The Summary:

Still waiting on final biopsy results. More surgery is likely. Betty is a mutant has a mutation.

The Details:

The hold up with my next round of treatment apparently is because the lab has yet to finalize my pathology results, and so my doc can’t make final decisions yet. Two samples were sent to the lab – from the same spot as my last recurrence (last May) and from deeper within my ear canal. We don’t know yet which (or if both) came back as abnormal. Oncologist sent the lab an “I’m very disappointed this is taking so long” email yesterday.

Most likely what they’ll do is more extensive surgery.  I’ll probably lose my ear for real this time, followed by radiation. I’ll have a new surgeon too, a head/neck specialist who I’ll meet next week. Whereas in the past, the idea seemed to be to save as much of my ear as possible, now it seems to be to take an ice cream scoop to the area and remove as much as possible in order to save me. I’ll sacrifice an ear if necessary for the chance of a longer life.

Then there’s sort of/but not really good news in that Betty has a particular mutation (BRAF) that occurs in about 50% of melanomas. Last year we didn’t think I had it. Initial tests were negative, but the final/definitive genetic test came back positive. The mutation makes the melanoma extra aggressive and more likely to be deadly (boo!), but it also opens up more drug possibilities (yay!). The drugs are very good at shrinking the tumors, but their effects don’t last long for most people (7-8 months). So the goal for me would be to get rid of as much of Betty as possible before trying them. The less cancer cells I have left in me, the better the odds that the drugs can eradicate Betty.