At the completion of the thymectomy the surgeon was quite convinced that the tumour was small and localised and in his opinion Deepa would be fine and manage with minimal medication. We therefore didn’t worry too much about the biopsy although the Neurologist seemed keen on seeing the results. To our surprise the result was a Type 2, B2 tumour meaning that it had infiltrated beyond the thymus cavity into the fatty tissues surrounding it .While this by itself may not have meant any thing to worry about, we got a jolt when the Neurologist and the Oncologist suggested that she may need a combination of radiation and chemotherapy as follow on treatment. This seemed much too harsh for us considering the opinion of the man on the spot, the Surgeon.
A quick check for a second opinion from Apollo Chennai through a doctor who had treated a cousin, confirmed to us that no chemotherapy would be required although in their opinion radiation is a wise and recommended treatment. On the advise of the Neurologist, we got the biopsy samples returned to us (at a fee????!!) and attempted a second opinion through a Pathologist in GB Pant Hospital who we were introduced too through the Neurologist. She agreed to give us an opinion but didn’t agree to a written report!!?? Eventually she just confirmed the reading of the Apollo Pathology Report and left us in doubt about the quality and sincerity of her opinion. To complicate matters, we had another examination carried out by by a small private laboratory recommended by a friend .This laboratory categorically said that there was no invasion outside the thymus and that the tumour was Type AB tumour. Now into this pot of masala add the opinion of a leading Oncologist from Mumbai who, once again, the Neurologist advised us to meet, and had set up an appointment for us. The Oncologist said there was no need for either chemotherapy or radiation!!!??? Tut …Tut.
Reading through down loads from the Internet and in particular a thirty page research paper on Thymomas sent to us by Chitramaman, convinced me of how very important the pathology report was and also on the wisdom of going ahead with radiation .Never the less , I wanted another examination of the biopsy samples from a leading Hospital .We finally decided on Leelavati Hospital in Mumbai and there through a friend in Mumbai got yet another opinion .Leelavati insisted on seeing the Apollo Report before giving an opinion !!!?? They then reported that it was a Stage 2, B1 tumour!!
So there you have it, three different opinions after examination of the same samples, Stage 2, B2; Stage 2 B1 and Stage 1 AB!!!! Never the less I think it is necessary to go ahead with the radiation treatment. Knowing how very important the pathology report is, in terms of the post operative treatment, I was left rueing the suspect quality of the reports we had received.
There were more twists in the tale though … but that is for the next bulletin.