Friday, June 26, 2009

The Big Plan

The big plan is chemo, chemo, and more chemo! No surgery, no biopsy, no delays.

Chemotherapy will start this coming Thursday. We're going to try the gold standard for leiomyosarcoma (Gem and Tax) and then take a peek after six weeks to see if it is working. If it is not working (if something grows) then we'll switch to one of the other three chemo drugs that are effective against sarcoma.

Ladies, I am going to need rides to and from Duke for the first three weeks -- after that, the doctor will let me decide whether I want to drive myself based on how I feel. Nice.

So, now that we have the big plan laid out for ya, how about some details?

What did the scan show? The tumor in the psoas looks exactly the same, no shrinkage, but that is totally fine and expected. There are actually six nodules in my lungs (not four as previously reported) but the extra two are super small and evidence of them can be seen if you look back to earlier scans. So it's not like there are any new ones, just that this was a better scan. As for the pancreas, there is a 4cm mass in the middle. I got to see it! Dr Reidel pulled up the scans and showed me everything, whichwas awesome. The mass is still unfortunately a mystery.

Why not biopsy the pancreas? The doc explained that there are three things that the mass could be. And then he went on to describe the approach for each -- and it always came back to chemo. So basically, there is little point in a biopsy because no matter what the results are, the answer is chemo. We are going to watch the mass and watch my sugar levels (which would be a good indication that my pancreas is not working properly). If everything else responds fabulously to the chemo (like shrinks) except for the pancreas mass, then we would probably biopsy the pancreas mass later on... Oh, plus, if it is another cancer typical in the pancreas then the Gem I will be getting is a good chemo to attack that.

I love Duke! And Dr Reidel is great because he takes the time to explain everything and convince me and even spell things for me (because I am of course taking notes). I have more details to share but will have to save them for another post because it's time to go to breakfast.

Lou and I are in the Outer Banks. We spent the late afternoon on the beach, getting thrown about by ginormous waves. It was so much fun!

How you have a fun day, too.


Anonymous said...

Don't you worry about rides. Put me straight on your designated driver list. That is no problem at all.
-- Meredyth

Anonymous said...


Thanks for sharing your news with us. Enjoy being rocked by those ginormous waves. I took a walk in the woods at work yesterday and sent lots of positive energy your way.

Carol Q.

omerandpat said...

Karen and Lou:
Take a plunge into the ginormous waves for us--that is if you can plunge into them!
Luv ya,
M & D

Pat S. said...

Glad to hear you have a good game plan and now that you are taking time to relax too...Too much thinking, planning, etc. needs to have a break too...Enjoy the fun in the sun--hopefully, you have sun too...!!! Love, Mrs. S.

susan said...

We don't let a day go by without sending prayers and cyberhugs your way! We are with you on this journey!

love and hugs,
susan and dick

Anonymous said...

Karen, I've been catching up on your "journey" and would like to comment on what a friend brought up. I'd like you to meditate and use imagery to kick the "caca" out of those cancer cells. It doesn't matter what you "use" to attack the cells, JUST BELIEVE in what you use. Many times when I've had to deal with something, I "see" a file cabinet with its drawers open and all the papers "my problems" flying every which way. The important thing is that you believe and with all that you've been through so far, YOU DO BELIEVE. Oh how I wish you the very best - I continue to keep you in the "light". Good luck sweetie.

Anonymous said...

Hey Karen,
Sorry I haven't been commenting for a few days. I have been helping Sam move. You know I am there for you, where ever you need to go. You could have just pretended to need a driver to the Outer Banks -but OH NOOOOoooo!!! BTW, Do you know how to body surf? Hope to see you Monday nite. Maybe we can work out a schedule. Let Omerandpat know "we got it".

Delpfine said...

Hi Karen,

Sounds like the new doc at Duke is great. Wish I was there to help with the transport.


Anonymous said...

Karen my beautiful cousin, I sure wish I lived close enough to be your ride.

Robyn said...


Give me a call and we'll talk about the ride schedule. I want to help. There is the other offer still hanging out there as well...don't forget to let me know when you are ready for that...

Love you!

Anonymous said...


I finally caught up on your blog. I hope your weekend away is wonderful and restorative. I think of you often and am sending healing karmma and thoughts your way:-)

Love you,
A from Kent, WA

TBritt34 said...

Tom and I hope you had a grand time on your mini vacation. Although we are in Massachusetts visiting family, we think of you both every day and send positive energy and love your way. We want to thank you for sharing with us. Tom and Glo

Beth said...

Good luck on the chemo visit tomorrow. I hope that it goes smoothly.

Lisa V. said...


I'll be sending love and healing thoughts tomorrow as you start your chemo. Put me down on the list for transport. Glad you guys had fun at the beach!


Alan said...

Karen, Luv u gurl. Alan