The Day I've Been Dreading

Since our last visit, the infection in Hudson's mouth has gotten much, much bigger.  I called and asked if I should bring him in last week, but the back up oncologist is only in on Thursdays.  I could have seen the internalist, but I won't lie, I wanted a board certified oncologist to look at it, rather than have someone else guess.

The cytology done last time came back negative, but Dr. Janson had also said that they couldn't find a lot of tissue to look at.  It was mostly blood when the needle was stuck in.  The mass has increased to four times its original size and Dr. Glawe, the back up oncologist, is fairly certain it's another metastatic osteosarcoma tumor. In addition to the increase in the mouth mass, we found two other new subcutaneous lesions during this visit.  While the Kinavet is doing it's job and decreasing the size of the shoulder mass, it isn't stopping new growth.

The mouth mass is painful for Hudson, so we have scheduled surgery on Monday, June 4th to have it removed by Dr. Stubbs.  This will be a debulking procedure to make him more comfortable, but will not remove all the affected tissue.

We could start Hudson on Leukeran, if desired.  It, like Kinavet, is not intended to treat Osteosarcoma tumors.  Both are intended for mast cell cancers.  The chance of efficacy is only 20%.  Palladia is also an option (and a mast cell chemo,) but side effects are 75% likely and include GI upset, urinary concerns and internal bleeding.  While we have been lucky with Hudson and he has experienced very few chemo side effects, I am not willing to put him through the side effects that could occur on Palladia.  We've already seen that his cancer is very adaptable.  No matter what chemo we put him on, the cancer is twisting itself to become immune to it.

 Hudson is like a garden.  The seeds of the weeds are already there.  For each one we pull, another pops up in a different location.  This is why we are choosing not to remove the subcutaneous lesions.  The fact that he has developed multiple masses since our last visit is very concerning.  While he is still feeling good at home and hasn't been sick, the rate at which he is developing new masses has led Dr. Glawe to expect his quality of life to begin to decline in the next few months.  She is estimating that he has 2 to 3 good months left.