[Dailydrool] Our Elsinore's cytology report results, not so good

[Elizabeth Lindsey]

It was about this time in the evening ten years ago that we had to let our Jane Basset go. She was old and tired, and we think she probably had some kind of abdominal cancer. Not a day goes by when I don't still think of her and wish she were here, though never during a thunderstorm because she hated those so much I couldn't wish her back during one of those. She was gentle, had a great sense of humor, and loved to chase deer through the woods. She loved chasing deer so much that I hope that's how she's enjoying her eternity. She also loved us very much, and we loved her.

So somehow it feels rather fitting that it was today we received the pathology report from the cells an oncology intern removed from the lump on our Elsinore's rump during the initial consult on Tuesday, a report that shows they're cancerous. To wit:

"Fortunately, for us, the cytology that we repeated on Elsinore's was diagnostic and the results indicated that the mass on her hip is a soft tissue sarcoma. Unfortunately, this is a locally aggressive tumor that tends to send tendrils of tumor cells off the periphery of the mass, resulting in necessity for extensive surgical margins to best control this tumor. With this information, incisional biopsy (what we had previous discussed doing) will not be necessary. The next step is to consider staging and surgical removal of the mass. Staging includes thoracic radiographs that can be done on the day of surgery. If 'cure' is our goal, surgery would likely include amputation; however, non-curative intent surgery would involve mass excision. This option would be best followed by adjunctive radiation therapy or chemotherapy."

I'd been cautiously optimistic because the oncology intern who looked at the aspiration said it could very easily be just a mass of inflamed cells and nothing malignant at all. 

Oh, well. 

So what to do next? 

What we won't do is amputate Elsinore's leg. That's not an option Ken and I want to pursue.

I think what we will do is return to the oncologist for an information-gathering visit. I'd like to know more about this particular kind of cancer. How does it usually behave? What can we expect from it? How active did it appear to be (how much mitosis going on in the sample)? Just how involved might it be in Elsinore's haunch? Her regular vet was reluctant to de-bulk it, which is what the "staging and surgical removal of the mass" means. He said there are a lot of nerves in there, plus the muscle. I'm sure the surgeon/oncologist will encourage us to de-bulk the tumor. Surgeons are surgeons because they love doing surgery. No point being a surgeon if you can't do surgery, right? 

I think we will also make an appointment with the vet who specializes in hospice care. I know she will have a very different perspective. I think between the two of them, we may be able to find the right path, given the situation and the nature of this particular kind of cancer.

What we don't want to do is go in with a wrecking ball and completely destroy Elsinore's quality of life. Her quality of life is tremendously good right now. With the exception of not being given treats every time she tells me she needs one. Other than that, her life is terrific. I sure don't want to mess with that if it's only going to mean she's never able to regain it after this kind of surgery. A surgery that destroys more than it salvages doesn't seem like a winning proposition.

I kind of think I'm talking myself out of the surgery. But I also think it's still a good idea to hear what the surgeon/oncologist have to say about this. And then the hospice vet. And, of course, if any of you have thoughts about this or questions I need to be asking, I'm happy to get them. If I don't reply immediately, it's because I'm working under a tight deadline this week and next, and my mother's moving to Detroit this weekend. When it rains, it pours…. 

It's hard to get a report like this one, but then I look over at Elsinore who's looking intently at Ken who may be headed in the direction of the treat bowl or the leashes, and I'm happy that her life remains unchanged for now and she shows no signs of needing to go join our Jane any day soon. It's only us who are feeling differently now, looking at her and realizing our time together will come to an end much sooner than we'd wanted. But, of course, it's always too soon, isn't it?

Elizabeth