Post Surgery Pathology Reports

Despite multiple return trips and stays at the hospital due to post surgery infections/fevers we continue to have encouraging news from an ultimate prognosis perspective.

The pathology results have come back on the resection (tumor removal) and they are very encouraging. There are three classifications of resection - R0, R1, R2. R0 means that all the discernible cancer was removed - including tissue analyzed microscopically. R1 means that all of the visible cancer was removed but there are some microscopic bits left on the tissue still remaining in body. R2 is when they simply couldn’t get all of the visible tumor out as it was compromising organs or parts of organs/tissue difficult to remove.

While an R0 resection is preferred, R1 resections are common and don’t necessarily change ultimate prognosis. We debated long and hard about where to go for surgery, specifically to maximize our chances for an R0 resection. Ultimately we decided to stick with Yale cause we really trust the team here and the full suite of care is better than we could have ever imagined. (Staff visit Crash/us on their off hours/days and we have the cell numbers for many of the medical staff). Our expectation was for an R1 and we didn’t think changing hospitals/surgical teams was a guarantee of a better result.

It takes a bit of time to microscopically analyze all of the margins of the removed material but we are very happy to report that it’s been determined that our team got an R0 resection!

The chemo treatments had reduced the volume of the tumor by 90% (consistent with best case reports using the treatment protocols we’ve been following). It essentially went from a big inflated ballon to a thin ribbon of material. In order to ensure they got any potential cancer out, they removed all non-critical areas that the original tumor was pushing against. It turns out that those areas had not been contaminated by the PPB tumor. The removed pericardium, the entire middle lobe and the diaphragm - all tested negative for cancer, which means that at this point it is assumed that the cancer was fully contained in the lower right lobe and the right pleural - both of which have been completely removed. Further, the tumor that was removed has tested as a Type II PPB, not a Type III - also slightly unexpected but very welcomed news.

We still have a long way to go - need to understand the source of these fevers/infections (we are currently in the hospital for a 3-4 days stint after a procedure that drained a bunch of fluid that had collected in the chest cavity previously occupied by his lung), need to address and analyze the “cyst” in his other lung, need to run further Dicer 1 mutation tests on the removed tumor, as well as keep on this chemo protocol for another 6 months. BUT as I like to say, most all news we’ve received since diagnosis has been positive from a prognosis perspective (touch wood).

We are both good about focusing on our end game here - cancer free - so these frequent hospital admissions are made much more tolerable by the improving prognosis. And by the support we feel by so many.

The photo Gallery has been updated with several recent pictures.

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