Amy's 'momentary trouble'

After getting the report that we did yesterday, I had some follow up questions for her oncologist. The following is the email conversation we had:

VH - Can the liver and lymph node enlargement be caused by the chemo?

Dr. M - The liver abnormalities can be a byproduct of the chemo depending on what they are. Similarly we do see lymph nodes wax and wane in size during chemotherapy.

VH - She mentioned a 'thickening' around the area where the tumor was. Is this in general or is there actual evidence that another tumor is growing?

Dr. M - There is not clear evidence of tumor regrowth in the tumor bed

VH - The MRI is scheduled at the end of the month, I don't want to wait that long, can this be moved up to as soon as possible? This week even?

Dr. M - I will work to move up the MRI

VH - Is there any evidence of tumor growth on the liver?

Dr. M - There are abnormalities on the liver that may be benign or may be tumor growth, but the CT scan was not clear enough to distinguish. The radiologists think an MRI may distinguish this.

VH - She mentioned that you said there were 'Concerning factors' but wasn't able to remember specifics, can you remember?

Dr. M - My concern is that Amy is not as energetic/doing as well as I would have hoped and when that is the case in general I always get concerned about cancer recurrence; when we combine that with changes on the scan I get even more concerned but at this point it is just concern.

VH - I know she will continue with the therapy, but what are our options or next steps? More surgery? Biopsies? If so, how far out?

Dr. M – We may talk about biopsies or other types of Xrays if the MRI is not diagnostic

VH - Lastly, I am sure that you have see what is going on with Amy before, so cutting through all of the 'waiting to be sure' stuff, what are we facing? What does your experience and gut tell you?

Dr. M - Vince, at this point I do not want to speculate other than to say that at this point I am concerned about the possibility of rapid tumor relapse while on chemotherapy which would be a bad thing but at this point I am not certain; just concerned. We will do everything we can to figure this out more rapidly and then regroup.

Amy had a really rough day, her mother and youngest sister left to go back to Iowa and they had a lot of tears.

This is Amy's story as seen and told by me – V