July 10, 2013

I got a call from Nathan’s oncologist late in the morning. The first thing she told me was that she hadn’t heard back from the surgeon at KU Med, so she didn’t have any information about his surgery yet.

She then told me that his ANP was down to 11.7, this is the marker that we’ve been using to gauge how effective the chemo has been. It started out at 37,000 and had been dropping by a factor of 10 on a regular basis, so we were expecting this to be a low number.

Next she told me that his tumor had decreased over 50% in size. At it’s largest point his tumor is 46mm, whereas when it was first measured it was 116mm. Again, during his whole treatment thus far it has been dying from the inside out and getting smaller and smaller.

Then she talked to me about the images from the CT scan. They were able to get very good and very clear images, since Nate was sedated. The first thing she said was that his lungs were clear. In the ER they took an X-Ray and it wasn’t very clear and they marked that since he had cancer they couldn’t rule out that what they were seeing wasn’t some form of lung cancer. It wasn’t.

Throughout the entire process Nathan’s tumor had been in a bad place for surgery, which is why they couldn’t cut it out right at the start. It was pressed up against the Hepatic vein, which runs through the Liver, and it was also sitting on the Inferior Vena Cava, the big vein that brings blood back to the heart from the lower half of the body.

At his last CT scan the tumor had pulled away from the Hepatic vein but was still too close to the IFV. This is why we had to do two more cycles of chemo. But now there was a 2mm gap! Nathan’s doctor spoke with the surgeon who did Nathan’s biopsy and he said that there was plenty of room now, so that was very exciting news!

The last thing we talked about was Nathan’s neutropenia. His counts were low, which again we expected since he’s just finished chemo. She said she wouldn’t be surprised if the surgeon wanted to hold off until his counts were up, but she had also seen them go ahead and do surgery with low counts. Since she hadn’t yet heard back from him she had no idea on what the plan was.

This was all a big relief, we had gone to bed the night before not knowing anything at all, and neither Malia or myself slept comfortably.