How MD Anderson’s pathology team changed my life

One Friday last October, I felt three tiny bumps behind my right ear. By Monday, they were the size of marbles. I panicked. It’d been only two months since I finished chemotherapy following my February 2017 Hodgkin’s lymphoma diagnosis.

At the time, I was doing my residency at a hospital in Lake Charles, Louisiana. I showed the bumps to an oncologist there, and he urged me to get them checked out immediately. After a CT scan, I had two of the three lymph nodes removed so they could be biopsied. When my Lake Charles oncologist called me with the results, he asked if I was sitting down. I knew what was coming next: “Your cancer is back.”

Unclear pathology results and an uncertain lymphoma diagnosis

The oncologist said the pathologist was convinced my lymphoma had returned but couldn’t subtype it. As a result, my results were being sent to two other medical centers in Louisiana for review.

Six different pathologists reviewed my case, and none of them could figure out what was happening. One even said that I might’ve been misdiagnosed the first time around. My oncologist told me to seek care at MD Anderson because no one in Louisiana was equipped to handle my case.

When I called to set up my appointment, MD Anderson requested all of my medical information, including all of the tissue samples taken since my initial lymphoma diagnosis.

Additional pathology tests reversed my diagnosis

I traveled to Houston a few days later and met with Dr. Nathan Fowler. He tenderly explained to my husband and me the poor prognosis that often accompanies a quick lymphoma relapse. He scheduled me to start chemotherapy the following week to prepare me for the stem cell transplant I’d ultimately need, but first he wanted to review my pathology and scheduled me for a CT scan and a bone marrow biopsy. Those tests changed the course of my life.

The day I showed up to MD Anderson to start chemotherapy, Dr. Fowler walked into my room, beaming.  “Abby, this almost never happens,” he said. “I rarely get to tell people that they don’t have cancer, but you don’t have cancer!”

I was shocked and speechless! Dr. Fowler explained that Dr. Jeffrey Medeiros, the chair of Hematopathology at MD Anderson, had redone my pathology tests and had been combing over the results for the past week. Although my lymph nodes had several markers seen in cancer, the findings were inconclusive and the lymph node swelling could also be from a benign cause, and my CT scan and bone marrow biopsy were negative. That proved there was no evidence of recurrent disease. After consulting with several colleagues, MD Anderson’s pathologists determined that I likely was suffering from an acute inflammatory response to my original chemotherapy treatment.

Moving forward after my cancer scare

To be honest, I was a little hesitant to accept that I didn’t have cancer because of all the previous confusion, but Dr. Fowler assured me that the risk of waiting to start treatment was smaller than the risks associated with undergoing an extremely aggressive type of chemotherapy. I returned to MD Anderson for a PET scan in December 2017, and it came back clear. I’ve had two more since then, and they’ve also come back clear.

I’ve got one more quarterly follow-up before I can say that I’ve been in remission a full year. I’m cautiously optimistic I will get there.

A new outlook

I’m eternally grateful to MD Anderson for saving me from unnecessary treatment and for taking the time to thoroughly examine my case.

This whole scare has entirely changed my priorities. It made me realize that as much as I wanted to be board-certified in Family Medicine, I wanted to spend time with my 2-year-old son even more. As a result, I left my residency program and hectic work schedule behind to stay home with my son and be there for my family. I know these days of his childhood are ones I’ll never get back, and my cancer scare reminded just how precious every day really is.

Read more from Abby Shoenfelt on her blog, TheMommyMD.com.

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