Good News

The doctors did laperoscopic surgery and used ultrasound to guide them while they took several biopsies.  They looked at the biopsies in the operating room and did not see any evidence of cancer.  They assume that the activity they saw on the CAT scan was inflammation from the radiation he got last fall.  They will send the biopsies to be further analyzed by the pathologists.  I was told there is still a 5-10 % chance that they will find cancer in those cells.  The other good news is that they took a tour of his abdomen while they were in there and saw no other evidence of cancer cells.

He will spend tonight in the hospital and tomorrow will come home.  He will take at least a couple of days to recuperate at home.

Thank you everyone for your support -- it makes such a difference knowing you are all out there cheering and praying for him.

January 29

Just an update that Kerry's surgery was delayed several hours and did not start until around 5 pm Portland time.  Will post more info as I have it.

January 27

FYI -- on Tuesday, Kerry's surgery is at 11 am (he has to be there at 9 am).  Sorry if my previous posting led anyone to think the surgery was at 9 am.

January 21

The laparoscopic biopsy is now scheduled for Tuesday, January 29 at 9 am.  If it turns out to be melanoma and there are no other tumors seen outside the liver they may proceed with a liver resection and remove the part of the liver with the tumor.

January 18

After talking to the liver surgeon today, Kerry and the doctor decided to do a different kind of biopsy.  Rather than an ultrasound guided needle biopsy through the skin, they will do an internal laparoscopic biopsy which uses an ultrasound probe which can be placed directly against the liver and will provide the best visualization of the liver for an accurate biopsy.  The date for the biopsy is postponed since the liver surgeon who would do this is out of town next week.  We won't know the date of the biopsy until next week.

January 17

The liver board decided to do a liver biopsy next week.  Did not get to talk to the doctor, but presume that this is to make sure that the serpiginous thing (sorry I can't throw any medical terms at you that sound any better...) that lights up on the CAT scan is really a tumor and not inflammation due to the radiation.  Kerry is out of town at a training to learn to use EPIC -- the new torturous computer system. He may have a chance to talk to the doctor more tomorrow and get some details.

The procedure is Tuesday at 8:30 am and he is expected to be there for 6 hours while they do the ultrasound guided biopsy.  He will be under IV sedation -- not a general anesthetic.

That's all I know for now.

Maggie

January 14

Today we visited Dr. Hansen, the liver surgeon, who spent over an hour talking to us about the possibility of Kerry's liver surgery. He explained that the surgery would likely involved removal of the right lobe of his liver as well as part of Kerry's diaphragm which the radiation to his liver tumor "spot welded" to his liver.  It might also involve removal of part of the lung if there is adhesion there.  So all in all, a larger surgery than we were thinking about going in.  It could take between 4 and 12 hours depending on the degree of involvement of the diaphragm and lung. The good news is that he says that liver surgery is much less risky than it used to be because of their improved understanding of the liver anatomy.  Very little blood loss usually occurs.  The other good news is that the detailed CAT scan they did last Friday did not find any tumors in the liver -- other than those shown by the previous scan.

The next step is that the tumor board will review his case again on Wednesday in light of the detailed liver CAT scan.  If they approve, then Kerry has to decide if that's the route he wants to pursue. The surgery could take place as soon as a couple of weeks. Healing could take a couple of months with about a week anticipated in the hospital.

January 11, 2013

The tumor board said the tumor might be a good candidate for surgery.  Kerry gets a more detailed catscan of his liver today and goes in to talk to the surgeon on Monday.  Will have more information then.

January8, 2013

The results of Kerry's most recent scan were that there is a tumor in his liver that is growing at a rather rapid rate.  He started having some discomfort 2 days before the scan so was not surprised by the results.  The good news is that there are no tumors anywhere else. At this point there seem to be 3 potential courses of action:

• Yervoy -- a drug which can be effective in putting melanoma tumors at bay.  It doesn't work in all patients, but is the only FDA approved treatment there is that he hasn't tried to treat his stage of disease.
• A drug trial with an MEK protein inhibitor.  The OHSU doctor gave an explanation heavily laden with biochemistry terms that I never studied in college -- so I really don't understand its mechanism of operation.   It is a phase 2 trial that has been effective with patients with the NRAS melanoma mutation that he has.  The side effects vary, but do not appear to be deadly or irreversible. As with Yervoy, it doesn't work for everyone and we wouldn't know until it is tried if it would work for Kerry.  Also because it is a trial, the long term effectiveness or side effects are not know.
• Since the tumor is only in one lobe of his liver, some consideration is being given to removing that lobe.  Apparently the liver regenerates quite quickly.  A group of doctors (called the tumor board) meet tomorrow to discuss whether this is a viable option. Two of the doctors Kerry talked to yesterday seemed to think that this might be his best option.

Making decisions like this are very difficult.  Please send us your good thoughts.