Another bump in the road (01/17/2013)

Connie, my sister Mary, and I arrived at University of Michigan Health System (UMHS) facility at 2pm today. The blood draw was completed quickly but doctor appointment was scheduled for 3:30pm (hurry up and wait). We were seated in patient room 37 at 3pm. I thought we might get to see the doctor earlier than scheduled. We ended up waiting in the patient room for an hour. The doctor arrived a little after 4pm and gave us the update.

The MRI shows two small tumors in the liver (sizes are 3cm and 1.8cm). The MRI images are also not completely clear and another MRI may be required before deciding on next steps. The oncologist reported that tumors in the liver are surely the source of the climbing/fluctuating CEA levels. The other news was that the CEA level went down from 40 on 1/2/2013 to 20 today (20 is certainly a big drop but far from the normal range).

The next step is for the UMHS Tumor Board to review the MRI results and recommend next steps. The possible next steps are:

– Another MRI done under sedation (hopefully with clearer results)
– Surgery to remove the tumors
– Chemo (folfiri and erbitux) to shrink the tumors, followed by surgery
– Chemo alone if the tumors are not operable
– Focal Radiation therapy

The best option that we can hope for is surgery. If the tumors can be surgically removed there is still a chance for full cure. If the tumors cannot be surgically removed the chemo treatment may reduce the size of the tumors and slow the growth.

The tumor board will do their review in the morning on 1/24/2013. I will meet with a Hepatopancreatobiliary Specialist/Surgeon on 1/24/2013 at 1pm to review the Board recommendations

Sad to note: I don’t think I know how to pronounce “Hepatopancreatobiliary.”  🙂

As I said in previous blogs, our current state-of-the-art technology is still far from perfect. How can the CT scan and PET scan show a clear/healthy liver and the MRI scan show two tumors? Can an MRI image that was deemed poor quality due to breathing be relied upon for surgical decisions? How can the “rising” CEA level climb and then fall like it does if the cancer continues to grow? Is there any significance to the large drops in the CEA levels? Unfortunately the doctors don’t have all the answers…

And so the fight continues, with partial and imperfect information. Your continued Prayers are hereby formally requested (and very much appreciated)!!!

I wish I had a little break between the initial chemo and what looks like a bumpy road ahead — but it is what it is.

Thank you all for your continued support and prayers.

God and Peace be with you.

Phil

PS. The pictures are from the Family photo session we did over the holidays (Thank you Liz at YourLittleWishes). These were the first two pictures completed. We’re looking forward to seeing the other pictures soon!