We met with G's oncologists again today to talk about the biopsies they took last week. I had a feeling we weren't going to hear what we hoped to hear and I was right. The last biopsies they took 3 months ago showed little to no immature cancer cells. The cells they harvested were mature or maturing cells. This time they found cancer cells in the biopsies. The most likely cause for this is sampling error. Last time they drew the biopsies from parts of the area that did not have cancer cells even though they existed and this time they drew from the area where the cancer was. If that is the case, we will just continue on and hope that in the next twelve weeks the chemo will finish it's job and there will be no more abnormal tissue to biopsy. If is in fact coming back and the biopsies were representative of reality, we are in for a little more than we initially thought. Dr. Marina is contacting the chairman of the Childrens Oncology Group in Seattle to find out what the research shows people are using to fight rhabdomyosarcomas that are resistant to initial therapy. I sincerely do not believe that this is the case. When we put the whole picture together, the fact that the primary tumor is gone and the secondary tumor in her lymph node is 51% smaller than it was three months ago indicates that the chemo is working and we are beating this thing. There are just no other options. We fight on.
I thought I'd add to Adam's post to explain what I heard in our meeting. The results of the pathology report is just one small piece of the big puzzle. I was always taught in medicine to look at the big picture...the patient and they will guide the treatment, recovery, etc. Gabriella is doing amazingly well, despite the three drug chemo which she bounces back from every time. Granted it is taking longer for her to recover and her body is getting more tired but she is still bouncing back. As our doctors told us in the meeting, sometimes obtaining more information is not the best option. The placement of G's original tumor IS easily accessible VS. other children's tumors which are normally NOT biopsied at this stage of the treatment. They are mostly biopsied in the beginning because access to these areas where rhabdo can appear (abdomen, sinuses, extremities) are difficult to get to because the child has to go through major surgery and the risks are too high. We asked our doctors how often they see cases of Rhabdomyosarcoma...5 to 6 a year. We asked them how many cases they've seen where placement is similar to G's pelvic rhabdo....1 ever 2-3 years. Over a course of 20 years, that's less than 10 patients a year! Basically, we are exploring in uncharted areas. The doctors don't know what it means that they found cancer cells still with the biopsies. They don't know because it's not normally done. They can't tell us if it is still active. Most likely, the cancer was still there with the last biopsies BUT they didn't actually obtain a sample of those cells. We are talking about fishing for a needle in a haystack here. Even if we did a PET scan at this point, it would not be conclusive. Thus I say as our doctors told us, the overall prognosis is still GOOD, her CT still showed signs of NO METASTATIC DISEASE, and her MRI still shows SHRUNKEN LYMPH NODES.
Going to meet with our radiology oncologist today, Dr. Donaldson.
In Hope and Gratitude.