Another trip to St. Jude, another scan, and another overwhelming sense of relief! We have had so much going on–busy at work, end of school, planning for summer–that we have not talked about or dwelt as much on this scan, but the stress was still overwhelming. We expected a call from the MRI staff when Alexander was done with his scan and moving on to the lumbar puncture, but after a couple of hours went by with no call, we decided to check back in person. As we sat in the radiology waiting room, we could barely speak, thinking that something could have happened that caused the staff to need to take more time. Would that be the case if something were immediately apparent on the scan? We didn’t know, but all the pent-up anxiety boiled over when Christy refreshed her MyChart to see that the scan had already been read. We scrolled down … and then we both read the magic words, “unchanged from last scan.” We both yelped and cried with relief and hugged each other tightly. It’s impossible to look forward to anything with a scan upcoming; now we can look forward to our summer adventures!

Alexander continues to be his usual self, and we are constantly amazed at his intellectual progress. His speech and thought continue to develop in sophistication, and his reading is coming along nicely. After our clinic appointment, we met with the endocrinologist, who noted that Alexander’s body is not growing fast, if at all. It’s one data point–maybe he didn’t stand up quite as tall as he could have when his height was being measured–but it could mean that his growth hormone production has suffered as a result of treatment, a well-known issue for kids who go through this. We may have a growth hormone test done when we go to St. Jude next, but we don’t know whether intervening to stimulate growth is appropriate. Above all, we don’t want to give Alexander supplemental growth hormone and stimulate the growth of cancer cells. But we have confidence in our care team that they will give us good advice on that subject, as on every subject regarding Alexander’s care.

In our clinic appointment, our wonderful oncologist mentioned the development of a blood test that can detect free-floating cancer DNA in the bloodstream before any evidence of macroscopic cancer appears on a scan or symptoms of progressing disease appear in the body. It’s not clear that this test will change the game for Alexander, but, paired with appropriate early intervention, it could save the lives of children and adults alike whose cancer might otherwise have gone undetected until it was too late. Every step forward gives hope.