we love Dr. T

Alternately titled: a post in which I use the C word way too many times 

Warning: lengthy medical update ahead! 

My parents and I met with Dr. Tauer, Mom's oncologist, this morning. The last time we sat in that exam room and talked to him, it was not a good visit. This one was. :-)

The last few times we've seen Dr. Tauer have been at 6:30 in the morning when he'd come by Mom's hospital room and wake us up. So today he gave us a recap of the outcome of Mom's surgery, just in case we weren't quite awake enough to remember what he told us the first time. And I haven't discussed her surgery in detail here before, so now I will. The bad news is that Mom's tumor was bigger than they thought it was going to be (about an inch long) and that it had spread to some lymph nodes. Dr. T wasn't expecting either of those things. Dr. Behrman removed ten lymph nodes, and the five closest to the tumor were positive for cancer. The surgery was longer and more difficult than Dr. B thought it would be because the tumor was adhered to one of Mom's blood vessels and he wasn't anticipating that. The good news is that all of the margins around the tumor were clear, meaning Dr. B was able to remove all of the cancer.

Mom asked Dr. Tauer if they'd made a mistake by doing surgery (as in, would they have still done it if they'd known it had already spread to lymph nodes). To which he replied "Absolutely not!" He went on to explain that, without surgery, there would've been no hope for a cure. However, now that surgery's been done and gone so well, they have the opportunity to cure this. He was careful with his words - it's not a guarantee, but an opportunity. One we wouldn't have if God hadn't sent us a willing and very skilled surgeon.

Because cancer spreads through the lymph system and Mom's cancer had gone to lymph nodes, she has to have chemotherapy to kill any stray cancer cells that could be floating around in her lymph system. The chemo she'll get is called gemcitabine (Gemzar), and she starts a week from tomorrow. We're a little confused on the exact schedule of her treatments, but we do know there'll be eight of them. After that, Dr. T will do regular CT scans to check for any signs of recurrence. Dr. T told us this is a mild chemo and probably won't cause hair loss or nausea (yay!). It'll probably make her tired and could cause her blood counts to drop, so they'll watch those closely.

Mom will also start Herceptin back next week, which is the maintenance treatment she's received for breast cancer for the last six years. Herceptin is a treatment that only targets cancer cells that express the HER2 protein and is supposed to stop them from growing. Dr. T has no other metastatic breast cancer patients who've been on Herceptin as long as Mom has. She'll stay on it as long as it's working.

On to our next answered prayer . . . we found out today that Tarceva is an option for Mom! This is the drug I asked you to pray about while Mom was in the hospital. Like Herceptin, Tarceva is a "targeted treatment." Unlike Herceptin, Tarceva targets cells that express the HER1 (or EGFR) protein. Because Mom's breast cancer is HER2 positive, Dr. T was surprised to learn that her pancreatic cancer is actually HER1 positive. This was great (and kind of weird) news! Dr. T said it just proved once again that's Mom's a very unique individual, ha. It also proves once again that God answers prayer. As long as it's approved by insurance, Mom will start Tarceva with her chemo.

Dr. T answered all of our questions and then some. He's great at what he does. He made sure we understood that this is a big deal, that pancreatic cancer is bad. But he also made sure we understood that there was hope. He reminded us that Mom has surprised them in the past (by surviving stage IV breast cancer) and encouraged us to keep praying for another miracle. Love having a doctor who believes in the power of prayer!

In other news, Mom's had a pretty good couple of days. She's still having some stomach issues but not as bad as last week. Her eating is a little bit better - at lunch she had four chicken nuggets from Chick Fila! Sleeping is not better. Dr. T prescribed a few new meds today, including something new for sleeping since the Ambien doesn't seem to be doing the trick. He told us that this one of the worst surgeries they do (we'd already figured that out), and the recovery is just going to take a very long time. He said to expect four days of recovery at home for every one day in the hospital. Eventually Mom will learn what works for her and develop a new normal. We're hoping that day comes sooner rather than later and Mom will soon feel like her old self again.

Thanks so much for your prayers for Mom's appointment today. It was a good day. :-)