We've been quietly living our lives the past few weeks. Quietly waiting to hear from the doctors about a plan for Zaida. I can honestly say, it's been nice not hearing anything. I could pretend everything was fine, forget all my troubles. I don't have any more particularly bad news to report, but Dr. Clark called late this afternoon.
She had been working hard contacting MD Anderson, going back and forth. She was right that they had been waiting until after some big tumor board, a meeting of some kind where I imagine they talk about cases and stuff (I really don't know exactly). That is why it has taken so long to hear back.
Dr. Clark had sent Zaida's last few scans and labs. MD Anderson is "very worried it's tumor." Well, we kind of figured, anyway! They, including the surgeon Dr. Hayes-Jordan, are recommending cryosurgery for the spot on Zaida's liver. This is freezing it with a probe, or "frying" it, she said. It is often used on external cancers, like skin cancer, but can also be used internally. http://www.cancer.gov/cancertopics/factsheet/Therapy/cryosurgery
She also mentioned radio waves, but I don't know what this means. Cryo is less invasive, less risky, but then there would be no tumor tissue for testing. Maybe they are recommending this because there is no need to test it? There aren't any more tests? Dr. Clark doesn't like the idea of cryosurgery for Zaida because there would be no tumor to test and because they wouldn't be able to see if there are any other areas of tumor in her abdomen. One of the problems is Zaida's cancer appears as tiny tumors throughout the abdomen, and start out too small for scans to detect, but they can be seen with the naked eye. Cryosurgery would only target the one tumor on the liver. So far, the signs indicate that the tumor load is very small, so there may only be the one spot, but it would take a surgeon's eyes to know for sure.
The surgeon does NOT want Interventional Radiology to use a needle biopsy because the risk of tracking it on the way out is too high. She can get the tumor surgically and would have to remove a bit of liver, but she's concerned about another huge surgery. I asked Dr. Clark about the problems with repeated surgeries. Is 1 surgery so different from 5 surgeries, for example. She said that there is not necessarily any more risk, but it all boils down to scar tissue. Each surgery produces scar tissue, and the more scar tissue, the harder it is to deal with while removing tumor nodules. I said that the surgeon (after Zaida's last surgery) was extremely surprised at how little scar tissue she had. Dr. Clark said that a kid could have one surgery to remove an appendix, for example, and have lots of scar tissue. Another kid could have 10 surgeries on his lungs and have almost no scar tissue. There is no explanation; everyone is different.
Dr. Clark wants us to get labs done this weekend in Boulder and get in touch with MD Anderson next week. Dr. Clark is going to send some emails and try to get a good contact person at MD Anderson. Unfortunately, a wonderful PA there we've loved and worked with, is leaving (or has left) and we're not sure who to call.
The surgeon Dr. Hayes-Jordan would like us to go down to Houston to sit and talk about the options, then come back in a few weeks to do whatever it is we decide. I said to Dr. Clark that we would love to do this in ONE trip! She is going to push for that, as she knows how hard it is on us with all the traveling.
In case this wasn't enough to think and worry about, there is a BONUS! We've just found out our insurance (with Eric's work) is changing to Anthem Blue Cross on March 1st. Dr. Clark, Presbyterian St. Lukes, and MD Anderson are in-network, thankfully. However, we still have questions (which will hopefully be answered next week). For example, I have no idea what happens if Zaida is in-patient, recovering from surgery (or whatever) on February 28th, and then it's March 1st. I know we're not the first to have this series of events, and it probably will work itself out, but I also know that insurance can be a huge headache. We could choose to wait until after March 1st to do anything, but waiting (especially after waiting over a month already for answers) is not something I want to do!
As always, thanks to everyone for following our story and sending all your love and support. It means the world to us! Also, thanks for reading this far; I know this is a huge post!