Well, at least the surgery we were planning on is off again. It looks like there may be a different kind of surgery in E.'s future instead.
He staffed E.'s case with the Multi-Disciplinary Team this morning, which is essentially getting a consultation with 40 different practitioners in the cancer arena. All biopsies were "free of tumor," which is GREAT news. Rather than do the esophagectomy surgery though, the recommendation was to do a "dissection of the right supraclavicular node."
What that means is that they want to remove that once-positive lymph node in the right shoulder area and dissect it to make sure there is no more cancer. Even though that lymph node has decreased in size and was no longer "hot" on the PET/CT scan, there is still a chance that there could be microscopic cancer there.
The Team couldn't decide if surgery would be the best option in E.'s case. While they were impressed with E.'s amazing response to treatment, I'm assuming the fact remains that the scientific data is simply lacking. It was reiterated several times that right now, E. is cancer free. The question for the doctors remains, "How are we going to keep you cancer free?" The general consensus from the Team was to "WATCH" E. with regular PET/CT scans for any possible recurrence.
If that effin (yes, this lymph node is worthy of the f word with a capital F) lymph node tests negative, that would be the plan . . . regular PET/CT scans. If for some reason it tests positive, E. could receive radiation specifically targeted to that lymph node.
As it was explained to us previously, if there is a local recurrence in the future, an esophagectomy could be performed at that time. Likewise, if there is a distal recurrence, surgery would never be an option.
While a bit discouraged initially, we are shifting gears and look at these changes with a positive attitude. This surgery will be minor in compared to what we were expecting, with a much shorter stay in Texas and a MUCH SHORTER recovery. It's all good.
S.
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