Dr. Hochberg came in this morning with some preliminary results from the biopsy. It’s looking like Ana has an extremely rare form of vascular cancer which starts in the lining of the blood vessels and can spread anywhere in the body, but is most commonly found in the liver, lungs and bones. So, this is a vascular cancer, not a liver cancer.
The name for this disease is epithelial hemangioendothelioma (EHE). The bad news is that since it’s so rare, there’s no prescribed chemotherapy regimen known to shrink it. Sometimes it responds to chemo, and sometimes it doesn’t. The GOOD news is that we spoke to the liver surgeon, Dr. Wu, shortly after speaking with Dr. Hochberg. He said that the tumor is operable as is – which means he can remove it even if they can’t shrink it, but Ana will likely need a complete liver transplant because of the blood vessel involvement.
She will still get one or two courses of chemotherapy to try and shrink the tumor and eliminate any microscopic cancer cells. The oncologists used the term “low grade” to describe it – meaning it is not growing rapidly. Tumor shrinkage would enable Ana to feel more comfortable as she waits for a suitable transplant and also prevent it from growing anymore. Dr. Hochberg and her associate, Dr. Elmacken both feel this is an aggressive tumor, but not the MOST aggressive tumor (since it hasn’t spread beyond one or two lymph nodes located close to the liver).
So…what does this mean? First of all, we don’t have the finished biopsy results yet, so there is a chance this diagnosis can change, although Dr. Hochberg felt pretty confident that they’ve identified what this is. Jim and I are going to meet with her hopefully this weekend to discuss a plan of action. Ana could potentially begin chemotherapy as early as tomorrow. We have lots of questions, but at least now we’re starting to get some answers. I will post an update as soon as I can.