Molly and the nervous fellow

• Bloodwork, appointment with Dr. T and treatment at Siteman South County

I stayed up late last night getting ready for today's appointment. I spent time researching how the liver spots could be investigated further and also what kind of treatments might be available. I won't bore you with all of the details about Doppler ultrasounds, PET scans and biopsies. Or the details about radiation, ablation, radioembolization or surgical treatment options. But I'd be happy to share my Word document with you. I just know that I felt ready to sit down and talk it all through with Dr. T.

Dr. T wasn't up first though. When we got back to the patient room, we got to meet with one of his fellows. With Hector still in Colombia with family, Tina tagged along with me today and I think we made the poor guy nervous. It's okay for there to be laughter in an oncology office! My advice: Just follow your patient's lead.

Dr. T came in and it wasn't great news to start, the MRI shows "at least" 4 spots in my liver - new lesions of 6 mm, 5 mm and 4 mm, along with my 7 mm lesion that has been there all along and remains unchanged, that appears as a cyst on the scans. We immediately jumped into treatment options. Treat just the spots - with some sort of ablation (burn them or freeze them). Treat just the liver - with something like radioembolization. Or treat the body - by escalating my chemo to the next level. We talked about scheduling me to meet with an ablation specialist and Dr. T let me take a look at my MRI.

So we are all looking at the MRI, and seeing the spots (all near the exterior sides of the liver - seemingly not connected to important bile duct structures) and we're discussing how this MRI from yesterday was analyzed by comparing it to my MRI from last January, a full year ago. So these lesions might not have just popped up in the last 3 months, they could have been there 6 months ago, or 9 months ago, or who knows. So talking through it, we decide that we are going to continue the maintenance therapy and schedule another MRI in 8 weeks. Then we can answer the question - are these lesions growing on my current course of treatment? And if so, then we decide on what escalation is needed at that point. I'm satisfied with the discussion and the resulting decision.

Tina and I got settled in the treatment room and we talked about soccer and other nonsense... and the time flew by. She even got to meet Molly in her pearls, a sweet therapy dog who comes by on Tuesday mornings.