Saturday, August 29, 2009

As things stand now

On Friday (August 21st) at an appointment with Kate’s oncologist, she and I were notified of the location and severity of a “reoccurrence” of her cancer. This “reoccurrence” had first been suggested by Kate’s oncologist when, in July, she started experiencing eye problems (double vision as well as tearing and tracking issues). As these symptoms continued through the months of July and August, Kate was given MRI and CT scans in an effort to determine weather these events were caused by a reoccurrence, her previous radiation or chemotherapy treatments, or a viral infection. As stated above, we were told that, upon review of these scans and her medical history by her oncologist, the Duke hospital oncology department, the duke radiology department, and a number of other hospitals known for their knowledge and treatment of cancer, that indeed there was a tumor in and around her Cavernous Sinus (a small aria located near to the brain stem) and that the only operations and therapies they could think to suggest would/could not be attempts to cure the condition, but only to buy us sometime.

After collecting ourselves Katherine and I notified our parents of this information. A day latter, lead by Katherine’s tireless mother Emily, we began to locate as many and as good of second opinions as we could find, and began contacting other physicians to see what they felt the best course of action would be. Since then the attentions of a number of oncologists, radiologists, infectious disease specialists, and other family docs, within North Carolina and up and down the east coast have been focused on Kate’s situation, her MRI’s, and her medical reports. While most of these second opinions have agreed with the original diagnosis, a few have reopened the possibility that this could be an infection.

As of tonight the situation is this. Kate has a growing mass located near some extremely “high value real-estate.” The location of the mass makes it nearly impossible to attempt to remove it by surgery or even biopsy the mass itself. The mass could be a type of fungal infection known as Aspergillus . This is a very dangerous, but curable infection that would only require Kate to take a set of incredibly strong antiviral medicines. Medicines that are as powerful and debilitating as some chemotherapies. Emily, members of Greenville’s infectious disease team, and Dr. Chan ( the physician in Boston who headed Katherine’s last treatment process, Proton beam therapy) think that this is likely due to Kate having had this same infection (in another location) earlier this year (“removed” in May) and due to signs they see in the MRI. But the mass could also be a reoccurrence of her cancer. Which could be treated, but likely not cured by some combination of surgery, chemotherapy, and radiation. This diagnosis was made by the folks previously mentioned at duke, and has been seconded by the infectious disease doctors at Duke, radiologists in Winston Salem and Greenville, as well as by Kate’s primary physician.

As there are arguments for and against the mass being one thing or the other and arguments against treating one way without ruling out the other, our next step will be to do a biopsy of a nearby location which could tell us what the mass is without approaching that high value real-estate. That biopsy (we are told) should give us enough information to determine the course of treatment. Either way this is an incredibly serious situation which upon receiving the results of the biopsy, will require Katherine to begin treatment in earnest.

We know and greatly appreciate that many of you will want to do whatever you can to help at this time. As things stand right now what Kate wants most is for this thing to be found to be an infection (as that is more easily curable and would reverse the vision problems). All of your prayers and best wishes towards that and toward her health in general are all that we would ask.