Medical Stuff

After countless tests that required many pokes, Bo was left with no usable veins and some very cool pictures of his skeleton. They confirmed the worst but also eliminated some of the terrible. While the tumor was relatively small, about the size of a golf ball, it touched the wall of his chest and his heart, in the lower right lobe of his lung. The tests confirmed that there was no heart or bone involvement, so surgery could likely be done laparoscopically. The surgery was scheduled, and the tumor removed, but they found a second tumor that was in a very dicey place--under the phrenic nerve and on top of the aorta, it had taken over a node there and Dr. Ramachandran called for a consult because he did not want to risk a mistake and was worried it might require a full thorocatomy that he did not want to do at this time. The tumor was not highly adherant so they managed to remove both with generous margins and did not see any additional tumors.

However, the two tumors confirmed the cancer diagnosis, though not the type, and the most logical type, PPB often takes a direct walk to the brain. So we waited another day before we could get a pathology confirmation and a brain scan. The pathology report confirmed Type II pleuropulmonary blastoma, but cleared him of any brain involvement--for now. He still has to undergo a PET scan which will more conclusively show any additional tissue involvement. Then he will start chemo. He will go in on a Monday, have his central line portacath placed by Dr. Ram in a simple surgical procedure then go right to clinic for his first treatment. We don't have an exact clinic schedule yet, but he will be given six drugs (the recommended PPB registry regimen, so you can see it there) over five weeks, with three weeks to heal, for eight cycles, so if all goes well, 48 weeks, but probably more than a year since cycles do not always begin and end on time. We will do treatment here. We are getting second opinions through the registry--our surgeon knows Dr. Dehner, the pathologist in St. Louis, and Dr. Gruner has been consulting with Dr. Priest in St. Paul.

We have no idea how well Bo will do in treatment, but we do know that his treatment is intense. Mark, one of our friends who happened to be there on the day Dr. Gruner came by to deliver his treatment regimen, is a cancer researcher and he said he was pretty certain he had never seen so many drugs thrown at a cancer, but he has no reason to question the recommendation, it just confirms how scary this cancer can be. Dr. Gruner said a lot of her kids do relatively well in chemo, they take treatment, go play, throw up, and go play again. Some never show any sign or discomfort and some are knocked flat for the whole time. We have every reason to think that Bo will do relatively well, but will probably have a few bad weeks. His principal has been wonderful, both she and his last teacher came to visit in the hospital and has vowed to help us do whatever she can to help Bo through the next school year.

And so that's all we know for now. We are still waiting for a pathology report from the registry and staging won't be complete until the PET scan which we can't do until he heals from his surgery. Neither of those things are likely to change anything but will give a better idea of how he progresses through treatment. The sun is coming up, so I have to get started--we are going to see Pirates of Penzance today, I think, the weeks went by so fast, I am not sure we got our tickets arranged, but that's the plan, anyway! With love, Lisa