Yesterday, Zaida had her routine MRI and blood work in Denver. The initial report was that everything looked great. A couple areas on the liver (artifacts) were gone and all was well. I wish I had more good news. Dr. Clark called me today with bad news. There is a small (suspected) lesion on top of the liver (not *in* the liver), under a rib. It is 14.7 mm by 9.4 mm - pretty small. This combined with the CA-125 result of 41.3 is not a good sign. The CA-125 has been below 30 for a couple years, and for it to pop up is not good. It can come up for other reasons, like infection, irritation in the abdomen, or any other growth in the abdomen. Another blood test will be done next week to be sure, but Dr. Clark is very concerned.
They did not do an MRI of Zaida's chest, as we always do, because the insurance company had just denied coverage for that. The doctor has assured us she will get it covered. So, the plan right now is to do a CT scan of her chest, an MRI of her head, and a re-do of the CA-125 next week. Before anyone panics, the scans are mostly precautionary. We don't expect any problems in the chest or lung area, but there has been a spot on one lung for many years that seemed like scar tissue, and never changes. The scan of her chest is mainly to monitor that. Now, the reason for the brain scan is that Zaida is prone to the occasional migraine (with vomiting and severe pain) every month or two, and a rare ordinary headache. The doctor does not suspect any tumors in the brain as her headaches do not present the way a brain tumor would, and migraines run in families. I get them sometimes and my mom get them sometimes (not sure if anyone else in the family gets them?). I know what a migraine is and I'm pretty sure Zaida got very unlucky with the roll of the migraine dice. We are just being thorough with the brain scan!
Depending on these tests next week, Interventional Radiology might do a needle biopsy of the spot. Then we would know for sure what we are dealing with. Either way, Dr. Clark is going to consult with Zaida's previous MD Anderson doctor, Dr. Anderson (who has moved elsewhere), and with her current MD Anderson doctor (and possibly her MD Anderson surgeon).
The good news is there is no ascites (fluid in the abdomen created by cancer tumors) and the spot is small. If you've been with us on this journey for a while, you might remember the last time Zaida relapsed in early 2012. At that time, her CA-125 popped up to 51 and she had a small pocket of fluid build-up behind her stomach, a sample of which showed an (unexplainable) infection of bacteria and yeast, and a few other abdominal fluid biopsies showed a small number of cancer cells. Chemo, surgery, radiation, chemo, chemo, chemo...
We talked to the girls about it a bit. We told them about the spot and additional scans and blood test, and that she may need surgery again, but we just don't know yet. Zaida seemed concerned, but not really upset. Runa didn't say much. We try to keep it light. We'll talk to them more later, I'm sure.
I spent all afternoon trying to process all this. It is really scary and disheartening, and I am prone to imagine the worst. I really feel like we don't know enough information yet, and so we don't have a complete plan, and not knowing is painful. Bottom line - she probably has cancer again, but we are hoping is just a small relapse, if there is such a thing as "small relapse." We may end up in Houston again for another 14 hour surgery, or we may not. She may get a new treatment, or not. Maybe the universe will spare us and this will turn out to be nothing. Ultimately, we'll deal with it.