We had our appointment with Dr. Cunnigham and were completely unimpressed. He had not been through Jon's file nor had even thoroughly read the results of the PET/CT/MRI. All he knew was that Jon's condition had worsened at that he was going to move forward with the Y90 embolization. He recommended an oral chemotherapy drug that had some synergistic effect with radiation which only offered a 10% improvement at best. Not at all what Dr. Chue had in mind.

When we saw Dr. Gosswami on Friday we only focused on the results of the liver MRI/Pet and the outcome of the chemoembolizaitons. During our visit with Dr. Cunningham I was able to read all three radiological reports and came away with the entire picture. The cancer persists in the right lobe of the liver and has spread more invasively into the left lobe, there are five new spots in the lungs and a new mass adjacent to the pancreas. The two abdominal lymph nodes have increased in both size and activity. Not a good report at all and definitely not amenable to the oral chemo Dr. Cunningham had recommended. By the time we were driving home I was absolutely livid. Dr. Chue had wanted Jon to return to the oxyplatin/5FU/taxol regime or possibly try methyltrexate. Dr Cunningham hadn't bothered to even consult Dr. Chue. After discussing the visit with Jon we decided to call the nursing staff and request a consult with Dr. Chue. Jon called this morning and has an appointment set up with Dr. Chen tomorrow who will act as the conduit to Dr. Chue. This cancer has become much more aggressive in the past few months and we both believe that Dr. Chue would choose a different approach. He is also schedule for his arterial mapping at the UW on Dec 2 to prepare him for the Y90 embolization that should take place on the 4th or the 9th, any chemo will be scheduled around the surgeries. Dr Goswami tells us that the Y90 is much more tolerable then the chemoembolization since there are no chemotherapy drugs involved.

Jon is determined to fight this battle with everything he's got. I will continue to support and facilitate whatever path he chooses.