2nd opinions from 2 encologists and 1 surgeon in private practice

Past few days, we have consulted 1 adult encologist , 1 child encologist and 1 surgeon,  all in private practice.

Both adult and child encologists opined that since there is lung metasize, amputation is of not much significance. A relapse is still possible.  They are concerned about the aftermath of trauma of child  losing leg.

Child encologist and surgeon opined that surgical removal of tumour with maximised safe margin may not be possible for leg or arm. Studied both MRI and MRI report  to confirm that ‘’cherry” tumour does not engulf the peroneal nerve at all. It is near but they does not rule out the possibility of removal of tumour without damaging the nerve.

Child encologist proposed ‘’varying-margins” surgery and  highlighted that it is possible to perform the surgery with a pathologist on site to help ascertain the extend of removal by testing removed tissue on site. If the small margin removed near the nerve is not clear, a possible localised radiation   may be administered later to eradiate the cancer cells. Surgeon highlighted that we must be mentally prepared for a footdrop issue much as he tried to prevent it. For details, see http://www.youtube.com/watch?v=J7-L9MFRXD8&NR=1.

Child encologist is concerned about the nodes previously existing in Samuel’s lungs, he proposed to explore the possibility of localised radiation to curb the possibility of relapse here. However, he stressed that like chemotherapy, we have to balance the risk of side effects involved in radiation too.

Child encologist  is very concerned that surgery has not taken place within last week. 4^th week after chemo as chemo drugs normally wear off after 3^rd week.

 The last chemotherapy was 17/10 and yet the surgery was scheduled on 5 Dec. Usually chemo will resume 2 weeks after surgery. If surgery is confirmed on 5 dec, it would mean the next chemo will be late Dec or even January. Thus, there will be a lapse of 2-3 weeks without any suppression of cancer cells. Also, he opined that Sam’s blood count is most ideal for surgery now. He is concerned about the 2 nodes during this period.  

5 Dec is not ideal also for another 2 reasons – our KKH surgeon will be overseas from 6 Dec till ? and our KKH encologist is on leave from Dec 1 to Dec 14.

The private surgeon is a ex-kkH surgeon who may be able to work with the KKH encologist. He wants us to seriously consult with our encologist as before making this decision.

Now, we have to seriously consider the change of surgeon or perhaps even change of hospital. Many issues to consider eg are the opinions correct and is the surgeon suitable? Transfer of case notes, stem cells collected...Etc

Plans for next few days

Monday morning, we are seeking another opinion from a surgeon cum encologist from another restructured hospital. Hopefully, his inputs will assist us in this decision making.

Late Tuesday afternoon, we are seeing our KKH encologist after she meet with our KKH surgeon.

Wed reversal to KKH surgeon?

Wed morning(tentative pending our confirmation to engage private surgeon)

Discuss further surgical details with private surgeon and mental preparation of surgery to Samuel by surgeon.

Thu afternoon(tentative pending our confirmation to engage private surgeon)

Also, due to exigency of the need for chemo, we have tentatively requested him to book facilities for surgery on Thursday afternoon.

Prayer requests
Please pray for HIS peace to be with us, we will trust and will hear HIS voice to guide us in this critical period.  Specifically for HIS joy and peace to comfort Samuel as he is clearly shaken... did not eat or sleep that well. As a matter of fact, he had fever that night after seeing the surgeon.

His provision of the right, suitable and kind surgeon on time for this critical surgery.