The Next Step

We had Scott's follow up appointment yesterday, and as usual for us, we had some good news and some dumb news.
The good:

• Scott is healing fabulously.  The surgeon is very happy with how the incision site looks, Scott's range of motion, and advancement of activity.  In his opinion the surgery just couldn't have gone any better!  So, thanks everyone for all those prayers!
• The lymph node that we saw on ultrasound and CT back in October, which was the primary indication for surgery, was no longer a lymph node at all really - just a big old ugly tumor.  It was definitely time for it to go and we are all glad it's out.
• The left-over thyroid tissue which they removed was all negative for cancer.  We glad for this and think it's better to have it out and leave no doubt in our minds.
• The enlarged lymph node they suspected higher up in his neck (close to the base of his skull) was negative for any cancer.  In fact, they removed about 23 lymph nodes from that area as they were trying to get to this one specifically, and all of them were negative.  However, this leads us into the not-so-good news.

The Bad:

• The fatty tissue that was surrounding the lymph nodes which were close to the base of his skull was interspersed with medullary carcinoma.  
• It would be prudent to continue exploring various forms of treatment and we aren't done yet.

This is a big bummer for us, but we're diving into the next step.  The docs are all rather confused as it is unusual for cancer to spread through the fat in this way.  It would make more sense in our piddly minds for it to keep spreading through the lymph nodes as it has done so far - where it has an understandable blood flow and lymph flow and we can see why it easily travels throughout.  But no, Scott's already confusing and rare cancer has to get even more weird.
We've searched case reports and are pouring over the research, but unfortunately nothing similar to our situation has been published and nobody we've talked to has a clear cut answer.  The next step that our surgeon recommends, and which some new research is recommending, is that we move onto a type of radiation just for Scott's neck.  Since there are no tumor borders, the cancer in this area isn't something we can just go in and cut out as we've been doing with everything thus far.  Also, we wouldn't even know where to start (besides just harvesting every last little bit of fat from his neck which would be silly) as none of this showed up on any of the scans.  We are also running into the concern that if we just leave it, and it continues to grow and spread, each neck surgery we have begins to carry greater risks.
SO, in the next week hopefully, we are meeting with Scott's endocrinologist, as well as a radiation oncologist, to further discuss treatment options.  We are also consulting with our specialist in St. Louis to see if he has any other ideas.  I have finals next week and am working on my 20+ page paper for another class due after the weekend, so our plates are getting a liiiiiiittle full.  Also, Scott goes back to work on Saturday and we're hoping that all goes well.