Monday, December 27, 2010

Post op Day 7 --a terrible start and a good ending

Early in the morning on December 23rd, Dr. Roses came into Deb's room and told her she was progressing well and that the final pathology report was back. We had been anxiously awaiting the final pathology because we knew they were looking to see if the tumors had any 'vascular invasion' which may mean further treatment might be needed. However, at this time in the morning when Deborah was alone, he said "interestingly........the pathology report shows that the cancer cells are not primary liver cancer cells. The cancer originated somewhere else and metastasized to your liver".  And then he said "but that is nothing you need to worry about right now". Talk about a terrible start to the day!

When we arrived a little later, I looked at the pathology report that Dr. Roses had left for us and read that the type of cancer cells they found in her tumors were called 'neuroendocrine' cancer cells and that they can mimic primary liver cancer cells, or hepatocellular cancer. So, in the biopsy that was initially done in Phoenix, the pathologist had incorrectly identified the cells from needle samples that were taken from the tumor. In this final pathology they were able to dissect all the tumors very precisely and look at a much larger sample, enabling them to make this new determination.

Understandably, Deborah and all the family were very concerned and wanted more information from the doctors. Dr. Roses had told Deborah to have us page him when we came in, so we did and he was able to shed more light on the situation. He said neuroendocrine cancer is quite rare and that they were very surprised at this finding. He said it is a slow growing cancer and the main problem with it is that it spreads to the liver. This means that she has had the main treatment for it already by having the liver resection. This much is behind her. He said the primary tumor is usually as small as a pea and that in some cases the primary tumor is never found. It can be located in a variety of places including the stomach, the pancreas, the small bowel, the lungs, the appendix, and other less common areas as well.

Dr. Roses said this is not terrible news, just unexpected and will require a slight change in direction. They are planning a special nuclear med scan using radioactive dye that is easily picked up by neuroendocrine cancer cells. This is scheduled on December 28th and will involve a series of pictures taken over a two day period. The hope is that the primary tumor location can be identified. If they find it, then it will likely require surgical removal at some point. Deb has a good attitude about it right now. She wants to get better from this surgery so she can be strong enough to handle whatever will be required in the future.

I told you there was a good ending to the day and that was that Jared arrived!! Yay! 
He was a breath of fresh air and a lifter of spirits.

 Jared and Paul will be with Deborah for Christmas.


  1. Deb, you look great! I bet it was wonderful to have your son there. I'm glad to see you up and walking so much. Keep up the good work.

  2. What a crazy way to start a day! I love when doctors come and give news like that when you are sleeping and have been sleep deprived. Keep moving! Looking great!