Arlene’s blood tests were confusing and it was difficult to make a definitive diagnosis. However, the ultra sound indicated there were small masses in the pelvic and lung areas. It was imperative to perform a bronchoscopy, and a biopsy to define whether this indicated cancer ,and if so what stage was the cancer in and was there metastasis.?

When Michael and Arlene showed up at Vic De Fino’s office he was in the waiting area, and ushered them into a room away from other patients. Michael realized that this attempt at privacy did not augur well. Vic sat close to both of them ,and presented the results. As he finished Arlene said” Vic do I have cancer?” Vic sighed and answered” we don’t know that yet, and I need you to spend an overnight in the hospital. I have contacted Dr. Clive who is the finest gastroenterologogist in the area to perform a bronchoscopy, and also we will biopsy the small masses. All of this will be performed under anesthesia.” Michael had a thousand questions, but deferred as to not share his panic with Arlene. He totally trusted Vic and knew of Dr. Clive’s outstanding reputation.

The next day Michael escorted Arlene to the hospital ,and immediately on entry they were treated as dignitaries. Michael was so loved and respected that everyone in the surgical area pledged to do everything in their power to make the one day a seamless success. Arlene was given a private room on the eight floor with a view of the East river. After she was prepared for the procedures Michael hugged and kissed her, and then found his way to Vic DeFino’s office.He had a host of questions, but realized that at this point Vic had no definitive answers. The next day and a half were longer than he could imagine ,and in fact Arlene handled the waiting period better than him.

The day after the tests Vic De Fino opened the folder with the results and almost wept. It was never easy for him to view such dooming indicators, but it was beyond painful when reading the fact that someone he loved had fourth stage cancer.

The results from Arlene’s tests as well as the Bronchoscopy left little doubt that Arlene had adenocarcinoma, and apparently the primary tumor in her esophagus had metastasized, and spread to other organs.Vic was devastated, and could find little hope in the results that were staring him in the face, In an hour Arlene and Michael were to be in his office, and though he often had the painful task of giving bad news to patients this was emotionally excruciating. Not only was Michael one of his closest friends and colleagues, but Arlene was truly one of the most special persons he had been privileged to know
.
Exactly at ten minutes before nine Arlene and Michael arrived and were escorted into Vic’s office. It was apparent from Vic’s demeanor that the news was not positive. Michael immediately launched to a series of specific questions, but before Vic Could answer Arlene spoke. “Vic I have been around medicine for a good part of my life, and I need to have you answer one question.” Michael and Vic were silent as she again asked the critical question.”Do I have cancer?” Vic looked down at his hands, but knew he could not avoid the answer to that question. “I afraid you do Arlene.”Michael began to ask for the specific results of the tests, and what had the experts recommended as a treatment protocol.Although stunned Arlene placed her hand on Michael’s and said.” I know I will be in good hands so let’s begin to explore where we go from here.” Both Michael and Vic who were distraught could not get over the grace and courage in which Arlene handled the news.For the next hour they discussed the treatments that were available. Doctor Clive had recommended immediate surgery in order to contain the spread, and hopefully enhance her quality of life.