Ilkka Sinisalo
Amazing American
In an effort to portray this situation in an accurate manner, I have simply been giving out information.
Those other posters offered anecdotes which will make anyone upset, and rightfully so. I wish all of those posters the best in dealing with their respective grief. However, reality is ES has a survival rate of 80-90% with the 5 drug regimen I outlined earlier coupled with a 60-70% 5 year event-free survival rate. These are relatively (very) good numbers. Notice my wording- "odds are chemo will work". That is because, indeed, the odds are in Oskar's favor right now. This does NOT mean it's a guarantee. As with all forms of cancer, like you mentioned, being in better shape at baseline is good. Less comorbidities is never a bad thing and can only help your odds.
Your fiancee, though undoubtedly bright, is wrong. Amputation is only considered in "select cases" per the NCCN guidelines for refractory (read also: non-responsive or partial response to IV chemotherapy) disease in the large bones (femur, pelvis, etc). I believe Oskar was having shoulder issues. If this is the site of his disease, which is a reasonable conclusion, this is a more distal and not large bone, increasing his chances of good outcomes. Issues arise if this is not the site of his disease, meaning it has metastasized. I personally believe this is not the case as he is under the keen eye of doctors every single day.
After his chemo he will get imaging done on his lesions. If lesions still remain and local control is warranted it can easily be done with simple excision and extraction (cut em out) with or without more chemo +/- radiation.
Again, I am not downplaying the seriousness of a serious situation. I just want people to be realistically aware of logistics. Fear mongering is not what needs to happen right now, nor is blissful ignorance.
DancingPanther, PharmD (with the help of DancingPanther'sFriend, PharmD, BCOP)
Thanks for the info. She is an ear nose and throat surgeon sub-specialising in head and neck cancer. It sounds like your mate is more of an expert whereas she probably knows mostly what she has learned in the textbooks (side note, I constantly ask her about medical issues because I’m no longer shocked at how much she knows about general medicine, not just head/neck surgery. I think she knows more about medicine than I know about everything in the world combined).
She had a patient last year who was an (Aussie rules) football player and had moved to Perth from near Melbourne. He was early to mid 20s, very fit, lived a healthy lifestyle. When he came in she ended up finding cancer in his nasal passage that was so advanced it was inoperable. It was to the point where it looked like he would not even be able to fly home to die near his friends and family, because of the likelihood that he would die on the flight. Fortunately he ended up being able to fly.
Those are the stories that really stay with me. A guy with his whole life ahead of him who walked into the doctor’s office feeling unwell and found out he would die within a month. Or a close friend of mine who was killed when a car crossed the median and hit his car head on. It can happen to anybody in the blink of an eye, with nothing to blame but bad luck. Fingers crossed that Oskar can come through this with a long life ahead of him.