Today our little girl Myra had her follow up visit with her oncologist. We were up bright and early to make the one hour drive to Malvern where we would hear the results of the flow cytometry test that would tell us whether the type of lymphoma was indolent (slow to progress, meaning a long survival time) or aggressive (quick to progress, meaning we would have a bigger mountain to climb). Myra took a new squeaky dinosaur along for the trip and seemed pretty unconcerned about the whole ordeal, while Hue and I were struggling to keep our composure. Today, I clearly had a better understanding of the agony my clients endure while awaiting lab results.
Dr. Vickery started the conversation by saying "This will be confusing". Uh oh. Thankfully, she is really good at getting things down to a level that is pretty understandable (although I am still waiting for her written report before feeling really comfortable with my understanding here).
It seems that Myra's biopsy from the intestine showed a small cell lymphoma comprised of mostly B cells. This is the more indolent type of bowel cancer found in cats, rather than dogs. Myra's cancer did not fit the picture for the indolent form because her lymph nodes in her neck blew up after surgery. When they were measured last week, one was 4.5 cm wide and the other was 3.5 cm. This fit more with the aggressive form of cancer. The flow cytometry test was performed to determine which type of cancer she really has.
After her first dose of L-spar last week, I thought Myra's lymph nodes felt smaller. Her energy level soared and she has been begging to eat all day long. I was right; the lymph nodes measured 3.5 and 2.5 cm today!
The flow cytometry test came back with the indolent form of cancer - the small cell. Dr. Vickery was thrilled, but not nearly as much as Hue and I! We refrained from jumping up with a high five in the office, but what a relief! The doctor decided that Myra would not need to start steroid therapy (great news!) or any injectable chemotherapy. She did recommend that we start Myra on an oral chemotherapy medication (I'll let you know what it is when I know; it's being shipped to us). Our other option is to do no chemotherapy and wait until Myra becomes symptomatic with either lymph node enlargement, lack of appetite, or vomiting.
We also will need to perform abdominal ultrasounds every 3 months, along with lab work to watch her white blood cell count (it never went up during this saga). If we see a mass or thickening of the bowel or her lymphocyte count goes up, her chemotherapy would need to be much more aggressive. I asked again about the whole body radiation, but she felt there was greater risk of side effects than benefit, so we are not pursuing that at this time.
Now I have a few days to decide whether to give the oral medication. Myra is doing so well and I believe that her herbs, supplements, and diet will really help her fight this. Back to decisions, decisions.
If I don't treat and her cancer progresses or becomes aggressive, I'll feel horrible. If I do treat and she has side effects or the cancer progresses, I'll feel horrible. I have time to ponder the issue, so for now I'm going to keep going with DINOSAUR THERAPY!