Rachel had her official 2nd opinion visits in Boston today. She met with a neurosurgeon at Boston Children’s Hospital, who said that from a neurosurgery standpoint she doesn’t need another surgery.

Then she met with a sarcoma specialist and a radiation oncologist at Dana Farber, who said she needs surgery to remove the remaining cancer cells in her spine and radiation treatments. They strongly recommend proton beam radiation, which is only done at Mass General. Proton radiation is more precise and doesn’t have the “exit dose” radiation that traditional radiation has. Given that her heart and lungs are on the other side of the cancer cells, limiting the exit dose is really important.

Dana Farber didn’t specify whether she needs the surgery at Mass General or if it could be done in Portland, but did seem to imply that it might be easier to have everything done at Mass General, and indicated that it should be soon – within the next month or so. Of course, since the treatment will be done at Mass General and not Dana Farber, these doctors that we just met (finally, after pushing for the appointments) won’t be the ones treating her and we’ll now have to wait for information from Mass General.

The sarcoma specialist did mention that Rachel shouldn’t have the final doxorubicin treatment that’s in her treatment plan, since she already had one treatment of that back in December when they thought she had the other cancer. She also mentioned a medication to protect her heart from the doxorubicin should start to be used going forward with future rounds of doxorubicin. They also mentioned referring Rachel to a genetic counselor once the genetic testing results come back because approximately 10% of osteosarcomas are genetic – which would put her at increased risk for other cancers and could also mean we should have Rachel’s sisters tested as well.