November 15, 2006 - Visit to Radiation Oncologist

Dr. B, my radiation oncologist was in a conference when my PET/CT results came in last week. Therefore, he was not part of the conference with Dr. S. His opinion is slightly different from Dr. S's. In fact, his opinion is that the CT/PET results are highly inconclusive. Now, you all know that I have been on this roller coaster ride before. However, I'll take any glimmer of hope that I can get at this point.

It turns out that there are two areas of concern on the CT/PET. First is the previously radiated area. The area of concern happens to be right in the middle of the area that received the highest dose of radiation. While an experienced, although conservative, radiation oncologist reviewed the films and concluded that the new area of concern could not be radiation damage. Dr. B could not agree with 100% certainty. Although possible, it is highly unlikely that cancer could grow in this recently radiated area. The bad news is that if in fact it is cancer, then it is a very tough cancer.

The second area of concern is on the outer edge of the liver, where my liver was resected last year. This is typical behavior of the cancer coming back (to come back to where the incision was made). Nevertheless, the surgery I had last year had clear margins. This means that if the tumor was 6cm, they actually cut out 6cm + x and the x portion was not cancerous. Therefore, the tumor was encapsulated in the mass they removed.

Because my tumor markers are also all slightly elevated, everything is leading to a recurrence; however, the recurrence may be limited to the outer edge of the liver rather than the celiac where I recently was treated.

My next step is to go to MD Anderson at the University of Texas in Houston, which has the #1 Gynecological Cancer Clinic in the nation. They may want to redo all the scans. More than likely, they will make a recommendation for a treatment plan. There are lots of chemotherapies that have not yet been tried for me. Although they used the ones with the highest probably of success, they have not been successful for me. Hopefully the next one will be. Alternatively, I may be going into a clinical trial. There are a lot of anti-angiogenesis drugs out there that have demonstrated remarkable ability to inhibit tumor angiogenesis (the process of forming new blood vessels required for cancer to spread)