Surgery Update

Hello All,

Mooki, Stephen, & I just spent several minutes with Dr. LaQuaglia, Toby's surgeon.Toby is now officially "post-op," after having undergone a "gross total resection." Between the bone marrow biopsies & surgery, the entire operation lasted about six hours. Dr. LaQuaglia was able to remove the primary adrenal tumor, which was surrounded by a capsule relatively easily. There were two additional large "masses" above & below the kidney that he also took out. The hard work of dissecting away tissue searching for cancer-laden lymph nodes followed & Dr. LaQuaglia said that he was "able to take out everything he found."The blood vessels to Toby's kidney & the kidney itself are okay.

Toby didn't bleed too much (400 cc) & on the whole, it sounds like things went as well as can be expected.What's in store for Toby now is that he's to be transferred to the PICU (pediatric ICU) at Cornell while he has a breathing tube & is on a respirator which will breath for him. This will probably be for a couple of days. He also has a chest tube (a tube which allows excess fluid to drain from the surgical bed), an NG tube (nasogastric tube) to keep his belly decompressed, & an epidural IV for pain control.

Once Toby's back at Sloan & recovered, he'll resume chemo (potentially as early as next week) for at least 2 more cycles followed by radiation & antibody therapy.

I'd like to thank Heather, Andy & Rachel, Carrie, Sonia, Monique, Fran, Mirm, Shana, Barbara, Martha, Jonathan, & Merci, all who spent time with Mooki & Stephen throughout this long & trying day. They talked, fed, & most of all provided a much needed & welcome distraction - thank you all so much.

I'll try to send another update in the upcoming days.

Yoram