extent of disease, she will try to remove whatever cancer she sees if she can do so quickly. I will be able to restart treatment a week later.

I made the decision to have surgery within minutes; I had already considered this scenario during the week I waited to see Dr. B. I had already evaluated, processed, and plotted this next step. Plus, I’m by nature a quick decision maker, even when it comes to big, life-changing decisions. I’ve always trusted my instincts, the seeming signals the universe would send to me. It was no different here. Josh was taken