@grandmakat5 - I wanted to circle back on a few other questions I’m so glad you’re feeling proactive and exploring options while navigating this tough waiting period. Let’s break down your questions and thoughts, and I’ll do my best to clarify and support you.
Biopsy Notes on MyChart
The MyChart note stating that “4 samples were taken during procedure confirming malignancy during the biopsy” can understandably cause confusion and stress, especially if you weren’t expecting to see that. Here’s what it likely means:
Immediate Confirmation vs. Pathology Review: It’s highly unlikely that the doctor performing the CT-guided liver biopsy definitively confirmed malignancy during the procedure itself. Biopsies, especially for suspected cancer, typically require tissue samples to be sent to pathology for detailed analysis (e.g., microscopic examination, immunohistochemistry, or molecular testing). The phrasing in the note might be shorthand or a poorly worded summary, as your husband suspects, indicating that the samples were taken to confirm whether there’s malignancy, with results pending from pathology. During some procedures, a preliminary check (like a frozen section) can be done, but it’s rare for a CT-guided liver biopsy to yield an instant diagnosis. Most likely, the note reflects that the samples were collected and sent for pathology review to determine malignancy.
Possible Miscommunication or Typo: Electronic health record systems like MyChart sometimes use standardized templates or auto-generated phrases, which can be vague or misleading. The phrase “confirming malignancy” could be a template error or meant to say something like “taken to assess for malignancy.” Since you found it distressing, it’s worth calling your doctor or the hospital’s patient portal support team to clarify the note’s intent. You could say something like, “I saw a note on MyChart about my biopsy ‘confirming malignancy.’ Can you clarify if this means a diagnosis was made during the procedure or if samples are still being reviewed by pathology?” This can help clear up any confusion and ease your mind while you wait for the official results.
Waiting for Pathology Results: Pathology reports typically take a few days to a week, depending on the tests (e.g., 3-7 days for standard histology, longer for molecular studies). Since you’re still waiting, it supports the idea that the samples are being analyzed, and no final diagnosis was made on the spot. I know the waiting game is brutal, and it’s okay to feel overwhelmed. If you need tips for managing anxiety during this period, I can suggest some strategies
Histotripsy as an Alternative Treatment
You mentioned “histroplasy” (likely meaning histotripsy), a non-invasive procedure you’re researching at St. John’s in Santa Monica, about 20 miles from your home in Southern California. Here’s what I can share based on available information and your interest in avoiding IV chemo like oxaliplatin:
What is Histotripsy?: Histotripsy is an FDA-approved, non-invasive ultrasound-based technology that uses focused sound waves to mechanically break down targeted tissue (like tumors) without incisions or heat. It’s being studied for liver tumors, including metastases and primary cancers like hepatocellular carcinoma. The procedure creates microbubbles in the tissue, which collapse and destroy cancer cells with precision, sparing surrounding healthy tissue. It’s appealing because it avoids surgery and often doesn’t require general anesthesia.
Use at Mayo, MD Anderson, and St. John’s: Mayo Clinic and MD Anderson have been involved in histotripsy trials, particularly for liver cancer, with promising early results. St. John’s Health Center in Santa Monica is part of Providence, and some of their facilities are exploring or offering histotripsy through clinical trials or specialized programs. The 95% success rate you mentioned likely refers to specific trial outcomes (e.g., tumor ablation rates or local control), though exact figures depend on the study and cancer type. For example, a 2023 trial for liver tumors reported high ablation success, but long-term survival data is still emerging.
Capecitabine and Histotripsy: You mentioned taking capecitabine before the procedure. In some protocols, systemic therapies like capecitabine are used to shrink or stabilize tumors before local treatments like histotripsy, especially for metastatic disease. Histotripsy itself doesn’t typically involve IV chemo like oxaliplatin, which aligns with your goal of avoiding it. However, whether you’re a candidate depends on factors like tumor size, location, liver function, and overall health. St. John’s would likely evaluate you through imaging (CT/MRI) and your biopsy results.
Next Steps: It’s fantastic that you’re researching options early! To see if you’re a candidate, contact St. John’s Santa Monica (Providence) directly—ask for their oncology or interventional radiology department. You can say, “I’m interested in histotripsy for liver tumors. Can I schedule a consultation to see if I’m eligible?” You’ll likely need your recent scans and pathology results (once available). Since it’s close to home, that’s a huge plus for convenience. If you want, I can search for more details about St. John’s histotripsy program or check for recent patient experiences
Emotional Support and Next Steps
The waiting game is so tough, especially after seeing that MyChart note. It’s okay to feel like you’re jumping the gun by exploring treatments—it shows you’re taking control, which is powerful. To help with the emotional rollercoaster:
Distraction: Try low-key activities like watching a comforting show or listening to music.
Support: Lean on your husband or a friend to talk through the stress
Clarification: Call your doctor or MyChart support ASAP to clarify the biopsy note—it might ease some anxiety. And besides that's their job! Would you feel comfortable in doing that?