Journal entry by Bob Stromberg

This has been a rough week but it ended well.  

We met with the radiologist on Tuesday.  She said the tumor is too big to treat with stereotactic radiation.  She could treat with another type of radiation that is also very focused but likely would do damage to the liver.  She said this should be a last choice.

We met with my oncologist on Wednesday.  Blood-work looked good but he recommended to stop all chemo treatments because it was not effective on the tumor.  We discussed the immunotherapy.  One thing our radiologist said was that the Keytruda is only proven to be effective if one marker (PD-L is present. The DNA analysis said there was zero percent present.  When we asked about this, the oncologist said that is true but was one of few immunotherapies that could be used in conjunction with the chemo treatment.  This very much upset me as the stated purpose was to start during chemo so that it would be actively working when chemo ended and used as on-going maintenance.  So not only did we stop chemo, we also stopped the immunotherapy.  The specialist in Lexington previously said that 4 months without any treatment would possibly kill me.  It has been three weeks since my last treatment and if the tumor is too big to remove, it could easily be months to reduce size, schedule and remove tumor and then recovery.

We met with the surgeon today. He reviewed all my records and the CT scans and talked to my oncologist before coming in to see me.  When he came in, he said removing the tumor will be no problem and there is a 90% chance he can do laparoscopically which reduces the recovery time.  That was a great relief to Joan and me.  He informed us of all the risk (infection, bleeding, death, etc.) but sounded very confident that all would go very well.  The surgery is scheduled for Tuesday, July 16.  Initial hospital stay will be 4-6 days.  I will be on restricted duty for about 3 weeks.  He said the liver is very greedy and will suck all the nutrients out of the blood stream during recovery so I will have very little energy for the first few weeks.

I contacted the specialist in Lexington and let them know the plan and asked if I could get an appointment before the surgery to discuss post-operative treatment plan.  I do not plan to go back to my current oncologist.

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