There’s good news and there’s bad news. There are ups and there are downs. Two steps forward and one step back… that’s how it goes with Adrenocortical carcinoma.
The 11th (and hopefully final) round of chemotherapy and the TACE procedure that was done on April 3rd significantly improved the state of the liver, with the two main tumors becoming “100 percent necrotic” with “no evidence of viable residual tumor” stated on the radiology report. There is also no new growth in the liver. Basically, TACE did its job! However, there are still a few remaining suspicious areas in the liver so a second round of TACE was recommended. They will go in and spray anything that looks suspicious and hopefully “finish” the job. This will happen on June 26th at Columbia Presbyterian under the guidance of Dr. Susman who is just wonderful in every way imaginable.
Yesterday (June 12), Alexis had a CT Scan of the chest that revealed 5 spots in her left lung, the biggest of which is the size of a blueberry. Dr. Fojo was not overly concerned. He has literally seen thousands of these lung nodules in his career and he knows how they behave, how the grow etc. Lung surgery will eventually be required but its not urgent (probably will not happen in 2018). From what we have learned, treating lung metastases is a more manageable process. The incision is on the side between the ribs and supposedly women respond much better than men with cancers in the lungs (who knew!) Plus, the lungs are usually an “endpoint” for adrenal cortical carcinoma, so the cancer does not typically spread from the lungs to other organs. The liver is the opposite – very difficult to treat with its complex network of blood vessels and bile ducts. Thus, the treatment plan is still laser focused on getting the liver clean and cancer free, first and foremost. The lungs are secondary. In Dr. Fojo’s own words, “we’re still all about the liver”.
This disease is exhausting. Fellow ACC warriors and the wonderful staff at St. Francis Cancer Institute have gotten us through some dark times to say the least.
P.S. Here are a couple of painted tiles that we came across while at the infusion center at Columbia Presbyterian yesterday – they really spoke to me.