2nd Opinion

On Monday, Jan 7th, Roni and I drove down to Baltimore, MD to meet with Dr. Esquival for a second opinion. We were supposed to meet with Dr. Sugarbaker in the morning, then Dr. Esquivel in the afternoon, but it turned out our appointment with Dr. Sugarbaker was never confirmed, so we never did meet with him. It turns out that that was not such a bad thing. We have been hearing rumors that he is looking to start slowing down his practice and might retire. I heard that he is in his 60s. He has helped many people and I think he deserves to take it easy if he wants.

Now, on to what Dr. Esquivel had to say.

When we got there, I went in to get my vitals taken, while Dr. Esquivel had a look at my latest CT scan. He came in shortly after that to examine me, which was basically just poking and prodding my stomach. He then said something to the effect, "You have nothing to worry about", then said he would me us in another room to discuss what saw.

As for the scans, he asked if we had seen them, and said yes, and that Dr. Loggie had already showed us where the "recurrence" was. He said he wouldn't bother then, and we went into a small room to talk.

He started off by saying that he did not want to know what Dr. Loggie said until after he told us what he thought. He then said that currently, he did not think we had anything to worry about for now. He said that after looking at the scans for the past 9 months or so, he did not see any significant growth of tumor, but did say he was not sure why the tumor markers continued to rise, but did not seem too concerned about it.

Something interesting that he said, coincided with something that Dr. Loggie said. Even though my initial pathology report said I had signet ring cells, he did not think I did. He told us that when people are diagnosed with signet ring cells, they usually don't live past 12 months, and here I am, 4 years later. He also said that the second pathology report we had done, did not mention signet ring, something we weren't sure about until Roni came back and looked at the second pathology report and saw that in fact, it DIDN'T mention signet ring cells. Dr Esquivel said that what might have happened was that there might have been a few cells, which were recorded in the pathology report, but in fact were so few, they should not have been mentioned.

Another thing he wondered about was the 3 out of 10 positive lymph nodes from my first surgery. He said if they were really positive, and I did in fact had signet ring cells, I probably wouldn't be here today.

He also agree with Dr. Loggie in that he did not think surgery was necessary right now. He said that because of where the tumor was (spleen and on the back side of the liver), he did not see any immediate need to cut me open. I was glad to hear that.

So overall, it was an encouraging consultation. I am still concerned as to why the tumor markers keep going up, but both Drs Loggie and Esquival do not see any immediate need to do anything. They're not even suggesting chemo right now. I can live with that.

One thing that does have to be done, is a new pathology report from my original surgery. Both Dr. Loggie and Dr. Esquival want to look at the original tumor to find out exactly what is going on. If they confirm that I, in fact, did NOT have signet ring cells, then that will explain some things. We also need to figure out what is going on with the tumor markers.

Well, that's all for now. I'll be scheduling an appointment soon with my oncologist to discuss the consultations with Dr. Loggie and Dr. Esquivel. I'll post again after that to let you know what my oncologist thinks should be done next.

Till then, thank you all again for keeping me in your thoughts and prayers.

Kevin