Dancing on the ceiling!

First off, we are both so relieved! It could have gone so bad at this point and instead it is very good. The Fellow said that all three doctors plus the radiologist plowed over every image from the biphasic CT scan. And they found nothing of importance! There were a couple anomalies but they had nothing to do with the cancer situation. Hey, no one is perfect!

Let me be clear, even in the area of the liver and modified plumbing, there were no cancer sites observed. Talk about your dancing on the ceiling!

So, why is Mary doing radiation and chemo therapies (details below)? For the simple reason that the biphasic CT scan can only find things that are a certain size and larger. Remember, the pathologists, working under microscopes, did find cancerous material in the removed bile duct tissues. And, the margin between what they observed and what Dr. Visser left in her abdomen was inadequate. The CT scan cannot find cancer cells of that size--they are much too small. If there is cancer present and it is microscopic, the biphasic CT scan will pick it up after it grows a bit larger.

Dr. Fisher spent quite a bit of time with us. He did a poke, probe and listen to Mary's lungs and abdomen. He then informed us that chemo would be done simultaneously with radiation. The particular chemo is known to enhance the affect of radiation on cancer cells. It may also enhance the reaction by some normal tissue as well but we'll just have to be on guard.

Mary will likely have some side effects with this chemo. He gave us a rundown of what to expect and when to start or stop certain of the therapies to make sure there is no exacerbation of the problem. The chemo will likely cause some skin problems, mouth sores and loose bowels--although none of these are absolutes. The brand name for this "mild" chemo is Xeloda. Mary will take a dose morning and evening after meals.

What happens after the radiation is completed in about 6 weeks (or perhaps a bit more)? No one knows yet. About a month after the last radiation treatment, Mary will have another biphasic CT scan. At that point, if it is also clean, they may or may not put her on chemo and it may or may not be mild or aggressive if she goes on it. If she does go on it, it could be for four to six months of chemo depending on what they proscribe. Basically, cholangiocarcinoma (bile duct cancer) has not been studied in depth for a lack of cases--it is just too rare--so there is no statistically derived protocol for treatment. No matter what, she will be on a surveillance schedule to provide early detection of any subsequent cancer.

Now, just to let you know how hospitals teach patience to their patients. The blood order had not arrived at the blood draw station. Someone didn't submit it correctly, apparently (the same someone, we think, that messed up the CT scan order from a few weeks ago). So instead of a 9:30 blood draw, it was more like 10:15. Which, delays the Oncologist for he wants the results before he is willing to see Mary. So, the 10:30 appointment slipped a little bit--we saw the Fellow at 12:10 and the Oncologist at 12:40. As a result, we finished the 10:30 appointment at 1PM and grabbed a sandwich from the Cafe in the Cancer Center. We arrived at the radiation department at 1:25PM, Mary changed into a gown and promptly at 1:30 they called her name--to tell her they would be 15 minutes late. At 1:45 they called her name--to tell her it would be another 15 minutes. At 2PM, they called her name and Mary is in having her treatment as I write this.

I still don't know what time she is scheduled for tomorrow. Our corps of volunteer drivers would like to know and hopefully that will be confirmed today.

But all that doesn't matter! The outcome is the best possible! No detected cancer sites. We are feeling more than pretty good right now. In fact, dancing on the ceiling doesn't describe it!