I just had a long conversation with Dr. Chue about Jon's treatments. Jon has experienced nearly constant diarrhea the past 24 hours and is having difficulty tolerating this chemotherapy. He's lost about 10 pounds and is not able to eat very much due to nausea and stomach pain. As a result, Dr. Chue decreased the dosage of chemotherapy to alleviate some of the side effects while hopefully maintaining the effectiveness. We discussed the pros and cons of the SIRT and Dr. Chue's biggest concern in the spot that was seen in the right lung that has increased in size since the last scan. For the past 18 months it was thought to be a scar of some kind but since it has increased in size Dr. Chue is certain that it is indeed cancer. He wants Jon to complete as many of the current chemotherapies as possible to insure shrinkage or eradication of the tumor in the lung before we proceed with any localized treatment to the liver. Although the SIRT is considered minimally invasive it will make Jon sick for a period of time due to the by-products of tumor death and liver tissue necrosis. As a result there will be a recovery period where Jon will not be able to receive chemotherapy which could allow any cancer in the lung to spread even though the cancer in the liver would be diminished.

So here is the master plan...Today is chemo number 7 of 12. Dr. Chue would like Jon to have 8-10 sessions if he can tolerate it safely. We will rescan at that time and hope/pray for elimination of the lung tumor. We have an appointment at UW on May 21 for the SIRT which should coincide with chemo number 9. If all looks good he will move forward with the SIRT to kill as much of the cancer in the liver as they can. Once he recovers from that procedure he will resume chemotherapy to eliminate any remaining cancer. Jon will need some recovery time from chemo to get his blood counts to a safe place for the SIRT so we don't know exactly when it will be scheduled. Everything really hinges on the results of the next scan which should be sometime near the end of May.