Again

It was difficult to come up with a name for this post.  Friends that have already heard the news suggested that expletives are most appropriate to describe the situation--Ernie's base of tongue cancer has returned. 

The local ENT doctor was concerned about how fast Ernie's swallowing and breathing were deteriorating.  When he first saw Ernie in early October, the doctor was not convinced that a trach was inevitable.  Two weeks later, it was critical. 

The rapid change in Ernie's condition made the doctor suspicious.  So, when he did the trans-nasal endoscopy, he did a biopsy as well.  He was very casual about it--one of these "while I'm in here I might as well go ahead and take some samples" kind of thing.  I think he did not want to alarm us.  Unfortunately, the biopsy confirmed his instincts. 

After several days of discussion with our wonderful medical teams here and in Baltimore, we've decided to pursue two paths simultaneously:

1.  Palliative Care:  this is a dedicated group within Wake Forest Baptist that focuses on symptom and stress relief.   They will make sure Ernie is not in pain, work on helping him get some good sleep, help us get appointments and supplies more quickly, etc.  This will be especially important if Ernie's symptoms continue to progress at a rapid rate. 

2.  Aggressive Treatment:  Ernie will have a PET/CT next Wednesday to determine if the cancer has spread beyond the base of tongue.  Once the doctor's know what areas they need to treat, they will come up with treatment options.  We have asked both the Multi-disciplinary Tumor Boards at Wake Forest and Johns Hopkins for recommendations.  We should have these about a week after the scans.  While the options are more limited and more drastic, the good news is that there are options.

Ernie took the cure once, now he will have to take the "re-cure."