MD Anderson testing day #1

On our way to Houston yesterday, we got a phone call, letting us know that Alan's biopsy was scheduled for Thursday. The schedule we saw was not for the biopsy but for the blood draw and IV. Later that afternoon, as we arrived in Houston, we got another call saying that a CT scan had been scheduled for Wednesday morning after the blood draw and anesthesia assessment, before our appointment with Doc H2, the pediatric oncologist at MD Anderson. We also had a quick conversation with Interventional Radiology, the department taking care of Alan's biopsy on Thursday, where we were told they prefer we stay in the area 24 hours after a procedure. So we left home expecting a quick overnight trip and it has stretched into a three-day stay.

This morning Alan had the blood draw and chest CT. The blood draw went smoothly for once as did the anesthesia assessment for tomorrow's biopsy. The CT was delayed while waiting on paperwork from Doc H2, but it was completed just in time for us to grab a quick lunch then go up to the Children's Clinic for our appointment.

Doc H2 is working on the assumption that the mass in last week's MRI is another recurrence in the tumor. Undifferentiated sarcomas in the abdomen are difficult to deal with as there is not a lot of data on the biology of them. They use treatments based on other sarcomas (particularly rhadomyosarcomas) but there's just no to way to predict how it will react. He will be requesting a detailed record of Alan's (extensive) chemo treatments from Doc P in order to formulate a new plan. Alan is up against some hard limits using Doxorubicin (one of the reasons for the chest CT) and he did not react well to the Ifosfamide and Etoposide last year. Doc H2 has an alternative in mind, one that Doc P could administer on an outpatient basis in his office.

Further plans would depend on how well the tumor responds to the new chemo regimen. Another surgical resection of course, and because this is a repeated recurrence, we will now be seriously be considering radiation therapy, despite the risks to bone growth, secondary tumors and fertility. We can only hope that he is a candidate for Proton Therapy, but that is dictated by the physics of the situation. Dr. Huh will schedule another MRI after two rounds of chemo then continue to refine the plan from there. In the meantime, we will see him and Doc L next Wednesday after they've had a chance to see the preliminary biopsy results.

Detailed results will take at least at least 7 days, but the preliminary results can at least tell us if we're dealing with malignant cells, rather than the infection that Doc L posited last week. There's no hiding from the fact that if the tumor is aggressive enough to break through while he's undergoing chemotherapy we will have quite a fight on our hands. There's still room for hope though, and we are clinging to that possibility fiercely.


Fun with Play-Doh while waiting to see Doc H2