Tuesday 7/25 - pathology & prognosis

The tumor has been identified as chondroblastic osteosarcoma; not one of the 3 we had expected from the initial report. It does create cartilage ("chondroblastic") which is why it was difficult to identify but it's actually a form of primary bone cancer ("osteosarcoma").

This is of course not the news we were hoping for, but we had some additional tests yesterday and determined that it is localized, i.e., has not metastasized or spread to other parts of the body! If those tests had not been clear, there would be very little chance of survival, so this was a HUGE relief.

Dr. W, the surgeon covering for Dr. F during his vacation, explained that the cure rate for a localized osteosarcoma at my age is ~70-75%. It is generally somewhat lower chances for osteosarcoma in the hip bone, but he said mine is also smaller than most, so it may balance out to around the same odds. As he emphasized, the key being: the majority of cases are cured. (We will get through this!)

Next steps

The treatment is expected to involve about 6 months of intensive chemotherapy, followed by surgery, and possibly additional chemotherapy at the end. Although the cancer has not spread in any detectable way, Dr. W explained that there are usually microscopic cancerous cells in other parts of the body like the lungs. That's why the current practice is to undergo chemotherapy (not just surgery) and why the cure rates are much higher today, e.g., compared to Terry Fox's time.

There is no way during chemo, unfortunately, to know the success of the treatment. After treatment, I will continue going to follow-up appointments for 10 years, starting with higher frequency and then tapering off- and it's over this time that we'll see if it's cured.

Given the intensity of treatment, we're planning to shift my care to Maryland area so I can be home with all the support of family and Washington Grove. We're considering John's Hopkins and Georgetown - if anyone might have inside information about these or other nearby medical centers or specific doctors, we'd appreciate any input!
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