Evan returned to Health Park Clinic yesterday afternoon for blood work and a general check up. His white counts and ANC levels are good enough for him to continue Chemo next Thursday. This round of Chemo will be Methotrexate.
Meghan received a copy of the surgical pathology report on Evan and I had a chance to review it. There are positives in the report as well as challenges. The positive is that there were clear margins at each end of the bone removal. The bone marrow was sampled below the point of resection and there were no tumor cells noted in the sample. The surrounding skin and soft tissue of the resection area (including the original biopsy site) were sampled and tested negative for any tumor cells. The actual tumor that was removed was microscopically analyzed for necrosis and tumor type. The tumor is a high grade Osetosarcoma involving the metaphysis and diaphysis of the the humerus. The metaphysis is the area of bone that is next to the growth plate and the diaphysis is the actual shaft of the bone. High grade means that the tumor has a high probability of metastasis to other parts of the body particularly the lungs. Pre-surgery Chemo did not have the desired results for necrosis of the removed tumor. The goal of pre-surgery Chemo is to target 90% necrosis of the tumor and Evan's tumor was 60% necrotic. This is considered a Huvos Grade II result and is considered fair to poor in long term prognosis. Huvos Grades are I-IV with I having the poorest prognosis and IV having the best prognosis.
Evan will have several complete rounds of Chemo to attempt to rid his body of any left over chemo cells that the tumor was sending out into his blood stream. We will have to be very vigilant to constantly check his lungs for metastasis as his Huvos Grade tells us that there is a greater propensity for this to happen. We are extremely fortunate that Evan did not have any metastasis prior to tumor discovery as this would have been cause for great concern post surgery procedure and would have subjected him to more potent Chemo drugs. Superman always had to avoid Kryptonite or lose his super powers; with Evan the Superman his Kryptonite is metastasis and we must do everything to prevent the two ever meeting!
I will update when there is something to tell.
1 comment:
Hi Bob. I saw your post regarding Ifosfamide and thought I would see if your team recommended low dose IFOS? At MDAnderson they did IFOS at a very low dose that ran 24/7 for a week. He had a fanny-pack, so that he did not have to be hospitalized and could go places. They did not have that option here, so we went to Spokane, as they had a doctor that had trained at MD Anderson and agreed to do the chemo-to-go (as Tyler called it). It was a long drive, but much better than hospitalization (our opinion). Evan is so little, it might not be an option....but it was worth it for us to drive 5.5 hours one way to get the low dose, versus be hospitalized with high dose (and horrible side effects). Just a thought...sending much love your way!
Post a Comment