Questions not all answered yet...

Immediately after I put up a post at 3:30pm we were called into an exam room. We were there until 6:30pm, waiting for various folks to come and go, each one poking and prodding Robin's face, jaw and neck. We were delivered the final summary by the two surgeons in about a ten minute conversation at the end. It may have been longer or it may have been shorter, it's often too surreal to actually map clock time to these meetings where we listen to everything they have to say and then we ask a page full of questions which we prepared ahead of time. Most of the waiting time in the exam room Robin and I read magazines. This kept us distracted and prevented us from unleashing a verbal onslaught of questions on the various clinical folks who always seemed to know more than they were telling us during their brief visits to the room.

To give you the full story I just need to back up to yesterday. Tuesday we met the radiation oncologist just to follow-up on Robin's healing. There has always been (like all the way back in August) a swollen area on the right side of her neck, below her jaw. Robin mentioned that it had started to feel sore this past week. The radiation oncologist's reply was, "You'll have to get that biopsied before surgery because they may want to operate on it, and then depending on the results you may need to come back after surgery for more radiation treatments".

So, back to today and the two significant tests they performed.

#1 - the biopsy. While in the office today they performed a "fine needle aspiration" which is a fancy way of saying they inserted a small needle into Robin's neck to gather tissue from the "sore spot" which appears to be in her lymph nodes. They looked at it under a microscope and could see necrotic (or dead tissue). Necrotic tissue is a byproduct of cancer cells which tend to grow more quickly than the body can supply nutrients through blood vessels, causing some cancer cells to die off (become necrotic). The doctors don't intend to do any more testing on the samples they took. From this one look they know that they want to remove the lymph nodes from the left side of her neck during the surgery. End of story there. I guess the untold part of the story is that this is evidence that the cancer had a chance to spread beyond the sinus and beyond the gums. Not really good news, but at least they haven't yet spotted it anywhere else - like in another part of her body. Which brings us to the next test.

#2 - PET Scan. Well, we haven’t got the full story on this yet (why do I keep thinking we're going to get all the answers at once!). The surgeons explained that the main reason for performing the PET scan at this point in time was to detect any cancer which may have spread into other parts of the body. They are still waiting for the final reading by "whoever reads these things". All they could tell us today was that her right sinus still "lights up". Then they went on to say (I think?!) that this is common and they don't know if this indicates dangerous cancer cells, or remnants of the radiation/chemo treatment - but they will know for sure when they do the surgery. So why did they even do this test? Ah yes, it was to see if there is cancer anywhere else. OK, so is there? Oh, well the specialist hasn't sent his report yet. But so far it looks OK to proceed with the surgery plans. Supposedly the final reading will be complete by the end of this week. They will call to let us know if there are any changes. For now the plan is for surgery to be performed on December 11th.

We left feeling a bit under whelmed and awfully tired. Robin's spirits were a bit low at the end of the day. We're going to stay overnight in New York City and head home tomorrow. At the doctor's office Robin pretty much admitted the idea of surgery bothers her. The doctors said her job right now should be simply to keep working on getting stronger and to not worry about the surgery which is "still far away" (let's see, Dec 11th, that's eleven days from now!).

We asked if she will need more chemo and/or radiation. The reply was that the team of doctors will confer and make that determination after surgery.

Well keep you updated as we learn more!