PET SCAN RESULTS

We met with Dr. Chue for the PET scan results at 9:15 this morning. The tumor in Jon's lung is gone as well as the "too numerous to count" tumors in his liver. The lymph nodes in the liver/pancreas area are called "stable" in the report. That means that they have been reduced in size and no longer "light up" in the PET scan, indicating that they are no longer malignant. What remains are two tumors in his liver which have been reduced in size and may be amenable to surgery. The report also stated that the head of the pancreas was enlarged, but reduced in size from the last PET scan. We all found that strange since the original PET scan did not comment on the pancreas and all other scans called the pancreas normal. We hypothesize that the pancreas may have been enlarged at the original site of the tumor but since they had no basis for comparison in the first report they were not aware of it until they were able to compare it to the currently reduced size. This confirms that the original diagnosis of pancreatic cancer was, indeed, correct. (remember that the original liver biopsy was inconclusive) Dr. Liao and Dr. Chue were excellent diagnosticians from the beginning.

The next step is to consult a surgeon recommended by Dr. Chue. We need to determine if Jon is a candidate for liver resection or radiofrequency ablation. It is possible that he could have surgery to remove the rest of the tumors. If they are still considered too large then we need to proceed with a third round of intravenous chemo and then potentially the surgery after that cycle. There is always the possibility that the next chemo could obliterate the last of the tumors. I will call the surgeon tomorrow to schedule an appointment.

Jon is pretty wiped out. He isn't too excited about having surgery but is open to the possibility if they can remove the liver tumor without having to address the pancreas. Dr. Chue would like the surgeon to biopsy the enlarged portion of the pancreas during surgery. Jon is adamantly opposed to removing his pancreas. It might be best to do one more round of chemo to shrink the remaining tumors and then opt for the radiofrequency ablation which is much less invasive than a liver resection. We will know more once we see the surgeon (who Dr. Chue calls "a cowboy"!)

Jon will start on Interferon tomorrow and is holding off on Tarceva until we see the surgeon. Dr. Chue is planning on giving him a month off to recover before initiating the next chemo cycle, if needed. He also informed us that Aaron (poster child for pancreatic cancer) was unable to tolerate the consecutive chemos for twelve weeks like Jon had, so they did four weeks on, one week off, for three cycles. He felt that Jon could repeat that process so that he is well enough for both Levi and Erikas wedding on Sept 15 and Staci and Octavios wedding on October 20th.

All in all the news is good. We were hoping for a complete remission but under the circumstances we were probably a little overly optimistic. I am grateful for Jon to have a month off, this last month has been really hard on him. The last thing Dr. Chue said before we left was "Jon, a cycle of chemo, then a surgery, then you are going to make history". You can't ask for more than that!