Back to Square One

This morning we were back at the Cancer Center to meet with Dr. Quinn (Robert, not Michaela). He is an oncology surgeon, specializing in sarcomas, who explained that after J's case was presented at the Sarcoma Tumor Board twice (including this past week), it was consensually agreed upon that surgery was the next step. J will return to the main OR at UNMH on February 11th for further resection of the tumor (outpatient). It was removed entirely in the first surgery, however with margins (amount of tissue around the cancer cells) of only 1 mm. Their goal is about 1 cm. Fortunately, this second surgery should be similar to the first and not super invasive. They will clean out any soft tissue in that area, but not go deep into muscle or organs. We anticipate another quick recovery. 

Dr. Quinn stated that although this new tumor is being differently classified (see previous post), there were parts of it that resembled J's original tumor. Therefore, he felt that it was somewhat related. Also, rhabdo is rare. And spindle cell sarcoma is rare. So, for Jacob to have BOTH of these separate tumors, without any relation to one another, would be incredibly rare!!! If that were the case, however, it might be an indication of a genetic predisposition to cancer. The specialist from Boston posed the question of Li Fraumeni's syndrome. It is a mutation (very rare!) of the P53 Tumor Suppressor gene - one that is responsible for suppressing the growth of cancer cells. All of the doctors we have spoken to feel that this is a stretch. However since it's been mentioned, they are referring J to a genetic counselor for some testing.

As far as what comes after surgery, we are clueless! Our next appt with our medical oncologist, Dr. V., will be on January 20th when she returns from India. We hope to find out what treatment will look like. So far, all the other physicians are deferring to her expertise to make that call. 

Despite the frustrating return to square one, we are very pleased with the care we are receiving at the UNM Cancer Center. The friendliness & helpfulness of all the nurses, doctors & even the parking attendant has been quite impressive!!

I tried to anticipate any questions you might have, but feel free to comment or email us!
 

Hope you all have a great weekend!!! God bless!

PS - Tumor Board is a regular meeting of doctors, radiologists, pathologists, nurses, pharmacists, surgeons, etc that discuss difficult/complicated cases and use each others' areas of expertise to find the best plan of care for each patient.