Dana Farber Day

Turns out the folks at Dana Farber are, in fact, mortals.
Recap of the day below.

Doc #1, aka Dr. B - gyn oncologist
I am not going to name Dr. B by her full name because I am not a fan. Not. At. All.
She came and showed me the two pathology reports that the pathologists at Dana Farber (henceforth, DF) generated. The cervical analysis matched what we knew, the liver did not. She is convinced the pathologist at DF is correct and staged me back to cervical cancer 4B. In other words, the cancer in the liver is metastasized cervical cancer, not carcinoid (see the Reality entry for why this is bad news). I attempted to ask questions about her diagnosis based on what Dr. S and Dr. H had told me, and she pretty much blew me off (she wouldn't even review the tests that her department asked me to have and bring with me on disc).

Kelly and I walked out of that room frustrated and deeply upset. I felt that she wrote me off without really examining all of the evidence and knew that I would get no where trying to talk with her.

Doc #2, Dr. Chan - gastrointestinal oncologist
Everything that Dr. B was not, Dr. Chan was. I would send you all to hug her now because she, and her fellow, Dr. O, were amazing.
They actually looked at those test results that I brought and felt, based on those that the most recent diagnosis of two cancers (processes) was the most likely scenario. That being said, they would not sign off on that without more testing of the tissue samples, because it is possible Dr. B is right (I did not like typing that!). The testing is going to happen next week, and then my case is going to be brought before one of the DF tumor boards. That is where everyone involved gets together and settles on a diagnosis and the best-course treatment plan. The tumor board will meet on Thursday, so the wait is not too long.

The other big issue the St. Peter's pathologist and the DF pathologist do not agree on is the activity of the liver tumor that was sampled. St. Peter's says it is a 1 (low activity), DF says it is a 3 (high activity). The treatment will be different depending on the activity level, so that needs to be decided, if in fact, the tumor board agrees that the liver is carcinoid.

In between Dr. B and Dr. Chan I called "my" Dr. S who proved, yet again, why he gets the awesome label. He helped unmuddy the waters (that whole physician-to-physician thing...) and prevented me from climbing walls.

So, what does all of this mean?
1) It means I will not start treatment on Tuesday (say it with me: "It is essential to have the correct diagnosis before beginning treatment. It is essential to have the correct diagnosis before beginning treatment.")

2) It means we still need to sort out two major issues:
(a) Is this one process (cancer) - in both the liver and cervix or is it two processes - cervical cancer and carcinoid in the liver?
(b) If carcinoid in the liver, what is the activity level of the tumors?

3) Once those issues are sorted out, then treatment can begin. (Hey, have you heard me say that before?)

This is long...it is jargon-y (though by using the faux term jargon-y, I think I made it less so)...it adds more murk to the mix...it is my way of attacking cancer. Confusion!