Keytruda Infusion and Liver Mapping

On Monday, June 7, Mark was discharged from Providence Portland Hospital. He was quite weak but is gradually regaining strength. While he still has pain and nausea, it is not as intense. His recent health issues have resulted in rapid weight loss--probably 20 lbs. in the past month, so he looks a bit frail. 

On Wednesday, June 9, Mark had his 2nd infusion of Keytruda. Fortunately, he tolerates it well with only minor side effects. While we were there, Dr. Taylor shared results from the blood draw. Mark's bilirubin count is now down to 5.7--slow but moving in the right direction, which means the stent is working. (His bilirubin count was at 11 and needs to get to 1). His color is definitely improving. 

Dr. Taylor mentioned that other numbers from the blood draw were elevated, indicating stress in the liver. That’s not surprising -- there's a tumor growing there! We were more concerned when we learned that it could also be from the immunotherapy causing his immune system to attack the liver. We certainly hope that's not the case, as he would have to stop using Keytruda. So far, it has been effective at keeping other tumors from growing. Also, an MRI of his brain was done to ensure there's nothing there (ha-ha, well, at least no tumor growth!)  We learned this morning that his brain is cancer-free. Yea!!

Today (Thursday), the liver mapping was done, but the results did not turn out. Contrast was used to highlight the tumor, hopefully making it easier to see, but it actually made it more difficult to pinpoint the exact location. The radiologist wants the simulation redone, so we will return tomorrow (Friday) for this 2-3 hour procedure. The good news is that he will not need an IV to infuse contrast when radiating the liver. That is a definite benefit; he's had so many IVs recently! 

This is the updated SABR radiation schedule with the MR-Linac machine: (5 for the Pancreas and 5 for the Liver) 

• June 18 - P
• June 21 - P
• June 22 - P
• June 25 - P
• June 29 - L
• June 30 - P
• July  02 - L
• July  06 - L 
• July  07 - L
• July  09 - L

We are so grateful that the pancreatitis was brought under control quickly so he can continue with these cancer treatments. The more we learn about the SABR (aka SBRT) radiation therapy, the more we realize how fortunate we are. Traditional radiation could easily radiate the pancreas which would have severe consequences. The MR-Linac has only been at Providence Portland Cancer Center for one year, and as I mentioned, it is the only one in the Pacific Northwest, and one of four in the US. Patients come from all over the world to have access to this new, amazing technology. 

Mark's two sisters are here for a week, and they have been tremendously supportive and helpful. They have done lots of yard work, cooked meals, cleaned, shopped, and anything else we've needed help with. What a blessing they have been!