Confirmed: that spot is not a "shadow"

On Wednesday of this week (October 15, 2025), I had an ultrasound-guided biopsy performed on that new spot in my liver.  This was originally going to be a CT-guided biopsy (similar to the one I had back in December of last year) but doctors thought they could get to it just as easily via ultrasound.  And indeed they had no problems spotting the little bastard . . . so long as I held my breath just right:

No, that's not a tadpole in a pond!

My only "complaint" about going the ultrasound route is that the pictures aren't quite as clear/interesting when compared to a CT scan.  Obviously that's not a serious complaint though as I get great medical treatment here at Mayo Jacksonville!  I was told it would be about 2 business days to get the pathology results.

About an hour ago I received those results: Positive for malignancy. Consistent with the patient's history of metastatic myxoid liposarcoma, high-grade.  Referenced in the report is are digital images of the pathology, which I am going to request as they were not immediately available through the Mayo portal.

Am I shocked by the diagnosis?  Not at all; it fully met my expectations.  Yes, it is unfortunate and yes I'm quite concerned about this uptick in metastasis over the past year, but I'm happy to still be alive after now nearly 7 years after the first metastatic tumor was discovered in my right pelvis (back in January, 2019).  If I have to play whack-a-mole with these, then game on!  So far I think I'm winning, though both me and my cancer are in an active "fight to the death" and "there can be only one"!

So, how do we "whack" this particular "mole"?  My oncologist (Dr. Steven Attia) has already called me and he suggested some form of radiation for starters (as myxoid are very sensitive to Radiation Therapy, or RT).  I am also going to be scheduled for a surgical consultation.  Hopefully I can get these consultations done soon as it looks like the docs are all booked for weeks out. With any luck, I'll have this thing knocked out by end of year . . . just in time for family Christmas!

“Surprise” in September 30 MRI Results

First off, let me apologize for being so slack with updates.  Honestly, I was waiting for these fall scans before posting anything new.

Back on April 3, I had a CT scan of the chest, abdomen, and pelvis, which looked fine and even showed some slight shrinking of that right perinephric mass (the one treated with radiation in February 2025).  Still, a higher-resolution MRI six months later was going to provide more definitive results. And indeed, I was right!

According to the report, my latest MRI showed “decreased size of metastasis in the right perinephric space,” shrinking from 3.5 × 2.2 cm in November 2024 to 1.8 × 1.8 cm now — about a 50% reduction. Yes!  Oh, and my right pelvic tumor (irradiated in December 2022) remains “stable” too.  Another win!

The Twist

My excitement was short-lived though when I noticed the report also indicated a new metastasis (1.8 cm) in hepatic segment III.  Here’s a screenshot of the intruder:

The radiologist described it as a “new 1.8 cm circumscribed hepatic lesion in segment III, which restricts diffusion and shows heterogeneous enhancement.”  Honestly — and I realize this could just be denial talking — I wasn’t all that impressed with the image.  It didn’t have the same 3D look of the other tumors I’ve dealt with.  This one looked more like a shadow, with no real form at all.

Of course, the radiologist knows far more about this than I do!  Thankfully, my Mayo doctors are already on it and are planning a biopsy.  I’ll reserve final judgment until the biopsy results are in (probably a few weeks).

Processing the “Surprise”

So, that’s my big “surprise.” And while I’m not sure exactly what to make of it yet, I do feel confident that this tumor — like all the others — can be treated, whether surgically or with radiation.

It is true that my current chemo regimen seems to be losing effectiveness (as evidenced by two new tumors since my re-diagnosis in 2019, both in the last year), but maybe it’s at least slowing things down. Even my oncologist thinks I’m incredibly fortunate to be nearly seven years out from a stage 4 diagnosis.

Hopefully, my lucky (or blessed) streak continues and this latest blip doesn’t turn into a trend!