We met with the neurosurgeon last night. He said that the mass near David's spine has not penetrated the dural membrane and has not begun to put pressure on his spine, so he doesn't want to remove it yet. He wants David to have another MRI in three to four months to see how fast the mass is growing.

So that means the surgery for tomorrow is going forward. I think it will be a biopsy of the mass near his spine. It is very near the surface and big enough they don't have to get particularly close to the spine to biopsy it. I think they are still planning to install a Hickman port as well. I was reading about that. It seems they might order chemotherapy even if the mass is not cancerous. Chemotherapy sometimes is used in neurofibromasis-1 to shrink benign tumors.

The neurosurgeon tells me that he is most concerned about the mass in David's abdomen. His feeling is that it should be biopsied separately. He worries that it is different from the mass near his spine. There is a possibility the mass in his abdomen represents something wrong with his lymphatic system or his adrenal gland.

The neurosurgeon reiterated that since the most common forms of cancer has been ruled out pretty much, that if it is malignant, then it is something that is exceedingly rare.

I talked to the surgeon who is supposed to do the biopsy on Friday. She, the neurosurgeon, and the oncologists should be having a discussion later today on how to proceed. The main question is if there is sufficient cause to biopsy both masses. I understand both sides of the question, and both answers scare me. I really hate taking a risk that they are different, but the surgery to biopsy the deeper mass is far more invasive.

I would be less worried about the masses being different, but Kelly's boss's wife has two different types of breast cancer, one in each breast. That really drives home that the possibility that they masses could be different may be small, but it is not zero.