The biopsy confirms that my wife’s ovarian cancer, which had been present in her abdominal area, is no longer present there but is now in her liver.  This manifestation is strange in a couple ways:

• Ovarian cancer tends to spread moreso than relocate.  In my wife’s case, it’s essentially left the abdomen and reappeared in her liver within 3 months, without spending obvious time between the two.
• It doesn’t usually progress deeper inside multiple lobes of the liver.  In my wife’s case, it’s within 3 lobes.  As a consequence, it’s not a candidate for many traditional liver surgeries.

At the moment, my wife feels ok but not great.  She’s still not 100% from nearly a year of chemo.  But mostly she’s suffering from pain from the liver biopsy.  It took the doctor several attempts to obtain the liver biopsy.  I was in earshot for the whole experience.  Trust me when I tell you it’s something you never want to be in earshot of.

So, we’ve hit an ugly fork in the road.  The action plan over the next couple weeks is to investigate one of three possibilities.  There’s some potential mutual exclusivity involved — pick one option and the other two *might* not ever be available.

1. Conventional chemotherapy: That’s the path we’ve been on for the past year.  My wife hasn’t had obvious external symptoms of cancer, and there’s nothing in the abdomen where there was before, so we may just need more.  She’s had Taxol-carboplatin, Gemzar-taxotere, and Avastin in twisty combinations.  The next drug to try would be Topotecan.
2. Clinical trials:  The doctor is researching a number of domestic Phase II clinical trials that she might be eligible for.  Most of them involve my wife (and perhaps me) temporarily relocating to somewhere else in the country — Maryland, Illinois, Texas, etc. My wife’s relative health works in her favor as far as eligiblity, overall, but the devil is in the details.
3. Less-conventional surgery:  We’re getting a second opinion on edgier procedures like gamma knifes, radio and other forms of ablation, etc. and just generally getting a second opinion on my wife’s liver from gastroenterologists who specialize in that kind of thing.  It turns out that one of the best programs for this in the country happens to be local.

We’re all over thhe map in terms of how we’re feeling about all this — anger, numbness, depression, utter exhaustion, etc.  The only real constant is stress.  I’m writing this out so I can attempt to focus on other things that I have a bit more control over.  Also, because I’m having a hard time staying asleep at the moment…