A Wonderful Friday!

The alarm went off at 5AM so Mary could eat a bit before the 5:30AM cutoff required by her CT scan. We arrived at the imaging center a few minutes early--thanks to our GPS unit that took us to the right place instead of where I thought we were supposed to go. Hey...I didn't have to stop and ask for directions.

Mary caught a break right away and she did not have to drink the imaging goo. Instead, she was given an injection and taken to the scanner. It was all over by 8:20AM so we went to the closest Starbucks (thank you iPhone--there is an app for that) and had our drinks and a breakfast thingy.

The first task after arriving at the hospital was a blood draw. From there, we went to the reference library in Stanford's Cancer Center. We are looking for technical papers on the effectiveness of chemotherapy applied to cholangiocarcinoma in resected (operated on) patients. I did find one that cited a very old study (8 years) that reported a result from ~550 patients. It said there was no impact on the cancer for those who had chemo vs those who did not have chemo. At that point, the Librarian asked if she could run a search for us so Mary gave her the particulars and they will email us their results. Nice!

The good doctor was a bit late. We were called in about 12:10 for our 11AM appointment. And, we only had to wait in the examination room for another half-hour. What we learned is (get ready to cheer):

1. The CT Scan shows no visible cancer sites.
2. The CT Scan shows the liver is about back to where is was before radiation therapy.
3. The blood tests show her electrolytes (sodium, potassium, etc.) are all a-ok, nominal, no problemo!
4. Mary can stop the diuretics when the bottles are empty in about six days.
5. And, the official weigh in at Stanford shows Mary has eliminated all the bloat!

We then had a very nice conversation about next steps and need for chemo. Dr. Visser echoed what Dr. Fisher said in that there is no known protocol for treating Cholangiocarcinoma. What is known is that some patients react horribly to chemo, some do not. And, sometimes patients who have chemo do have relapses but then again some who do not have chemo do have relapses also. The doc said that Stanford believes in aggressive treatment and would probably recommend further chemo but that is really up to the Oncologist, Dr. Fisher. Of course, doing the chemo at all is up to Mary.

Dr. Visser was very strong in his opinion that "Mary is young" and she has the best odds of having a great quality of life for a long time. He said "You are young" at least four times so he is really trying to pump Mary up to keep the fight going.

Mary told him, by the way, that as of yesterday she felt the best she has felt since radiation started. He explained that radiation therapy is not immediate in its action and having the peak of negative impact occur on the liver generally occurs weeks after the radiation stops. Thus, the major concern with her system bloating for it may have indicated something more serious. The opinion now is that it is under control and she is in a super place.

OK, so today is a preview of Monday and the signs are good. We'll have a conversation with the Oncologist and then Mary will decide what she wants to do!