Tuesday, August 10, 2010

Interview with Dr. Charles Scoggins

I was able to talk on with my cancer doctor, Charles Scoggins, on Monday of this week. The discussion was candid and very encouraging.  We talked for more about an hour about my situation and the following were some of the questions I asked:
Am I going to be receiving Moh’s Surgery? (Moh’s surgery is where they take microscopic samples of skin to do a live biopsy during the surgery)
Your area is too large for Moh’s. We will be taking large sample tissues (skin and fat) and freezing it on site, and then take a live biopsy of a cross sample of that tissue.
(During my last surgery, they had to send the removed tissue off for a biopsy and wait for the results. The live biopsy will guide the surgeons well towards removing the bad and getting into the clean margins.)

With my present condition, would it be better if I were transferred to a sarcoma center? Like Houston or Vanderbilt?
We have the exact same equipment here as they have at those hospitals. I have personally trained for years at both Vanderbilt and M.D. Anderson in Houston. I have had extensive experience with your particular cancer. We will be doing the exact same thing here that would be done there.
What is my expected recovery time?
You are looking at 2-3 weeks if we do not have to do a skin graft and up to 6-7 weeks if there is a skin graft.
Has my cancer metastasized (spread)?
No. I will need to clarify my former statement. While it did show up in the fatty tissue samples from your last surgery, the biopsy did not reveal that the cancer was internal to the fat cells. DFSP Cancer creates “spindle” like fingers that run throughout the surrounding tissue. Your biopsy did reveal that these “fingers” ran through the sample, and therefore a radical resection of the remaining tissue around the wound is warranted. Your cancer should only be a problem right here (he pointed to the wound on my leg) and not anywhere else.
What are my odds of survival?
From what I have already seen and from my experience with DFSP, I am confident that your odds of survival are 100%. The next surgery should completely remove your cancer.
I have read where DFSP has a spread rate of 5%. So, 95% of the people who get DFSP will not see the cancer spread. Am I in the 5% or 95%?
I do not believe this cancer will spread beyond this region.
(in other words, I am still in the 95%)

How soon will I be able to travel or jog?
As soon as the stitches and wound drain are removed.
Will you be taking any samples of muscle tissue?
We will not be sampling any of your muscle tissue. There is no reason why we would need to.
Should I be taking Gleevac/Iminitab, the really expensive ($5000 a month!) cancer drug that some reports are indicating are successful with DFSP ?
I have seen no real indication that Gleevac works with DFSP. All research being done is still in its clinical trial stage. Why spend such money on something that is absolutely uncertain?
While he believes that this upcoming surgery should remove the remainder of the cancer, more tests will be done on the removed tissue that could still warrant more surgery in the immediate future.

From this discussion, there are a few prayer concerns that I would still like to ask for:
1) Pray that the Dr.’s will get a good look at the DFSP spindles as they perform the live biopsy. This will take a lot of time and will require trained eyes.
2) Pray that I would not need a skin graft.
3) Pray that the cancer will be completely removed.

May God bless us all as we journey through hardship.

- Bro. Dave

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