Good evening prayer warriors.... this is Lori. Many of you have been asking about whats next... this is long and detailed but should answer all of your questions.

We are home and Steve is recovering like a champ. We had a beautiful day in Boston on Tuesday, enjoying the weather, taking a ride on the Swan boat in the Boston Gardens and walking down Newbury Street, counting our blessings. This journey is a marathon, and we must not get caught up in the pain of the mileage. 

Our oncologist is traveling for the month but has been in communication with me via email. We agreed on the next steps and have a path forward. When Steve was diagnosed, a good friend who was on the same journey told me to remember three things 1) You are playing for time: this disease is challenging, but advances are being made daily. Find the most aggressive treatment, that gives you the best quality of life and live for the next breakthrough. No belts and suspenders approach to treatment 2) Make one decision at a time; only focus on what is right in front of you...don't try to speculate or plan 5 steps ahead.....its simply too much. 3) Write everything down: reflect on what you hear, research but only when you are not emotional. do it when you can think. Theres a lot to handle. Anyone who knows me is probably chuckling right now... where does it say "take control and charge forward?" I digress....

To that end, our next decision is to get a PET scan to be sure that the cancer is only localized to the neck and then meet with the radiation oncologist (who did his brain surgery) and plan for radiation. Completing these steps will ensure that we are moving forward, despite the wait. We also got clarity on timing for the results of the surgery to come back. Not as quick as we anticipated, but understanding helps.
                           1) Tissue from the excisional biopsy will be evaluated for malignancy verses benign mass. it will determine if it emanated from the lung or is a different cancer. It is very likely from the lung. This takes a minimum of 7 days. if I don't hear by Monday, I will be all over Dana.
                           2) Once the final pathology (above) comes back, then it goes to an internal lab for an oncotype screening. This will sequence the genomes to see if the driver of the cancer is a new mutation, or if it is a resistance mechanism to his medication. It will also look at a number of other factors. This takes 3 weeks! 
  
This process, while excruciatingly painful in its ambiguity, is vital,  as lung cancer treatment has evolved into precision medicine where treatment is essentially "customized" to the patient. The tradeoff to fast is specific, in other words, wait three weeks to ensure that the treatment is well aligned to the disease and therefore gives the best chance of success and longevity. So while this goes directly against my grain, it makes sense and I am at peace, hence, the plan A prep outlined above. 

So the biopsy results SHOULD come back on May 13th, the PET scan is scheduled for May 15th at 7 am (would've had it tomorrow but poor Steve needs a break!) meeting with radiation oncologist on May 20th, meeting with the surgeon in post op on May 23rd, and proposed results from the genomic sequencing expected on June 3rd. If the PET scan doesn't show any other areas of concern, he will likely start localized radiation to the neck ASAP. 

We are grateful for your support and ask that you unite in our prayers for peace, gratitude, the PET scan to not show any other mets, and a plan forward that systemically puts the cancer back to sleep.

In Christ, and with humility,

Lori and Steve