It has been a roller coaster of a year, to say the least. With routine follow up scans and appointments with U-M Pediatric Radiology and Oncology, my nerves and emotions go in waves. In the days immediately following surgery, I remember feeling a sense of relief and thankful for all the great doctors, nurses, and all the support from family and friends. And I continue to feel that way today.
On Friday, November 9th, Easton had his one year CT scans, with his follow-up appointment the following Tuesday. We went into that appointment nervous, but confident, as we have all his appointment.We didn't leave with that same feeling. We were informed that while the area where the tumor was removed from was clear with no evidence of local recurrence, there were a few, five to be exact, very small nodules on the posterior of Easton's right lung that were a concern. Their impressions stated the following:
"Interval development of several right upper and lower lobe soft tissue nodules as described above. These could represent infection in the proper clinical scenario, however, given patient these are viewed with suspicion for metastatic disease. These are too small to biopsy. Recommend short-term follow-up to evaluate for interval change."
Basically, the nodules on his lungs are a concern because the lungs are an area where a Wilms recurrence could occur. Not always does a recurrence occur in the place of the original tumor. If it comes back in the same place, it's called a local recurrence, a nearby place is a regional recurrence and another place is a distant recurrence. The lungs and the liver in particular are areas that are known to be common recurrence sites, so they watch these areas very closely.
The doctors explained that they were scheduled to meet with the "Tumor Board" the next day and would review Easton's case with pediatric radiologists, oncologists and surgeons to get their input and determine a time frame for repeating the scans. As much as I would have loved to have the scans done immediately, they explained that they needed to give the nodules time to change, so would likely wait 4-6 weeks.
I received a call from Easton's doctor immediately following the Tumor Board meeting with news that after closely reviewing his case, radiologists feel that these nodules are less likely cancer, and more likely an a-typical or resolving infection. They have requested a repeat scan of the right lung only (to reduce exposure to radiation) in 6 weeks.
So, while this news was a bit of a relief, and I feel like I can breathe a little easier, we now just have to wait. We are scheduled to head back to U-M on December 14th for repeat scans. Worst case scenario, the nodules will be bigger, and if big enough, they will biopsy them and if results come back that it is in fact cancer, Easton will likely begin chemotherapy. Assuming, and hopeful, that the radiologists are right, the nodules will prove to be an infection and will be smaller, if not obsolete, and Easton will continue his routine follow-up appointments as scheduled. Prayers for the latter, please!!!!
Easton and Grandma being silly before his one year scans.