I was in the air, in an aisle seat to Denver, when Brendan got the results back from his big biopsy and was instructed to head towards Dr. Rose's office. When I landed, I called Brendan for an update on everything we now know: I don't know how poetic I can be with all the information we just got presented with, so please indulge the rugged compilation of information I am about to lay down.
After the PET scan and biopsy results, the Lymphoma has been deemed Stage II, which is involvement of two or more lymph node regions on the same side of the diaphragm, and thus far it's location is isolated to Brendan's neck and mediastinum surrounding his sternum on either side. It is wonderful news that nothing has spread below diaphragm. Thus far, there are no organs being devoured by the cancer, but just to be sure it is only in his neck and chest, Dr. Rose performed a bone marrow biopsy on Brendan to ensure it wasn't running around in his bones as well.
Brendan said the bone marrow biopsy is not something anyone should want done (well, there go my vacation plans...) but that while it did not hurt, it felt like "a toothache in your pelvis" - and the discomfort is extreme. Brendan said the Novocaine shot hurt more, but that the "screwdriver, or ice-pick, or whatever massive thing he shoved in my pelvis" wasn't a picnic either. He had to have it done twice...just to be sure.
The biopsy results also allowed for typing and we are waging war against subtype Nodular sclerosis (or "NSHL") - which is "good" (sigh) to treat according to Dr. Rose. Wikipedia claims that it "is the most common subtype and is composed of large tumor nodules showing scattered lacunar classical Reed-Sternberg cells set in a background of reactive lymphocytes, eosinophils and plasma cells with varying degress of collagen fibrosis/sclerosis."
And apparently, they are no match for radiation and a little chemotherapy...(?) Theoretically, we are told that it is easy to treat because it does not spread like wildfire...just in Brendan's case, to the lymphatic left and right of his sternum.
Now, Brendan has a new laundry list of things he needs to get done between now and when his bone marrow biopsy results come back. He needs to take a trip to a sperm bank - because although the doctor says he has never actually had a case where his patient becomes infertile, it's better to be safe than be shooting blanks. He has to have another, more recent chest xray, to help map out the location of the tumors and to give more information to find further staging. (II/IIa, bulky/non-bulky, favorable/unfavorable...). Dr. Rose is currently assuming the results will reveal II, (the "better" stage II to have...) because Brendan has not shown any symptoms of stage IIa.
The most interesting part of this to do list is the port catheter that he will have installed in his chest. It will only be about the size of a dime, but it will be what truly limits his activity while he is undergoing treatment. The catheter will be snaked in through his veins, and as it is a segmented tube, if Brendan does any repetitive motion, the catheter can splinter in to pieces all around his chest cavity. Therefore, there will be no weight-lifting, no swimming, no kayaking, nothing that involves a repetitive motion with his upper body. The port will come out when treatment is done (estimated 4 months) but no repeated movement of his chest muscles until then.
Dr. Agos, of previous surgery fame, will do the port. Before treatment, Brendan will also need to go through a MUGA scan to test his heart and its muscular strength before they pump poison in to his body in attempts to kill the cancer.
If all these tests give us information that coincides with how Dr. Rose thinks Brendan is progressing (and the cancer is not in his bone marrow), he will only have to endure low chemotherapy with radiation. Dr. Rose gave Brendan a tour of the treatment facilities at Resurrection, and as far as Brendan can tell - it may not be all that bad. Lazy boy recliners, Dances With Wolves aka the greatest Kostner film EVER on VHS (iloveyou Two Socks), and a little dose of medication to ease the side effects will make it so that Brendan will even be able to take himself to and from treatment.
Thursday is the tentative day for the next phase of information burst, and at that point, we can start making treatment arrangements, and attack this thing from all angles.
In other news, the Lymphomathon team has exceeded and surpassed my expectations. We have already raised $910, and have 12 members. I will continue to thank thank thank these generous people each time I get the chance, because it is impossible for me to actually express in one round of thank-yous how much I appreciate them.
We are doing okay. The influx of "good" news is helpful, and as always, we each have a full plate of life to take care of in order to distract ourselves from the demons. Brendan and I are in the weeds with medical school applications, and mom and dad are work-work-working. Brendan's fiance, Heather, is in town for one more week, and once Brendan starts treatment the fight will truly begin.
No comments:
Post a Comment