We got a chance to talk to Ryan's oncologist today. It seems that the marrow biopsy this week has no bearing on management (one would ask, why do it?, and I guess doctors are debating it also). He is on a strict protocol of chemo, and all of the data is used to determine effectiveness of this protocol; when it was designed they included the Day 18 marrow biopsy ?perhaps to see if it was in any way predictive of outcomes. The biopsy on Day 30 is the one that will determine which "consolidation" regimen he receives.
He will get Vincristine on Day 25 (Sunday), and then can go home on oral steroids and have his next marrow biopsy as an outpatient.
Even if that marrow shows no cancer cells, the assumption is that there are still leukemic cells somewhere in his body. Then he will have multiple courses of various agents - some in-patient and some out-patient over the next 4-6 months. Then they will most likely proceed with marrow transplant.
If at any point he fails, marrow transplant may be considered earlier with as little as 2 weeks notice. I'm not sure I understand the logic of this approach, but perhaps the marrow transplants are more successful if more tumor is eradicated first. In any case, that's the general scenario.
The metaphor would be that they've done a major bombardment of the enemy, but they still plan to send in the SEALs and Green Berets to finish the job, mop up and wipe out any pockets of resistance...........
I think we're all worn out and emotionally spent at this point. The daily trips to & from Albany are wearing both Sophia and I out. Yet we want to be with Ryan. It will be better when he's home.
From Ryan's viewpoint, it will be hard to be at "home" when it isn't really his home, and he can't go do whatever he'd like. It's like being out on parole with and ankle bracelet. Sophia and I went shopping today so she can make their room "theirs". It looks awesome. Little by little, Ryan will be able to figure out how to spend his time with some sense of productivity and satisfaction. It's got to be hard to go from a hectic missionary schedule and a busy student schedule to having to just stay at home. And there's the complete uncertainty about what the next few months and years hold.
Although we know the God has a plan for him, waiting for the unveiling is agonizing.
One day at a time.......
---Barb
We so appreciate these updates, Barb. Helps us to stay 'in the loop', at least a little bit. Please let Ryan know that President Visarraga announced Ryan's diagnosis and condition at church on Sunday and suggested/recommended that the members may want to include him and you all in their upcoming fast this Sunday. It seems that there are many who are planning to do this. You all remain in our prayers......Michele Visarraga
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DeleteThank you so much. I know Ryan loves you all so very much and will be moved to hear of your fast for him. If anyone wants to send letters or cards, our address is: 85 Lower Newtown Rd, Waterford, NY 12188. Please tell everyone in your branch that serving his mission among the Hispanics is Utah was such a privilege for Ryan. Not a day passes that he doesn't speak lovingly of all of you and the influence you have had on his life.
Delete---Barb
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ReplyDeleteEven though it means more treatments, all the cancer cells must be destoyed or the cancer would come back?
DeleteAs long as there are any cancer cells, they can reproduce. Sometimes their numbers are small, and the body's immune defenses can eliminate them. But it really only takes one to reproduce. And that's the ultimate challenge with all cancer: how to eliminate the cancer cells and minimize the damage to the healthy cells. Kudos to those wonderful and brilliant people who study science and work away in labs studying cellular biology in an attempt to identify weaknesses in cancer cells that can be exploited to save lives.
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