New plan

Eila and I are very happy to be home and, after the morning with doctors, are looking forward to the weekend all together.  Today we met with Dr. Thomas and learned about the new plan for the second half of Eila's treatment, radiation and chemo.  He helped explain more about the "spill" at surgery, that it was just microscopic evidence at the margins.  Basically, he said that it wasn't that Eila's tumor was cut in half, that the surgeon really did his best to get it all out in one attempt but her tumor didn't end with a clearly defined boundary (it has microscopic cells that extend pass the visible tumor).  So Dr. Erhlich was trying to balance taking all the tumor cells against preserving as much kidney as possible, a few diffuse cells were left behind initially -- this created her "spill".  So while this means we have to add radiation to Eila's treatment, it will only be applied to the area of her original tumor.

Today we also met with Eila's new radiation team, learned more about how her radiation will go, and got things set up for next week.  She will need 1 treatment that is spread out over 6 days (meaning she gets one exposure a day, Monday to Monday), for a total dose of 10.80 grays (I don't really understand grays, so I'm not going to even try).  Although her tumor has been removed, the radiation will target the original tumor area (before it shrank from chemo) plus a 1 cm margin.  This area will include her kidney, liver, some intestines, and some ribs but it will NOT include her spine, any long bones, or right ovary.  All of that sounds better to us, less impact on her future growth since her spine and long bones (legs, hips, arms, etc) aren't included.  The exposure to her kidney is probably the biggest issue for her, but what can you do she's got a kidney tumor.

From July/Aug2015

Today she got to see the room she'll be in for radiation and had a CT scan to give the doctors images they'll use to line up the "lasers".  Hopefully she'll be able to lie still enough during treatments so that she won't have to be sedated; they say it doesn't take long but she has to be perfectly still.  So she practiced being a statue today.

From July/Aug2015

The other part of today was learning more about Eila's chemo plan going forward.  With Eila's first tumor, doctors realized that her left kidney had nephrogenic rests, which significantly increases her risk of developing kidney tumors.  So now that she's had to deal with tumors #2 and #3, we've decided we need to include new drugs going forward: cyclophosphamide, etoposide, and carboplatin.  These new drugs are stronger than ones Eila has received in the past and will require hospital stays for chemo.  The new drugs also mean new risks and this is kind of scary to us, but there is evidence that increasing the chemo regimen may inhibit those nephrogenic rests in her kidney from becoming new tumors.  We are all for increasing Eila's chances of not developing another tumor, so we're asking her to be brave again as we begin this new plan.

I know next week's radiation and chemo will be here before we know it, but we're looking forward to a restful and fun weekend with Annikka.  And then we'll try to settle into a new normal as Eila's into the second half of chemo and will get weeks off between treatments (one week of chemo, 2 weeks to recover).  If all stays on schedule she'll be done before Thanksgiving.