Monday, February 13, 2017

Admission to Oncology

Leave it to Molly to keep things leaning towards the unexpected!   Today's oncologist visit did not play out at all like I thought it would - but that's okay!   I went into the whole thing thinking she would get a dose of chemo, fretting about the side effects, and all of the questions I had written down on a piece of paper were geared towards that outcome.

Waiting room cuteness.
The oncologist had Molly's x-rays up on a computer screen in the exam room, and she reiterated that they looked great.   I told her I was paranoid about them actually being good!   We reviewed the normal bloodwork, normal x-rays, normal clinical presentation.   The oncologist told me that she wanted to run an additional blood test called "LDH" - the levels of this test can be off in patients with lymphoma.   She suspected this would also be normal, and it was.   They ran it right at the clinic - so nice to have instant results!   The vet palpated all of Molly's lymph nodes, and could not feel them.   Another good sign!   She wants Molly to have an ultrasound to check for lymph nodes that might be deeper in the abdomen than can be felt, so that we can see if they are enlarged - I am planning to have that done on Thursday if I can get the time off of work.

Molly's lymph node, somewhere in a lab far far away, will now be tested to determine if we are dealing with "B-Cell" or "T-Cell" lymphoma.   When we find out the answer to that, we will start treatment.   However, the oncologist says that it appears we are dealing with "indolent lymphoma" based on all of the test results and normal clinical presentation.   Indolent is a very slow growing and not so aggressive lymphoma, so that would be very very awesome if that was what Molly is dealing with.

The mast cell tumors were next on the list.   This kind of surprised me, since Molly's MCTs were all grade 2, low growth.   Benign.  Right?   I did show where all of Molly's tumors had been, and I mentioned that Molly has a really small, flat pink little bump near her nipple right near the same area.  
Our oncologist had a list of clinical indications that would require us to treat mast cell tumors: Recurrent and/or multiplicity of tumors, dirty surgical borders, malignant anatomic site ie inguinal area, mammary gland, digit or oral cavity, Histiological grading or high mitotic index.

Molly meets two of these criteria, since she has had two MCT recurrence since her original surgery last May, and two of those tumors were near the mammary gland.   When Molly went in the back to have blood drawn for the LDH test, she also had the little pink nipple bump aspirated and it was definitely full of mast cells.   Now the bump is larger and red and angry - so they gave her a shot of benadryl.     Molly is scheduled for surgery next Monday to have it removed, my poor girl.   She will also be taking pepcid and benadryl orally at home until further notice - this is a common course of action to get the histamine over production under control.   The ultrasound that Molly will have will also check for any sort of issues caused by her MCT, since it is in a high risk area.

So: ultrasound, another MCT removal surgery and waiting on results of lymph node testing.   Things are feeling a little more positive, that's for sure.

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