First, Do No Harm

We have our meeting scheduled with the team of four doctors for this coming Monday afternoon. We hope to get some real answers about how to get some real answers about what lurks inside our little Austin’s body. We feel we simply need more diagnostic information before we can make a decision about how to proceed.

It is obvious to me and Mark that if this shadow is cancer, or if we even have good reason to believe that it’s cancer, then we know exactly what to do. And that is certainly to remove the shadow and perhaps even the whole kidney. As unpleasant and potentially dangerous as they are, we will take dialysis and transplant over cancer any day.

The dilemma stems from the fact that we don’t know what this thing is. We do not know that it is cancer. And we don’t even necessarily think that it’s cancer. Truth be told, it’s a complete toss-up; the chances that it’s cancer and the chances that it’s not are almost even. Which is why we need more information, something definitive or at least something that tips the balance even slightly in one direction over another.

We can not go in and remove his only remaining kidney just in case, just to be on the safe side. Because unnecessary dialysis and transplant are not on the safe side. When I read through the charts of children who were enrolled in the National Wilms Tumor Study Group between 1994 and 2004 (the best data I have access to) and inevitably find myself studying those that died and why, there is a large cohort of children identified by the letters DDF: “died disease free.” These children did not die of cancer. They died of one of three things: infection, awaiting transplant, or transplant complications.

This is not a path we will go down unless we need to. First, do no harm is not only the motto that guides doctors. It guides parents as well.