Journal entry by Bob Stromberg

I had a CAT scan on Wednesday, June 19. Results were good and bad. The good news is that the cancer still appears to be limited to just the Liver. The bad news is that the tumor continues to grow. It is currently about 7 cm x 4 cm. My doctor has been very reluctant to remove the tumor for several reasons. First, I would have to stop chemo until after recovery (up to 2 months). The specialist in Lexington also expressed the same concern because the type of cancer is very aggressive. Since it spread through the lymph-node system, it could potentially be anywhere in my body. Second, the tumor is being used as a marker to determine if the chemo is effective. Theoretically, if the tumor continues to grow, the treatment is not effective and likewise, if it begins to die and shrink, it is effective. Third, the chemo does affect my immune system so I would be at greater risk while my immune system is compromised. However, since there is no sign of the cancer spreading to any other part of my body, my doctor thinks the chemo is being successful and containing the cancer but not killing the tumor. Also, the tumor is at the point now, that if they don't do something, it will be too large to remove later. He has recommended several procedures and set up appointments for me to meet with other doctors to discuss options. On Tuesday, I meet with my Radiologist. She said it is too big to do the Stereotactic Radiation Therapy treatment but could do a more general but focused radiation treatment. On Thursday, I meet with a surgeon to discuss two options. First is completely remove the tumor from my liver. The liver is regenerative and would grow back. But it may already be too big to remove. The second option is to a very localized treatment where they insert a catheter and implant radioactive crystals on the tumor. As the crystals dissolve, the tumor is saturated in radiation but surrounding area is only slightly effected. I am leaning toward surgically removing the tumor only because it has been so resilient that I fear to wait weeks or months for results only to find out it is still there and have not had any systemic treatment to prevent spreading. But I will wait to see what each doctor says. We are also forwarding the test results to the specialist in Lexington to get his recommendation.
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