Dear CCAM Partners and Friends,

Probably all of us are still a little numb from hearing the devastating results of Buntheep's MRI scans last week. Up until then, especially based on her steady recovery, we had been expecting each week that the doctors would declare Buntheep completely healed, so that we could take her to visit here and there in America, and then afterwards, back to Cambodia.

Everything had seemed to be pointing in that direction. The amazing 20-hour surgery back in December was very successful. Dr. Aldana had said that day that he had removed all of the tumor that he could see. However, a few days later, the MRI machine "saw" a tiny hidden residue about the size of a raisin or a pea, although the doctors predicted only a 20 percent chance that it would grow back. But apparently unseen even by the MRI, there was at least one more tumor cell hidden in another location. Now the tumor is indeed growing back from both of those places. In only 2-and-a-half months, it has already reached 30-40 percent its original size.

Following are some of the challenges now facing the doctors:

1. This type of tumor is very rare, particularly growing to such a large size inside the cranial cavity and crushing everything in its path. Therefore, there is not a lot of documentation for the doctors to refer to. They are mostly breaking new ground.
2. Because of the presence of the brain, the eyes, and the ears in that region of the body, it is impossible to remove a "margin" around the tumor to make sure that it has all been removed. That margin may comprise tissue that is absolutely necessary for the proper functioning of those important organs. Also, during surgery it is sometimes difficult to clearly discern what tissue belongs to what. It is quite remarkable that during the original surgery, apparently no damage whatsoever was incurred by the surrounding tissues (just as we prayed that God would guide the doctors' hands and give them wisdom). Buntheep's brain, ears, and left eye are currently functioning perfectly. But of course, further surgery would present new risks.
3. If even one cell of the tumor is left behind, it can grow back.
4. Even though this tumor grows quickly and aggressively, it is not "malignant" and may not respond readily to most chemo and radiation. Also, these types of treatments carry their own physical risks and consequences.
5. And how many times can the child's face be successfully removed and then replaced without damaging it? Also, if the partitions of the cranial cavity keep having to be removed and replaced, from what new part of the body will all that reconstructive tissue need to be harvested?

When Dr. Aldana told us about the MRI report last week, he explained that he needed some time to consult with other doctors, because he was not sure what to do next. Providentially, a large conference of doctors reviewed Buntheep's case yesterday.

Although they did not convene specifically for that purpose, nevertheless Dr. Aldana and Dr. Roy brought Buntheep's situation to their attention and "picked their brains" for answers. Today Dr. Aldana notified us that some of those experts in chemo and radiation are now on board with them to help create a plan of action.

In the meantime, Dr. Aldana urged us to take advantage of this "window of time" to leave Jacksonville for a few days and visit my mother in Alabama. Martha Crabbe, secretary-treasurer of CCAM, and her husband Max have driven down to Jacksonville to pick us up and take us back with them. We are now enjoying a visit at their mountain cottage in North Carolina before driving on to Alabama for a few days. Next Monday we will return to Jacksonville and meet Dr. Aldana on Tuesday to find out what he has decided to do.

Given all of the difficulties listed above, we are again faced with the reality that completely healing Buntheep of this tumor truly appears to be "humanly" impossible. But nothing is impossible for God! Please continue to pray to our Lord Jesus Christ for more miracles, in whatever way He wishes to provide them.

In His Hands,
Gioia and Buntheep

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