Rachel met with the surgeon, the pediatric oncologist, and a radiation oncologist at Mass General today. They still don’t have any answers on the timing of surgery and radiation, but at least now Rachel is no longer some nameless, faceless patient from some doctor in Maine that they can ignore. Rachel’s case will be discussed at their “sarcoma conference” on Thursday to discuss the best timing.

Rachel’s case is complicated due to the location of her tumor being on her spine. She will need to have supporting hardware placed in her spine after surgery. Traditional hardware is made of titanium, which not only makes imaging scans harder to read, but also causes radiation to “scatter”, making it difficult to treat with radiation. On the other hand, doing all the radiation up front will affect the surgery, delaying it in order to heal from the radiation. Her chemo will also need to be changed during and after radiation because it’s not safe to give doxorubicin or methotrexate during radiation (sometimes they give methotrexate during radiation, but not where hers will be on her spine.)