Tuesday, 15 March 2011

Diagnosis and treatment plan - 10th March

It's angiosarcoma - something I'd never heard of before this week - a cancer of cells lining blood vessel walls.  It's a rare cancer, and the way it's presented in H, with tumours in the muscles of her back and abdomen, is almost unknown.  But the histopathologist here thinks that's what it is, and the expert in London, whom H knows personally, agrees.  As well as the three muscle tumours there are two smallish growths in her lungs.  And she has two cysts on her scalp, one of which seems to be growing and is probably the cancer too.

We went to the hospital today to discuss treatment with the doctors.  Something needs to be done quickly about the main tumour because it's close to her spinal cord.  We wanted to get it cut out, but the doctors say that's not best because it will be impossible to take out whole and cutting into it risks post-operative bleeding which could itself damage the spinal cord.  The neurosurgeon talked us through the operation he could do to remove a vertebra and replace it with a metal cage, including some scans of someone he'd successfully done it to.  This involves going in through the chest to reach the front of the vertebra, then through the to do the rest.  We had no trouble agreeing that this seemed altogether too heroic for what would be a non-curative operation.

Instead H will have radiotherapy - a sophisticated version called 'tomotherapy'.  The radiologist wanted to irradiate her T12 tumour as well as the T8 tumour, but H said no, it would be better to keep it for monitoring the effectiveness of chemotherapy.  I was surprised how readily the radiologist changed her mind.  It takes some time to set up the tomotherapy, so it will start on Wednesday 16th.

Both the sarcoma specialist who's now in charge of the case and the neurosurgeon had H take off her trousers so they could test her leg strength and reflexes.  She is thinking of buying bigger pants.  But they probably suspected already that she's a natural redhead.

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