Dr. Ramhan Noodles

I couldn't help myself.

I'm sure I've spelt his name several ways up till now, but I've finally got it right. He is covering for Dr. Donadio while she is on maternity leave. Dr. Ramhan (ra-MON) has always had a special place in our hearts because he was the oncologist on-call last Christmas Eve when we ended up in the ER, and he's also married to our dentist!

We met with him yesterday early morning and he explained to us that Mom's case was actually presented at oncology rounds, meaning oncologists from every walk of life, including those who have cared for her, discuss her case, look at her files, and come up with what they think is the best plan. Because Mom has already done chemotherapy, and this transitional cell carcinoma wasn't knocked out the first time, it's less likely that chemotherapy would be effective a second time. The plan has taken on a new life, and this time we're trying radiation. Unlike chemo which is systemic, radiation is very focal. It only impacts where it hits. Which brings me to some very good news- once the tumor was removed, a thorough wash was done of Mom's entire pelvic cavity, and that fluid was collected and sent to pathology for testing. The pelvic cavity wash came back negative for evidence of cancer cells, so for all intensive purposes, Mom is cancer free right now. 

I know what you're thinking, "you said that last year before chemo too!" Well, when there's no physiologic (tumor) evidence or scientific (microscopic cancer cells) floating around, that's how they explain it to you. If there are any little cells hanging out, they're in her pelvic cavity, which is why radiation right to that area has the most potential to kill the little buggers.

Emotionally, this was very hard for both Mom and I to latch on to. It seems every day there is a new twist. You have ovarian cancer. Just kidding, it's a recurrence. You need chemo. Just kidding, you need radiation. As Mom put it, she has a certain comfort level with chemo; she knows her nurse, she knows where the bathrooms are,  and she knows she knocked the symptoms out of the park. Radiation is new territory, with new symptoms and side effects. We'll meet with her radiation MD, Dr. von Rooy, the second week of December to talk it all through. The earliest she'll start is in 4 weeks, because her scars need to be more than well healed so as not to put her at risk for infection. More to come on radiation...

Dr. Ramhan was very helpful on many fronts. He also suggested Mom have a baseline MRI on Monday. This is because she has nodules on her liver that were felt and seen during surgery. After looking at the impressive collection of CAT scans she's collected over the years, these nodules has been there all along with very minimal changes, but he just wants to get an MRI now of her pelvic area so they'll always have something to compare it too.

He also gave me some great resources to research and get linked in with clinical trials happening all over the country. I gave a call to the organization and was hooked up with Krista, who will have her pulse on all trials Mom is applicable to participating if she wants to. Any time Mom's situation or treatment changes (ie when she starts radiation), Krista gets a call, she modifies Mom's profile, and sees what else is out there. It's a phenomenal system, and so user friendly. We've gotten a list of 7 that meet her criteria so far, but we'll go through those in a few days.

We've also got an appointment with Dr. Choueri at Dana Farber, who we saw last year as well, and Dr. Bajorin at Sloan-Kettering, who Dr. Ramhan worked with closely for years. So we're covering our bases, consulting with the experts, researching clinical trials, drinking lots of tea, catching up on Mad Men, and rearranging Mom's bedroom today. We're very busy and productive people.