Some better and some worse news today. Kate, the consultant surgeon, came this afternoon to tell us what she had seen in the CT scan they did last week. The better is that the tumour is very much smaller than it was. The worse is that from its base on the adrenal gland it is surrounding a junction of major blood vessels, meaning that in surgery Isita’s right kidney would be at severe risk. Other veins and arteries are also involved.
The surgeon said it was as if the tumour were concrete poured around the roots of a tree. Her job is to free the roots without damaging them. She will pick away with a scalpel, even removing the outer surface of the blood vessels if necessary. But she will leave cancer tissue rather than do irrevocable harm.
Her concrete simile is apt also because the chemotherapy has calcified parts of the tumour. Is this good or bad? It makes the surgery much harder, but the calcified tissue may be dead. Dead tumour may be less necessary to remove. Can they tell what’s living and what’s dead? How much can be reasonably left? Would high-dose chemo kill a lot more of it? To fully understand what all this means we have to wait until the specialists have their weekly meeting on Thursday.
What we know now is that the main negatives are the threat to the kidney and the probability that the surgeon will not be able to remove everything. We already knew it is never possible to remove the entire tumour, which is one reason the treatment is so long and hard and surgery its least important element.
We were also warned at the beginning about the danger to the kidney. One possibility is that they will try to do the high-dose chemotherapy first, which is easier to recover from with two kidneys. This would calcify (kill?) more of the tumour making surgery harder still. But it would then be easier to sacrifice the right kidney.
I can’t deny that after the optimism of the other recent test results, we have been dunted by this news. But if there is one thing we have learned over the past months it is not to jump to conclusions. Despite all the science and precision, we are reliant on the judgement of the magnificent group of expert doctors who are looking after Isita.
What ever happens the next couple of months will be testing. At these moments we have to draw on our own reserves of emotional strength, courage and faith and Isita’s too. And you would not believe how bright and strong Isita is right now..