The MRI scan of Adam's right hip and femur is scheduled for Friday afternoon at 1pm. If the scan shows up an area that can be targeted for biopsy that will be the next step. If, however, the surgical teams feel the disease is too diffuse to make biopsy feasible we will be unable to take Adam to America for hu14.18 antibody treatment. Instead we'll have three options open to us:
(1) Do nothing.
(2) Take Adam to Germany for ch14.18 + IL2 antibody therapy.
(3) Revisit the possibility of enrolling on other clinical trials running in the U.S.
As I've said before option (1) isn't realistic at this time, it's simply too risky. As for option (3) there are no clinical trials that offer any proven results for children such as Adam. Moreover a lot of other trials require evidence of active disease in precisely the same way as the hu14.18 trial. If Adam doesn't qualify for that, he doesn't qualify for them either.
Continuing consolidation therapy, despite the fact we've never had a clear MIBG scan, is the thing to do. So if we can't get a (positive) bone biopsy, to Germany we will go. It's not great, but it's the best we've got right now. We're second-guessing that the biggest threat for Adam at present is the disease we can't see, rather than the disease we can. We're conceding that there isn't anything out there (at the moment) that provides a realistic prospect that Adam will be completely cleared of disease. These are determinations we have to make. The future consequences of them we will have to live with.