This morning, Bill and I met with several doctors and nurses at MD Anderson's Sarcoma Center. While the appointment times had no relationship to reality, we're so relieved with the bottom line that we're rolling with it.
We saw a nurse, a fellow, the oncologist (Patel), the cancer surgeon (Satcher) and his PA (Angela). While they don't have the radiologist reports back yet from yesterday's tests, the doc's both seemed confident that the CT scan shows no evidence of metastasis. So, it hasn't spread and I don't need chemo. Also, even though they don't have evidence of when the growth on my arm became cancer, based on the type of sarcoma, they all said it was "low grade." Hurray!
The oncologist said he would not have a continuing role (because what he does is chemo). He said the next step was likely surgery and radiation. The surgeon said he wasn't sure radiation would be necessary. Their next step is to take my case to the team, the sarcoma conference, which will happen next Tuesday. At that meeting, they'll get concurrence about the path forward.
About the only thing they seem to agree w/ CU on is that the next step should be surgery to get to safe margins. Those of you who have been reading this may remember that the CU team told me I'd likely have 3 surgeries: removal to safe margins, then a graft after there was some healing, then reconstruction after 6 months of PT/OT. MD Anderson, on the other hand, expects to do one surgery, with all three things happening @ once. I would be in the hospital for 3-7 days. Plus a day early for pre-op. The cancer surgeon would use the MRI as a guide (he said he could see areas that need to be excised already) because it provides some evidence of where cancer cells remains. During the surgery, they would also be taking little chunks of my tissue and looking at them under a microscope until the samples were clean. At that point, he'd turn the operation over to a plastic surgeon who specializes in hands & wrists to do what reconstruction is warranted.
One surgery means two less hospital interventions, so two less opportunities to get MRSA. Seems like a no-brainer in terms of risk management. Also, the surgeon looked incredulous about the 1 - 5 cm margin comment from CU. He said, based on what he sees in yesterday's MRI, while it will definitely be necessary to go into the muscle, they do not anticipate the need to get even close to amputation.
On the plane home. The PA is supposed to call about scheduling, but probably not until next week. So, while I was hoping to have a date when we left, we won't know until after the weekend when the next step gets taken.
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