After a lengthy visit with Dr. Chang at the University of Iowa Cancer Center, it was determined that the next course of action will be a liver biopsy.  He has multiple spots on his liver, but they are mainly concerned with one large one, which is suspicious for a malignant growth.  We will not explore any treatment options for the bile duct lesions or the pancreatic lesions until the liver is addressed.  If the liver comes back as benign, there are a few options that he has.  If it comes back as a form of cancer, there are no surgical options. It would be staged as a stage 4 cancer.  We are obviously hoping for the best outcome which is no liver cancer! We are waiting to find out when the liver biopsy is scheduled for, and will go from there.  Thank you everyone for the prayers and positive thoughts