One Step

 It has been a very compressed couple of days.  Time slowed down a bit as I waited to hear the conclusions of the tumor board and get the call from my doctor.  Yet I have to say, it was very different from Wednesday.  The shock was gone and I just wanted some information that would help me focus on the next step - what can we do next and when will we do it?

My doctor called late in the day to tell me the tumor board felt that more surgery would be the sensible next step for three reasons.  First, it would be very useful to get another tissue sample and do pathology to find out if the my cancer has transformed into something other than a grade two astrocytoma.  Knowing this or discovering that it has not changed character and is simply growing again would have strong implications for what treatment is possible and prudent.  Second, there is the possibility of getting more of a tissue sample beyond a tiny cell biopsy.  The vanguard treatments for brain cancer almost all require a fairly substantial tissue sample.  Even if there are no immediate possibility for me to get these treatments, just to have the tissue would open the door to at least being eligible for more down the road.  Third, there is still hope that the surgeon can "debulk" the tumor - cut it down in size enough to free up some room in my overstuffed cranium which might give me some time if it really does begin to grow.
I don't have an appointment yet but I should meet with the surgeon next week and go over the risks and benefits.  It is the same surgeon who performed my biopsy nineteen months ago.  He is a great surgeon, I have a lot of confidence in him, and I feel comfortable having a frank discussion when we see him.  Plus, I think he is the only member of my medical team for has peppered me with questions about the Foreign Service every time we've talked.
Steph picked up Walt from school yesterday and explained to him that daddy might have to go back in the hospital for a few days.  Walt wasn't fazed.  "That's okay, daddy's doctors are good."
Thanks for all of the prayers, positive energy, and since we are receiving in California -good vibes - that have been sent our way.  It means a lot to us.