2 biopsy's result

Yesterday I learned from Dr. Feldman at Group Health that the 2 biopsy's performed on Thursday resulted as cancerous. The bone biopsy in the left hip region is a fairly small area that can not be removed. It will have to be monitored for growth along with the tumors in the liver and hopefully the Octreotide (SAA LAR 30) injected every 28 days will keep the bone area from growing or spreading.

The thyroid tissue from the biopsy has been sent to a lab outside of GH for review. GH could not determine what type of cancer it was or if it is related to the NET/ Neuroendocrine Islet cell Carcinoma that has metastasized into the liver and bone. The lab will tell us the calcitonan level. If it is calcitonan positive we can do a para thyroid hormone test (24 hour urine collection with food restrictions).  It could be Pheocytochroatoma a type of thyroid cancer. We'll have to wait until Thur when results come back from the lab to see if it is a kind of cancer that causes high blood pressure in surgeries. If so we'll alert the anaesthesiologist in Portland. The thyroid can be removed but the surgery of the liver would come first, then of the pancreas potentially if that is determined to be the primary (separate surgery after I've recovered from the liver surgery). Then a third surgery could be removal of the thyroid. We haven't gotten that far and I haven't done research on my own around any of this new information.

Dr Feldman thinks I have worsening metastases, that the tumors are growing and that we should consider moving onto another treatment type. These would have quality of life issues associated with them.

Thankfully, I met with Dr. Bach at Cancer Care Alliance (SCCA) later in the day. We believe that the MRI and CT scan that showed no liver growth were accurate and that the Octreotide scan that showed tumor progression is not a good scan to measure tumor growth. There are too many variable factors. My Cromogranin levels are staying ok, another sign it isn't worsening. Feldman and GH tend to  think surgery in my case is still very controversial because the gold star of approval from a double blind clinical trial has yet to occur in the US. Woltering and Pommier agree on the same plan and Dr. Bach concurs.

Dr. Feldman sent the referral through to GH customer and financial services for the surgery last week. I'll be talking on the phone with them tomorrow about progress they've made and a timeline for a decision since 6/28 is only 17 days away.

On a happier note I got to help deliver my first granddaughter on Friday night. When my daughter in law called to say her water broke, we rushed over and I helped deliver the baby 35 minutes later. I saw her take her first breath and open her eyes for the first time. She is beautiful and the whole family is doing well.