Initial MIBG Scan Results

We have been absent from our family blog for one month exactly as our son Thomas was diagnosed with cancer. We were publishing over at CaringBridge (https://www.caringbridge.org/visit/thomaslauer/), but are now going to try to bring the two together seamlessly in order to continue the family blog I have written for 14 years. This blog post is copied from CaringBridge and is being published retroactively.

Note that the below good news comes on the ninth day of the very first novena that began being prayed for Thomas: a St. Jude novena by his 13-year-old brother, John.

Since we have any army praying for Thomas, we wanted to get results out to our prayer warriors as soon as possible.

While the children have seen their Mama and Daddy fairly calm and sweet this morning--Mama reading Frog and Toad, taking them on a walk, puttering around--this has been our Garden of Gethsemane. When Thomas crawled into my arms and said, "I want you just to hold me forever," I did not know how my heart could withstand this.

Thomas' tumor (about 11 cm = 4.5 inches = size of softball?) is confirmed to be a neuroblastoma. It has been a heavy burden for us to know this all week, as this is much more complicated than the originally thought Wilm's tumor on the kidney. There is a thorough, excellent, calm article describing neuroblastomas by the American Cancer Society:

https://www.cancer.org/cancer/neuroblastoma.html

This is one of those cancers that has a significant number of forks in the decision tree. Many factors change the prognosis of this cancer. It is staged a little differently than other cancers into three categories:

• Low risk (5-year survival rate of 95% or better),
• Intermediate risk (survival rate of 90-95%), and
• High risk (survival rate of 40-50%).

This is a cancer that is much better to find before about 18 months old and is rarely seen after age 5, so just Thomas's age alone (almost 5) made the oncologist initially concerned that he would fall into the high-risk category ... but now after reviewing this scan result, he now believes Thomas is in the Low to Intermediate risk level which is far more treatable.

Thomas had an MIBG scan and bone marrow biopsy on Thursday.  Our pediatric oncologist just called to give us "great news" (his words) after his initial review of the scans that the cancer has not spread. The tumor is localized to the abdomen and they also reviewed the the blood work and it looks great as well.  Praise be Jesus Christ.

The bone marrow test result will take a few more days to come back from the lab, and they are needed to confirm 100% that the bones are also clear of any cancer, but the doctor said that he did not see any cancer in the bones through the MIBG scan results.  

From what we understand of neuroblastoma and how it likes to spread to the bones in particular, there may not be actual tumors but the cancer is measured by percentage of bone marrow cells that are cancerous (e.g., less than 10%, more than 10%). The oncologist thinks it has not spread to the bone marrow, but only those pathology results will confirm that completely.

Continuing specific prayer requests:

1. Please pray that it is operable.

There are four surgeons who are going to review the results on whether this is operable, as it is very close to the aorta and the portal vein to the liver. 

If this is operable, the surgeons would go in and remove it and maybe Thomas would not need any chemotherapy or radiation. That would be the most ideal.

2. Please pray that the cell type is not aggressive.

We cannot know the cell type until either the tumor is removed (surgery) or a biopsy is done. You can read about the many prognostic markers here:

https://www.cancer.org/cancer/neuroblastoma/detection-diagnosis-staging/staging.html

If the tumor is operable, they will take it out and run pathology tests then. If the tumor is not operable, they will do a biopsy to determine the biology of the tumor.

The biology of the tumor dictates the special formula and anticipated duration of chemo and radiation. It varies a lot with neuroblastoma and is described as extensive.

What is next?

Immediately next is trying to have fun making some memories while Thomas still feels good.

Not so fun in the moment is that Thomas will be having his COVID test (the kind deep up the nose!) on Saturday.

On Sunday, we are having family photos taken of us, too!

Tuesday June 16 has been blocked by the surgical team for Thomas to have either a biopsy or surgery. On Monday morning, we will meet with the head surgeon for a full discussion of which event is feasible, what it will be like (if surgery, probably all day, very extensive--but still what is best!), and what the recovery would be like.

To summarize, continuing specific prayer requests are:

1. Please pray that the neuroblastoma can be completely removed through surgery.
2. Please pray that the cell type is not aggressive.
3. Please pray that Thomas tolerates the COVID test and that it is not traumatic.

As my husband wrote . . . Our Heavenly Father is the creator of all.  He created Thomas, and this tumor is a creature that must obey His will.  We are pleading with God to command this malignant creature and if it is His will to let this cup pass from us.

Our family is about to pray a rosary of thanksgiving and encourage any of you praying to remember to thank God for this initial good news!