As of 2011 there had only been 57 documented cases of these tumors worldwide. They do, however, have their own Wikipedia page so hey that's something.
The neurosurgeon went on to explain that tumor severity is graded on a scale of 1 to 4 with 4 being the most severe/bad. He said the biological behavior of the Papillary tumor is variable and could not be definitively graded on this scale except to say they believe mine is either a 1 or a 2. A 1 is benign and a 2 is potentially malignant. See this page for more information on the histological grading scale. Because it's not (yet) a 3 or a 4 (which are malignant) we're calling this a victory in the war on BKP.
Despite this victory the war is ongoing. My tumor did not show "significant mitotic activity" which he said was good. According to the aforementioned Wikipedia page these tumors most commonly occur in people aged 31.5 years (average) which is incredible because my biopsy actually occurred exactly 5 days before I became 31.5. The Wikipedia page lists the Papillary tumor as grade 2 or 3 - not sure why the discrepancy. Even though Wikipedia has never, ever been wrong I'll take my neurosurgeon's word for now. So, what's next?
My neurosurgeon has recommended I consult with a doctor with more experience on the matter. He's provided a referral to a neurosurgeon at the Duke University Medical Center in Durham, NC. The new neurosurgeon will assess whether another surgery (tumor resection) or a wait-and-see method (MRI every few months) would be best. My neurosurgeon has been incredible and if this guy at Duke is better then I may have to refer to him as "superneurosurgeon." This has the added benefit of helping me differentiate the two for this blog. Current neurosurgeon said, somewhat unofficially, that he would be comfortable with waiting a few months and seeing how the tumor grew (if it grew at all) but ultimately deferred to Superneurosurgeon's opinion. So... like nearly every great college basketball player from the past 30 years I'm going to Duke.
Now I wait for Superneurosurgeon's office to call me to set up the appointment. I'm hopeful they can see me before the end of December. My beloved Blue Devils have four home games between 12/15 and 12/30 and another three between 1/9 and 1/18 so maybe, if we come in to a large sum of money for tickets between now and then, we can turn this trip in to something fun. This may go without saying but I'm definitely hoping the new doctor recommends the wait-and-see approach. I might be over-optimistic but my hunch is that the wait-and-see is what will happen. With some luck the MRI (which would take place roughly in February) will show little or no growth which, coupled with the biopsy results, would indicate the tumor is benign. Should I need more surgery it will occur at Duke. Anyone have a place to stay in the Durham area?
All in all I am very happy. We're not quite popping the champagne and obviously nothing will match hearing "your tumor is benign" with all of this stuff ending in good health but it's hard to think of today's news as anything other than positive. It's groundhogs day with at least a few more weeks of relative uncertainty but it feels great having the worst possible outcomes crossed off. They even took my stitches out so now the only ways in which I scare small children are:
- My mohawk
- My teeth
- Forcing them to speak in public
- My gait
- My odor
- Asking them to pull my finger
- My general enormity
- My clown mask
So, like, basically nothing!
