Billionaire, I Am Not Your Wife! novel Chapter 40

Chapter 39: Cancer Is Progressing Faster

Cameron’s POV

Dr. Frank Mitchell’s office was on the eighth floor of St. Anthony’s Cancer Center of Excellence, with a view of Puget Sound that I suspected was meant to be calming to the patients and visitors alike. It wasn’t calming. I’d been sitting in the chair across from his desk for twenty minutes, watching him review Sedona’s file with the kind of blank look on his face that was something every doctor learned how to do, to avoid alarming his patients.

Frank Mitchell wasn’t just a specialist in his v=filed, our family also had the fortune of knowing him personally. He had been my family’s physician for fifteen years-Sedona’s too, before she left. He was fifty-four, silver-haired, and he was the kind of doctor who combined both medical knowledge mixed with feelings that was different from other doctors who preferred keeping things to a medical standard.

He was the type of doctor who remembered his patients’ names and their stories and didn’t talk to them like case files. Something to work, perform surgery on and move to the next number.

I’d chosen him for those reasons. Also because he was one of the three best oncologists in the Pacific Northwest and had direct connections to clinical trial programs at three separate research institutions.

He closed the folder.

The expression on his face was the one I’d been preparing myself for since Sedona’s call from the Chicago hotel room.

“Frank,” I said.

“Cameron.” He laced his fingers together on the desk,/measured. “I want to be honest with you about what I’m seeing here. Allow me to be blunt with you about this kind of thing, I do not want to give you any false hope.”

“Please.”

“The Chicago diagnosis was accurate. I have reviewed the scans attached to it, and it is consistent with what I know of stage three cancer. Stage three, as originally recorded, though looking at these most recent imaging scans-” He paused.

“There’s evidence of additional spread since the initial diagnosis. To be thorough, I’d want to run our own full body MRI scan, but based on what I’m looking at, we’re more likely dealing with stage four.”

The room was very quiet.

Stage four. I’d known it was a possibility-Frank had warned me on the phone before we’d arrived, had said the scans Cameron’s assistant had obtained from Northwestern had indicated that there were signs of progression, which meant the cells were moving faster than usual.

But hearing it said plainly, in this room with the Puget Sound outside the window and my sister back home who I had told her to have hope that we would win this fight…..

“She doesn’t know yet,” I said, my voice coming out with more steadiness than I felt.

1/3

< Cancer Is Pregressing Faster

+25 Points

“She’ll need to know. We can’t designa treatment plan without full honesty about what we’re treating.” Frank’s expression was careful, compassionate. “We’ll run the workup first. Confirm the level of the staging it is currently in. Then we sit down with her together and I explain all options fully. That’s how I work, Cameron.”

“I know. I know that.” I pressed my fingers against my eyes for a moment. “What are the options? Be direct with me.”

“For stage four gastric cancer, there are several approaches and I want to be honest that none of them are simple and there will be setbacks and all are not pain free.”

Frank opened a different folder-notes he’d been preparing, I realized, since I’d sent him the records three days ago.

“Standard treatment would be combination chemotherapy-the Chicago doctors started with the right protocol, cisplatin-fluorouracil is appropriate. However, there are also HER2-targeted therapies if her tumor testing comes back positive, which would significantly affect the treatment pathway.”

“And if it does come back positive?”

“Then we add trastuzumab, which has shown meaningful improvement in outcomes. Combined with chemotherapy, some patients see significant response. We’ve also had recent success with immunotherapy combinations, particularly pembrolizumab, for patients whose tumors show certain markers.” He paused.

“There’s also a clinical trial at Seattle Cancer Alliance-immunotherapy combined with a novel targeted agent that completed phase two trials last spring. Results were promising, Cameron. Not conclusive, not guaranteed, but genuinely promising. Several stage four patients achieved partial or complete remission. If Sedona agrees to try this out, it might increase her chances from 45% to 77%”

“What’s the eligibility?”

“I reviewed the criteria against Sedona’s file last night. She appears to qualify. It would require her enrollment in the next two weeks, before the trial closes its cohort.”

Frank met my eyes steadily. “I want to be honest about what this means. The trial treatment is aggressive. Significantly more demanding than standard chemotherapy. She’d experience severe side effects. Some weeks she may not be able to get out of bed. The treatment periòd runs twenty-four weeks, and we won’t see meaningful response data until week twelve.”

“But there’s a chance.”

“There is a genuine chance, yes. In the trial population, about thirty-one percent of patients who completed the protocol achieved remission. Another twenty percent saw significant tumor reduction that moved them to surgical candidacy.” Frank paused.

I looked at my hands. They were steady, I noticed distantly. They’d been steady all day, through the flight and the reunion and the drive and the first look at my sister in our childhood home-pale and thin and trying so hard to smile for our parents. They’d been steady because one of us had to be.

“Enroll her,” I said. “Whatever it costs, whatever needs to happen, get her into that trial.”

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