Not quite done yet...

Sorry for the delay in getting this posting done - things are never quite as simple as we might hope!

My pathology report wasn't terrible, but it could have been better. Of the sixteen superficial lymph nodes that were taken, five showed evidence of cancer (one of these was the nodule that I could feel, while the other four had smaller focuses). Of the six deeper lymph nodes that were taken (just inside the pelvis) one was positive. Fortunately, this positive lymph node was the first of the six (e.g., the closest one to where my tumor was) and it only had a small focus of cancer (3 millimeters within a 10 by 20 millimeter node).

So, we certainly are happy that we had these nodes removed. While there's no evidence of any more cancer, it certainly is possible that a few cells could be remaining in the area of my surgery or in the next chain of lymph nodes (deeper into the pelvis). Therefore, the current consensus is that I should have a course of adjuvant (i.e., following surgery) radiation.

While the decision and details aren't finalized yet, the general idea is that we'll treat the lymph nodes on the left side of my pelvis as well as my left groin (where I had surgery). I'll have radiation in daily sessions (around 20 minutes each), Monday through Friday, for about five weeks. The side effects should be minor: some skin irritation and fatigue (both will gradually increase throughout treatment).

In recent years, triple modality cancer treatments (involving surgery, chemotherapy, and radiation) have become increasingly common. Up until now, I've only have surgery and chemotherapy. As a personal practitioner of the radiation (i.e., a radiation oncologist) I suppose it's appropriate that I should now complete the trifecta? Maybe, but I never aspired to emulate Sy Sperling's level of dedication to his company.

Gwyneth and I will be going up to Boston on Tuesday to meet with a radiation oncologist at Dana-Farber. I'll also meet with our sarcoma radiation oncologist here at Hopkins. We hope to have all of the details settled shortly after that.

Importantly, my oncologists remain certain that there is no role for chemotherapy. Of course, not needing any more therapy would have been our first choice, but just short of that, radiation is not so bad. We should be done around the end of January or early February.

Thank you again for all of your prayers and support. We're not far from the one year mark since this all started; we certainly appreciate your persistence!

Robert, Gwyneth, and William