Results of the week 10 Scans

The last 12 hours have been quite tumultuous. Let me start by setting you up to understand what we were hoping for….

Understand that Alex was diagnosed with Embryonal rhabdomyosarcoma (ERMS) in September.

For ref, See:

http://www.cancer.org/Cancer/Rhabdomyosarcoma/DetailedGuide/rhabdomyosarcoma-what-is-rhabdomyosarcoma

The scans – then – found one main tumor just above his bladder, and 4 smaller tumors in his lungs, two in each. The plan – at that time – was to apply chemotherapy, and perform update scans in the 10^th week of the treatment. At that point, the main doctors – the Oncologists – would analyze the scan and recommend 1 of 3 possible paths: (1) Surgically remove the tumor, and apply more chemo thru the next 32 weeks; (2) apply radiation, then remove the tumor, then apply more chemo for 32 weeks, then (3) just apply enhanced radiation and chemo – in the event that it was not safe to remove the tumor. The doctors warned us that option (1) was unlikely, (2) was more possible, and (3) was a real possibility. There was the possibility of some mixing of different sub-options depending the way the tumor responded to the therapy, but these were the main ideas. We dreaded the *VERY* idea of option -3-.

So, our obvious first hope was that the scans in week 10 (last week) would show everything was gone. We didn’t really expect that… so we then hoped that the 4 tumors in the lungs would be gone, and that the primary tumor would shrink a lot (~50%).

What they saw in the scans was 2 of the 4 tumors in the lungs are *GONE*, and that the other 2 are smaller. Not bad! Also, the primary tumor shrank about ~10-15% approximately. While this was not as much as we had hoped, however, the Doctor told us that he saw evidence of NECROSIS – that being the DEATH of the cells in the PRIMARY TUMOR! He also stated that he saw evidence of ENCAPSULATION- he described this as being a being a condition in which the tumor could be removed safely (!!!!!!!). He stressed that he could not guarantee that the primary tumor was totally dead. There could be cells alive in various parts of the mass.

So, the next step is the surgical team. Tomorrow, we have a meeting to consult with the surgeons and see if they feel that the tumor can be removed. So tomorrow is yet another big day. If the tumor can be safely removed, we will have surgery as soon as possibly Monday, December 20^th.

This operation –IF IT HAPPENS- will only remove the primary tumor. They hope that the chemo will destroy the 2 in the lungs. If not, operation on the lungs would occur at a different point in the therapy. The operation will not be simple, also.

On Friday (no matter what), these teams of doctors, from Oncology, Surgery, Radiology, etc. will have a meeting to discuss what the strategy is for Alex. This is called a “tumor board” and we are not allowed to attend, but I’d love to be a fly on the wall for that time. The results of this meeting will be made known to us, and that will be that for the next several weeks, at least.

Several other possibilities exist. What if the surgical team feels that it is not safe to remove the tumor? The next step is radiation. There would be 28 days of high energy Xrays to kill the primary tumor, and a modified chemo routine would start also. Then they would scan again and determine if it can be operated on safely THEN…. There are several ‘mix-n-match’ therapy possibilities here, and I won’t go into detail now, because that’s speculation at this point.

We will let you know when more defined info is known.