Basically they are treating this like a debulking procedure, done with the probes under a CT scan rather than opening him up for a conventional surgery because Doc L does not have a good approach. Doc T thinks the optimum result they could achieve would be 50% and that Alan's case is very close to a situation where the risks could outweigh the potential benefit. The tumor is large for this kind of procedure and they will have to work around the post-surgical scaring from his hemipelvectomy. She wasn't sure what good she could do for Alan since all the restrictions mean she won't be able to get any margins. We appreciated her candor, but honestly we don't have a lot of options. We need to do something to buy time while Doc P and Doc H2 try to find another treatment. We hope this procedure will at least slow down if not stop the tumor from growing, at least for a while. Ideally once the body starts reabsorbing the dead cells perhaps the tumor will collapse away from the vital organs. Doc T did say that cryoablation is a procedure that can repeated if needed. It's a very long shot but one that we can pray for.
The way she described the procedure, they will be inserting multiple probes into the tumor with the guidance of the CT scanner. Once they are all in place she will start the freezing, and each probe will create a 3 cm pocket of ice. She will be able to see right away which parts of the tumor have been frozen. Because she is concerned with the nerve root, she will have neurologists place monitors on Alan's head and legs. They will periodically check on his nerve function as they proceed. Between this and the general anesthesia, the procedure will take two to three hours.
Alan will come out of the procedure looking like he has multiple paper cuts at the probe insertion sites. They will be bandaged and kept dry for the next day but after that he can bathe as normal. Doc T said her adult patients felt some pain at the probe sites initially but that soon went away. By the next day they are more than ready to be discharged so we hope Alan will be able to bounce back just as quickly.
Doc T was concerned about the low ANC Alan had during his last blood draw at MD Anderson so she added a CBC to his blood draw today, just to be safe. Then it was off to the Children's Clinic where Alan was hoping to be able to paint again. Unfortunately, there wasn't anyone from Child Life there so he had to be content with the Etch-A-Sketch. He earned a couple of SpongeBob stickers for doing his vitals, then when it was his turn to have his blood drawn, Child Life came by and got him some Play-Doh as a distraction. Then it was off to the toy box for his prize before going on to Anesthesia Assessment.
Alan had a great time smooshing the Play-Doh around while we waited to be seen. The assessment went quickly but in the mean time we got a message from the Children's Clinic - the lab had a problem and we had to bring Alan back to the Clinic for another blood draw. Alan wasn't happy about going back in, especially since there still wasn't anyone to let him paint. At least he was allowed to make a second trip to the toy box after the blood draw.
Since we had some time before catching the later shuttle back to the Ronald McDonald House, Alan got to spend 20 minutes going up and down the escalators in the Aquarium Lobby, much to the amusement of his fellow patients and passers-by. It was a full day, but we are ready for tomorrow!
Alan taking a ride on the luggage cart after arriving at the RMH yesterday
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