Через неделю новый 2018 год, а у меня колоректальный рак 4 стадии с множественными метастазами в печени во всех сегментах и опухоль в кишке, которая может привести к кишечной непроходимости.
Начали поднимать всевозможные связи. С учетом неработающих мед. заведений в России, прорабатывать вариант с Израилем, чтобы улететь туда и начать лечение как можно раньше. Каждый день были консультации с хирургами, онкологами, проктологами и химиотерапевтами из ведущих клиник Москвы.
И это было множество вариантов и тактик. «Спасение утопающих дело рук самих утопающих». Выбор врача и правильной тактики ложился на меня, человека без медицинского образования. Огромной поддержкой в этой ситуации была моя жена — врач (офтальмолог).
Итак, у нас были следующие варианты:
1. Операция на кишечнике на первом этапе. Далее химиотерапия и операция на печени.
2. Химиотерапия. Далее операция на кишечнике и печени. Причем порядок мог быть разный, а можно вообще сделать одномоментно. План в том, чтобы уменьшить метастазы и опухоль, а уже после оперировать.
Все это затруднялось тем, что впереди нерабочие две недели.
К первому варианту склонял небольшой размер просвета и опасность кишечной непроходимости, которая могла бы привести к неплановой операции и непредсказуемым результатам с учетом праздников.
В 62 больнице нас записали на резекцию кишечника сразу после праздников. Но ждать 3 недели совсем не хотелось. Чувствовал я себя хуже: каждый вечер температура 37,5, был бледный, как смерть, терял аппетит и вес. А самое неприятное, что я чувствовал, как время просто утекает. Это была настоящая гонка за жизнь. И сама неопределенность времени начала лечения очень нервировала.
В одной платной клинике готовы были прооперировать 29 декабря, но это было немного страшно, так как оставаться в больнице на новый год с риском осложнений, на мой взгляд, рискованно.
Так получалось, что хирурги советовали оперировать, химиотерапевты — начинать химию. Склонить весы к оптимальному решению помогли хирурги из ГНЦК и Института хирургии им. Вишневского.
Выбор был и относительно химиотерапевтической схемы.
Моя печень в тот момент была неоперабельна либо потенциально операбельна. Она была вся усыпана метастазами. Крупными (до 7 см) и во всех сегментах. И некоторые химиотерапевты предлагали по сути тактику “потянуть время”. Начать с одной схемы, потом перейти на другую. Без каких-то перспектив на радикальный выход из ситуации.
Я благодарен судьбе, что она свела меня с одним из лучших химиотерапевтов по моему типу рака из РОНЦ им Блохина. Он назначил мне максимально агрессивную схему лечения в первой линии (FOLFOXIRI), где сочетались два препарата, которые обычно назначают по очереди (с учетом моего возраста и сил перенести это лечение). Ставка была сделана на то, чтобы попробовать перевести печень в статус операбельной (то есть получить максимальный ответ на лечение и как можно скорее).
Чтобы начать максимально быстро, я выбрал одну платную клинику, которая готова была прокапать меня уже 3 января. А 28 декабря мне там поставили центральный венозный порт. Причем все онкологическое лечение в этой клинике можно было получить совершенно бесплатно (по ОМС).
Начало истории «Как я узнал, что у меня рак 4 стадии« (часть 1) здесь
Продолжение следует…
В качестве небольшого вывода:
Так складывается, что часто разные специалисты имеют разные мнения, а выбирать по сути приходится пациенту, которые не имеют медицинского образования. Очень важно, чтобы врачи обосновывали свои точки зрения. А пациенту обязательно надо вникать во все детали. Будьте проактивными, читайте, задавайте вопросы. Ваша судьба в ваших руках. Не стоит перекладывать ответственность за свое здоровье на кого-то еще. Важно осознанно подходить к делу, вникать в суть и общаться с врачом на одном языке.
Молодец что открыто начал говорить на эту тему. Я и моя семья столкнулись с этой проблемой в начале 2018 года. В марте 2018 года меня прооперировали в институте Вишневского. Низкий поклон замечательному хирургу Козлову Илье Анатольевичу. Я прошла курс лучевой терапии и пропила 5 курсов капецитабина. Всеми силами старалась совмещать лечение с работой. Спасибо, что руководство пошло на встречу и полгода лечения я работала удаленно.
Это был стресс для моей семьи. Спасибо моим близким за поддержку.
Конечно, диагноз рак меняет жизнь. Но — счастье что она продолжается и на твоем пути встречаются люди, которые тебя поддерживают и помогают.
Грамотное ведение канала
как ФИО замечательного химиотерапевта?
Держитесь! Я с 17 года борюсь, 3я стадия. Работаю, когда в состояние встать после химий.Дай бог здоровья коллегам, терпят! Воронежский заповедник. Вам терпения, оптимизма, достич стойкой ремиссии!
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