N.E.D.!!!

N. E. D.

Three simple little letters that mean so much.

No Evidence of Disease!

E. and I both came to Texas with good feelings. I was confident the news would be good. Yet, I had that little nagging of self-doubt in the back of my head. What if the news was bad? Would it be that much worse since I had convinced myself it was going to be good? Thankfully, I don't have to worry about that right now. It is all good.

E. had his labs on Sunday, his PET/CT scan on Monday and his Endoscopic Ultrasound on Tuesday. Today, we met with the doctor to go over the results.

• Labs

Look good. Everything was well within the normal limits. Matter of fact, E.'s blood sugar was the best it has been in a long time.

• Endoscopic Ultrasound

One little hiccup in the test was that E. still had undigested food in his stomach. He was given instructions not to eat for six hours prior to the procedure, but we knew that last time, six hours wasn't enough. Therefore, E. didn't have anything by mouth for twelve hours prior to the procedure and his last meal was easily digested Chinese food. It obviously still wasn't sufficient. Aside from the food blocking part of the view of the stomach, everything looked good. It was a completely NORMAL EGD (Esophagogastroduodenoscopy . . . say that three times). Multiple biopsies were taken as part of the procedure, but those results won't be available for a few more days, or possibly a week.

• PET/CT Scan

Nothing "lit up" on the scans. No pesky little glowing areas. According to the report, "There are no sites of abnormal radiotracer uptake along the length of the esophagus to suggest recurrent or metastatic esophageal carcinoma." Basically, E.'s cancer hasn't come back in the esophagus and it hasn't spread to other areas. You can't ask for anything better than that!

What now?

Right now, we're still in the "wait and see" mode. As you may recall, the surgeon had originally said that if E. could maintain a "period of stability" for approximately six months, he would offer him surgery. That is still the current plan. We will return for another PET/CT scan in 3 to 4 months and if E. is still N.E.D. at that time, it sounds like surgery would be offered.

Dr. M. explained that if E. continues to have no evidence of disease, he will have two options: 1. surgery or 2. "watch and see." The doctor stated that surgery offered to a Stage IV patient is really "outside of the box" as most surgeons and hospitals would never offer it. Timing is important, especially for Stage IV patients, he explained. If a patient has the surgery only to have metastatic cancer months later, the surgery was really a waste of time and effort. Yet, he also stated that he has never regretted performing surgery on a Stage IV patient when the right circumstances presented themselves. He seemed optimistic that E. was going to present "the right circumstances."

Surgery is not for everyone though. It is a MAJOR surgery that has lifelong implications. Quality of life can be affected. Dr. M. stated that it really is an individual decision. Without surgery, in all likelihood, the cancer would come back. But with surgery, the cancer could come back anyway. As Dr. M. said, we'll all think about it and cross that bridge when we get there.

In the meantime, continue loving and living life.

Which we fully intend on doing!

S.