. . .in which the Dealer allows the Joker into play.
When last we visited the pathology report, all was well — the tumor had been large, but self-contained; the margins were clear from Bangor to Cincinnati; the estrogen and progesterone receptors were receiving and strong.
There only remained the vexed question of the surveyed lymph nodes. Pathology discovered that, of the four taken, one was positive (bad), one was negative (good) and two had tiny, tiny, ohsoverytiny, isolated amounts of cancer in them (oh, dear, now what?).
Given the Medical Rule for when to take All the Lymph Nodes, it was a tough call, what to do next.
The call has now been made — the lymph nodes need to go. There are two ways to do this — one surgical, one radiological — and I am being set up to meet with the surgical oncologist and the radiology oncologist. Based on what little I have gleaned, I’ll probably just jump straight to radiation, since surgical removal has two gotchas — one, if any of the other lymph nodes are found to contain cancer cells, I’ll have to have radiation, anyway, in addition to the surgery. Two, the chance of lymphoma arising from surgical removal is twice as high as removal by ray gun.
I will of course know more after I meet with the specialists, Steve attending both meetings with me via cellphone from the isolation unit we like to call our car.
So, there’s that.