Pets,CTs and Other Animals

We had a most enlightening meeting with Dr. Goswami this morning. He provided us with the opportunity to review Jon's recent CT scan and the results were quite impressive. I now have a better understanding as to why the PET scan report was so confusing. In looking at the CT scan most of the small tumors show up as dead (aka necrotic) tissue. The large tumor next to the vessel remains but the entire center is dead tissue, there is only a small periphery of active cancer. In Dr. Goswami's opinion Jon has only 10% of the active cancer that was originally diagnosed in 2006. At first Dr Goswami was suggesting that maybe we take a "wait and see approach" but you all know that is definitely not our style! We figure that the stuff is dying lets hit it with everything we've go to kill it once and for all. We mutually decided to move forward with chemoembolization rather then the Y90 isotopes. Our rationale is that they have similar outcomes but the Y90 is a one-time deal. The chemoembolizations has more side effect (pain, nausea, etc) because they use a chemotherapy agent, however compared to the 64 chemotherapies Jon has already endured he thinks it will be manageable. The theory is similar to the Y90 but utilizes chemotherapy agents (our favorite cisplatin that did so well last go around) to kill the cancer and prevent any blood flow to the tumors. Preventing the blood flow alone should kill the cancer but the chemotherapy agents are added insurance. We are saving the Y90, since you can only do it once due to the high level of radaition, should we need it down the road. There are some formalites to negotiate before we have it schedule but are thinking mid-July for the actual procedure. They will do the right lobe first which is the worst tumor burden and the left lobe mid-late August. There also remains the possibility of Radiofrequency ablation, cryotherapy, or liver resection should this procedure be only partially successful.

There are now 3 small lesions in Jon's lungs which they are calling "stable" as well as the lymph nodes around his pancreas that still slightly light up on PET, but again are considered stable. As a result there is a good possibility that Jon may need more systemic chemo following the embolization however that may be in pill form rather than IV. He will be rescanned after the procedures and then every three months for the following year. We can also monitor his tumor marker but that is of limited value. His pancreas STILL looks clear. Dr. Goswami and Dr. Chue are working together to perfect the combined treatment plan.

Jon's put on about 12 pounds but still has a way to go to be back to normal. He lifted weights tonight and we are riding bikes with some friends in the morning (Toucan shorts, LoriB!). He really lost a lot of muscle mass this time around and says he's lifting as many weights as his sore muscles will allow.

This Sunday is Maelie's Second Birthday Party and we are excited to be able to celebrate together!

Kelsey's last day of school was Wednesday and we have had a herd of boys at our house ever since. They put up a tent in the backyard and made a giant slip and slide down the hill to the water. What a riot!