There are two word pictures, which have surfaced in these days of waiting between possible treatments:
The first has to do with “critical mass.” This is the concentration of radioactive material necessary for sustaining a nuclear reaction.
The second, the timing and circumstances of “The Perfect Storm.”
We are presently in a waiting period, which is accompanied by two large tumors, each of which are large enough and aggressive enough to constitute a “critical mass.” Such that either one of them once triggered is not manageable once a metastatic reaction takes place. Both are too big to be controllable with known protocols, and doubtful even with experimental protocols. For this reason we are on hold where surgical solutions are concerned, because surgery would act as the trigger for whatever cancer is not removed.
During this holding period we are looking into protocols, even those already used, to reduce either the size or the reactivity of any cancer that might be left in the wake of a surgical solution. It is just here that the perfect storm comes into the picture. In our case the perfect storm is where one of the two tumors is headed.
This is the lower abdominal tumor, which is headed for the nerve bundle at the base of my spine. It is not yet clear how close we are to entering this point of no help and no return. It is not yet clear how much time we have to find a way of reducing the overall reactivity of the cancer that remains in my body, but that is what has us on hold. Time is not on our side unless we can find a protocol, which works to reduce this reactivity.
Once we discover and are on that protocol for sufficient time to reduce reactivity, it might be safe to operate. If that should prove to be beyond reach then it will mean there is no longer any turning back from the perfect storm. Once the storm hits, it will be all over, because that storm contains, among other things, the inability to treat the pain any longer.
Just short of entering that storm, there will be nothing left but to go for the surgery, before the storm hits, in the hope that the surgeons will be able to reduce the critical mass to the point where an immunotherapy will be able to clean up any residual reactivity that might be left behind. As of now that appears to all the experts to be a very thin possibility.
As for time before the storm, it is difficult to say. It could be weeks or perhaps a month or two, depending on growth rate of the cancer in the wake of the, as yet, undetermined chemo protocol.