Hopes vs Risks

We went to the oncologist Thursday and she helped us understand the pathology/post surgery report and to put together a plan. When the surgeon took out the tumor, he also took out a lot of surrounding tissue. He said Glenn's tumor was fairly large. They took out 3/4 of his esophagus and 1/4 of his stomach. The pathology report has indicated that there were cancer cells in the margins of that tissue, as well as in some lymph nodes. He removed three that looked suspicious.

"Margins" is a term I had never heard before. My friend, whose husband is a Doctor and who had a tumor removed the same day that Glenn did offered this concise definition:

"When surgeons remove a cancer tumor, they always take out tissue beyond the tumor. That tissue is then examined for escaped cancer cells--those that have broken off the tumor to go roaming around creating new sites. When the margins are clear that means no other cancer cells were found in the surrounding area. Cancer in the margins means that escaped cancer cells have been found in adjoining tissue. In my case they would have gone back and made the excision bigger. In Glenn's case they can only take so much of his organs--plus they don't know if the escapees have already lodged in some other area. Stupid, blasted cancer cells!!!!! A pox on them!"

So that is what is going on. The pathology report could not say if the cancer cells in the margins and lymph nodes are alive and active or if they are dead. UGH!

At our oncologist, yesterday morning and she presented two options for Glenn. First of all, Glenn's body tolerated chemo, radiation and surgery well. He needs time to build up his strength, but he is really doing well. All the doctors who see him can't get over how good he looks, I agree, but I am prejudiced. The two plans presented are:

1. Since we don't know whether there are live cancer cells in his body, nothing showed up on the PET/CT scan in December. We can just wait and watch, and see if the cancer returns. He is a HIGH risk for the cancer returning.
   
2. Since he tolerated the treatments so well, he is a candidate to get more chemo. It will be a different chemo this time. We can wait three weeks, while he recovers. They will do infusions one day and have a pack that will automatically dispense chemo while strapped to him, for two days. They will do that every two weeks for three months.

If you know anything about cancer, and we all do, you know that the doctor can't promise that this will work. She is very hopeful that it will, but couched that phrase with, "it is not a small risk that the cancer can come back. If it comes back, it will be in other organs, such as liver and lungs, or lymph nodes.

She has ordered more tests on the tissue to see if there are abnormal proteins in the cells. If there are, she will add an antibody that has been very successful in treating breast cancer and has recently been discovered to help in esophageal cancer.

The risk after this proposed treatment of the three months of the new chemo, is still high that it could come back. That is where the faith and hope comes in. I have to say, that I am very thankful that his body is strong and that there is hope that this treatment will work. We still feel like we need to process this to know if that is what he is going to do.

We are praying that we can lick any rogue cancer cells IF they are out there. We also have been so thankful for your faith and prayers and would be grateful if you would continue to pray for us that we will know exactly what to do!