Daily Archives: October 30, 2010

A little local color and how about that biopsy

Wednesday morning I had a 7 a.m. check in at radiology. That necessitated a 4:30 a.m. departure time, and and although traffic was at a minimum (until, amazingly, we entered Boston), we came yea close to hitting a deer. It would have been a bad way to start the day, both for the deer and ourselves.

A few minutes before eight, we were led into the procedure room by the surgeon, who then carefully explained (complete with drawings, I love that) what he would attempt to do. As I had already been made aware, this was going to be anything but a slam dunk. The tumor that would be targeted was in an awkward position, not only within the lung (very peripheral), but in relation to where the needle would have to enter. There was an anatomical fissure within the lobe that could not be crossed and the exterior entry would need to be made through my (ouch) breast. A CT scan would be taken every step of the way to make certain that the needle was heading toward the target, and the team would be watching for a pneumothorax (partial lung collapse) as well as any excessive bleeding; both possibilities. Should either happen, it might be necessary to abort the procedure.

This would not be a needle biopsy, but a core; same idea but slightly different mechanism for retrieval of tissue (sort of like a spring loaded harpoon, only tiny). The list of potentially adverse side effects was gone over (I’m difficult to scare that way anymore) and once again I was told that this may or may not be successful.

Bring it on, I said. Come what may (and I was feeling very optimistic), this was going to be a hell of a lot easier than open chest.

And then my favorite part. I lay down, was wrapped in warm blankets and Velcroed to the table (big ol seatbelt, good thing I’m not claustrophobic), and just as I’m beginning to get to know the two attendants, the magic cocktail starts to flow through my IV. “This is going to be a brief relationship…” I say, and the next thing I know, I am on my stomach in the recovery area.

This is perhaps the hardest part. Groggy yet, I don’t know whether or not it all progressed as planned, but I am not allowed to speak or to move; as I am still at risk for a pneumothorax.

Soon the surgeon stops by, and I’m pretty sure I hear him say that everything went smoothly and he was able to retrieve a lot of tumor. At one hour post op I am wheeled in for an x-ray, and then again at three hours. At some point Alice (Dr. Shaw) stops by and grabs my hand. And then, finally, the three hours have passed, and I can turn over and sit up.

David is called into recovery, and the surgeon explains that, although far from straightforward, the operation was a success. My pleura (lining of the lung) had been tacked down, a not unexpected situation after having had several lung biopsies as well as a lobectomy. Oddly, this confers an advantage as far as making a pneumothorax less likely, but it would have made the open chest more difficult.

There had not been much hemmhoraging, and what I thought I’d heard him say was indeed true; he had been able to retrieve several cores. Yippee! I celebrated with a turkey sandwich and a ginger-ale, and then, still a bit woozy, David pushed me across the street to Starbucks in a wheelchair, where I had my first coffee of the day.

When we arrived home around 5 :30, I checked my email and noticed a message from a producer at ABC. She had ‘checked in’ with me the day before, and now she was requesting that I get in touch with her ASAP for an interview to air on the World News that evening. Crizotinib is in the news again, as Pfizer has released more data relating to phase two of the clinical trial (click here). I emailed the producer back and explained where I’d been that day; she immediately responded that there would be a short piece on the news anyway, and they had lifted a photo from my blog. So, those of you who think you saw me on the World News with Diane Sawyer Wednesday night, I think I did too! What a day.

On Tuesday I have my appointment with the trial team, including Alice. This morning she sent me an email saying that the pathologist had determined that there was plenty of tissue for the studies. So, the more conservative approach seems to have worked, and yesterday I was able to go hiking in the woods. Now I just need to keep my fingers crossed for some answers to our questions as to why the cancer is no longer completely responding to crizotinib.