Risks and Scenario Planning

The amazing thing about my poor burned arm is that, actually, as disgusting as it looks, all the blistering and peeling suggests I've begun to heal from the radiation treatment.  I guess what I didn't realize when I was told that my arm would get worse (after the treatment ended) before it got better is that this didn't just mean it would be more painful/swollen/red (indicating I had reached maximum dose, and active cell destruction, with maximum white blood cells dispatched to fight the killing), but that it would have to go through this blister/peel phase that would make people avert their glances.  I'm assuming that by the time my mom shows up a week from Friday, it's going to look like no big deal -- as it did two weeks ago.

I saw my internist yesterday (at a funeral service for one of Ben's schoolmates' mom's -- which is a tragic and shocking, but different story).  She said the radiation had probably killed all of the cancer cells left after the last surgery.  Which leads to the obvious question:  If the radiation "cured" me, why have another surgery -- especially one that will result in some level of permanent disability? 

On the one hand, if the radiation killed all the cancer cells, then it would seem that I've had enough, successful "treatment."  On the other hand, there's all the scary information (which some, like Sue Levy, say I shouldn't be reading in the 1st place) about wound complications, trickiness of reconstruction and levels of permanent disability from a surgery in the forearm where there isn't a ton of tissue, but the surgeon still needs to take a safe, i.e., wide, margin around a sarcoma.  And, there's the data on soft tissue sarcomas still resulting in a high level of amputations, because, to me, 15% is high, even though it's down from 70% two generations ago.  Finally, there's the pathology report which says (confirmed by literature) that the risk of this kind of soft tissue sarcoma metastasizing is quite low.

With all of these factors, how do we (me & my family, notably Bill) weigh surgery, with its certainty of some disability and a small, but still real risk of recurrence, against the slightly less small risk that there's cancer left in my body that will now start to regrow.  The medical literature and traditional Western providers are in complete agreement that doing the 2nd surgery is a no-brainer.  But if there's no sarcoma cells left, and they were of a type that is highly unlikely to metastasize (and kill me), then why not wait to see if the cancer returns, in which case I could have surgery then, and not commit to some level of permanent disability for the next 40 years? 

Nobody freak out -- I'm not suggesting that I'm abandoning the current plan.  Maybe it's having spent the last two days considering lots of scenarios with my colleagues in a work context -- something we do all the time.  We're always pushing and engaged in scenario planning.  So aren't there a couple scenarios here?  Is there a risk that's small enough that would change the calculation?