As compassionate and considerate as Dr. Dang was, he wasn't able to be very encouraging with the facts as they are. He suspects that Lisa's femur will need reinforcement via a surgical implant of a pin or rod,
though he'll defer to the orthopedic surgeon's recommendation (we have that consult on Thursday afternoon). I don't know exactly what type they'd use, but it could be something like is shown at this orthopedic site link or is shown in this YouTube video, but hopefully less invasive than either of them. If the surgery is required, it will take Lisa a couple of weeks to recover to the point where they can do radiation on the femur, which would then potentially be every weekday for about three weeks. We know Lisa's particular cancer responds well to radiation, and it is expected that it would not recur in that bone area again. If there is to be a chemo treatment, it would follow the radiation, rather than be concurrent with it. Meanwhile, the osteoporosis bone enhancement medicine can be given right away. Instead of Zometa, it will more likely be the newer and more effective medicine, Xgeva.
On the more routine side, Dr. Dang said that Lisa needs to have a regular dental hygiene visit, because Xgeva has a rare side effect of causing jaw problems, and you shouldn't have dental work while you're on it, so she has to have her dental checkup first. Also, Lisa is going to go get a flu shot.
On the less routine side, Dr. Dang wants to do a brain MRI. He doesn't expect that Lisa will have any problems there because of what they usually see with Lisa's cancer's current progression, but he wants to be precautionary and thorough. It will probably be scheduled later this week.
We talked with the doctor quite a bit about concerns regarding starting chemo again, since Lisa currently feels so good other than some manageable bone ache, and really doesn't want to necessarily give up that quality of life if the ultimate effect of chemo isn't very promising. It's something we'll continue to evaluate.
