“If” is the biggest little word in the world sometimes.

We all have those days when we wonder, “What if…” I had one today.

I spent the day at a patient conference on NET sponsored by the New England Carcinoid Connection. I listened to a number of doctors from Dana-Farber talk about everything from the latest research to surgical techniques.

Dr. Matt Kulke unveiled publicly two of the things we had talked about during my visit to Dana-Farber last month. They have successfully grown a number of NET Cancer cell lines in vitro and transplanted some of those lines into an animal model where they have grown successfully.

I got to raise my question about whether or not non-carcinoid  tumors growing in close proximity to NETs tend to be more aggressive than those that are not–a question I raised here last week–with Dr. Thomas Clancy, who told me it was a good question, but that no one knew the answer to it.

I made contact with a number of the people from the New England Carcinoid Connection–the group running the conference and had some good conversations with a number of patients an caregivers. I even encountered an old friend I had not seen in more than 30 years.

It was, in so many ways, a good day.

But in one of the morning sessions the dreaded “What if…” demon raised its scruffy head and derailed my mind for more than a few minutes.

Dr. Matthew Schenker was presenting on liver embolization techniques. These are methods of shutting off the blood supply to tumors in the liver without doing damage to the rest of the liver. The method can also be used to place chemotherapy drugs and radiation directly inside tumors. All three can obliterate a tumor in the liver pretty cleanly. Had Jane fully recovered from the heart surgery and not been ambushed by the series of carcinoid crises that ended her life, liver embolization was to have been the next step.

Near the end of his talk, he presented the case of a 54-year-old woman who had tumors in her liver even bigger than Jane’s were. The valves in her heart had been damaged somewhat, but not yet to the extent that Jane’s were. She was essentially where Jane was one year before her diagnosis.

The results of that simplest of embolizations were dramatic. The diarrhea, the flushing, and night-sweats vanished. The slight swelling she had begun to experience in her legs also disappeared.

Had we figured out what was going on with Jane just one year earlier, this could have been her story. We could have retired together. We could be fighting this battle together. Most importantly, we could still be here together.

But that didn’t happen. The horse with zebra stripes was still hiding in the forest kicking her to death for another year. And no one knew.

Tonight, I came home again to this empty house–as determined as ever to stop this disease from doing to others what it did to my Jane.

But the house is still too empty and too quiet.