NO CHEMO TODAY!

Mark is thrilled that he does not have to go back today and he is looking forward to putting several good days together. Our trip to Dallas didn't offer a whole lot of anything new. There is a plan for surgery, but the extent of the surgery is yet to be determined, as is the date of the surgery. At this point, there are still a lot of unknowns. I guess really, the only thing we do know is no chemo today.

The surgery will begin as exploratory. The plan is to head for an area of lymph nodes in the epigastric area (upper abdomen), remove them and have the pathologist in the room to determine if they are cancerous. If they are, the options become fewer. If they are not cancerous then he will proceed to evaluate what he can do with the liver. It appears, as before, that one lesion will be no problem. The other could be no problem or big problem. We are hoping that lesion will lift right out as well. If it does not, then proceed to plan C or D, whichever we are on by that point. The next option would be an ablation of that tumor which could be done in surgery. If that can't be done, he could place markers for radiation to be done at a later time. So, you see it is not cut and dry. Oops, gotta get kids to school. I'll be back.

Okay, I'm back now. Back to surgery. While everyone wants the particulars, we will have to be PATIENT and let the answers come to us as God works through the experts to pave the path for what is best for Mark. The long and short of it is that you have to believe in miracles to be on Mark's team. If you believe that He can - He will. Remember, CANCER is bad, but GOD IS GOOD, and He is definitely on our team!

As always, I am open for any questions, here are a few you might already have thought of.

Q. How long in the hospital?
A. Provided everything is routine, the expected stay is 4-5 days. the majority of the hospital stay is to watch the incision, watch for bleeding or infection, and wait for return of normal bowel function. Historically we have seen Mark recover quite well, so routine recovery will be just what we order!!!!

Q. What happens when you only have part of your liver?
A. If things work as they should, the remaining liver will continue to function normally and the removed area will regenerate and be able to function normally following a recovery period.

Q. I thought they already said the lymph nodes were cancerous?
A. This is true, but is based solely on pictures that have been viewed through scanning. However, lymph nodes can, and often are enlarged for many reasons, especially when someone is ill or fighting infection. The oncologist has assured us that those nodes could go either way and the only way to know is to biopsy them.

Q. If the lymph nodes are cancerous, can they remove them?
A. That poses a little more complicated problem. The number of enlarged lymph nodes would make it very, difficult if not impossible, to attack by cutting them out. That would lead them to plans C and D as described earlier.

Q. What is the plan after surgery?
A. Mark will have to fully recover from surgery before resuming any other treatment. That will be at least 4 and possibly 6 weeks. It is likely that it will not be the same medication. Dr. McCollum informed us that it is common for the effectiveness of chemotherapy to level off after 3 to 4 months. Typically you see the majority of the "good", ie shrinkage, during that time. He was not surprised then that the last scan did not show any more improvement. Ultimately, this could result in a change of medication following surgery - but, first things first.

We will let you know as soon as we have a date (hopefully today)
Love to all, Missy