We had a good weekend, Autumn seemed to do well!
Monday morning we learned a bit of news that wasn't as reassuring as we would have liked. As with most tumors, a piece of each one discovered is reviewed by a local pathologist, then again by a panel of pathologists usually specific to that particular type of cancer.
When the pathologist here looked at Autumn's tumor cells, he determined that she had a stage III (due to lack of spreading) Wilm's tumor with a favorable histology. Favorable because they found something known as "focal anaplasia" instead of "diffuse anaplasia". Anaplasia has to do with the DNA in the nucleus of the cells found in some areas throughout the tumor. This DNA has replicated many times without dividing the cell, so it's sort of a messy mass of genetic ugliness in the middle of the cell. Here at Cottage, the pathologist found ONE of these within the 20 slides that they created from the tumor. At the Institution, they reported finding three. If there is more than one, they call it "diffuse anaplasia" instead of being focal.
Intuitively, it seems that if there is one, there could always be more. We were hoping of course that it would be the ONLY one they would find, but I suppose that wasn't very likely.
A tumor with this diffusion doesn't respond well with the DD4-a treatment Autumn was originally scheduled to take. Therefore, she needs to be on another, more aggressive, regimen called UH-1. It has 5 total agents instead of 3 and the time frame in which they are given is a bit different. Each week consists of at least one day, but some weeks will have 4 consecutive days (each time is only 1-5 hours), but there are about 5 of those throughout the 7 month period.
They also extended her radiation one more week, only to the area that was affected (instead of her entire abdomen like they are doing this week).
I suppose one way to look at this is being thankful that we KNOW what it is and there we are getting the best chemo that currently exists for this tumor. It's never fun to hear something like this in the first place, and then to be told it's a bit worse than we thought, but what can anyone do? We are in this life right now. People are having a hell of a time in places like Japan and Libya. Life really may not be fair for anyone, but we are given what we are given and life moves on. Autumn is such a strong amazing little girl, I can hardly believe it myself when I look at her.
She just had her first treatment of this new regimen about an hour ago. They gave her 3 of the 5 agents. One of them gave her a headache like no other poor thing, but the other two went quickly and without incident.
I can say it has been fun passing a little time alone with her, no sibling rivalry and lots of love. THAT I can take anytime!! :)