Dr. Apolo from NIH called me this afternoon to advise me that she had reviewed my PET scan with Dr. Brad Wood, Chief of NIH's Interventional Radiology Section (bio). Dr. Wood said he was willing to try to do a biopsy. He had one slot available this Friday, otherwise, it would be on Tuesday, September 10. He said it would be a difficult biopsy, and he would need some atypical equipment to do it. She didn't fill me in on all the details, but I got the impression that this would be different that a regular ultrsound-guided needle biopsy. Dr. Apolo is now trying to coordinate getting an OR and the proper equipment together for this Friday. She will let me know. I said that anytime Friday was fine. She said she'd get back to me, hopefully tomorrow, to confirm.
I now realize that I don't know what kind of biopsy that Dr. Wood may be planning. I had assumed that it would be fine needle aspiration, where a thin needle is guided into the lymph node, or a core needle biopsy, which uses a slightly thicker needle. Both are minimally outpatient procedures. The other option is an incisional and excisional biopsy, where the patient is under heavy sedation and more tissue is taken. It's also usually an outpatient procedure, but it can have a longer recovery time.
Whatever procedure it is, Dr. Apolo said that confirming the distant mets by biopsy will be important to guiding her in recommending the appropriate clinical trial. Apparently she intends to have the metastatic lymph node run through NIH's DNA sequencer to do a genetic analysis of the mutations and characteristics of my cancer. This is cutting edge stuff which no insurance company would pay for, because it's all experimental. Your tax dollars at work.
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