Stopping Treatment. Upcoming Procedures.

Cliffs Notes:

• Symptomatic AF

• Stopping medical treatment indefinitely, due to side effects.

• Liver Embolization #1 scheduled for Dec 11.

• Live Embolization #2, January 7.

SYMPTOMATIC:

Paul's definitely struggling quite a bit recently with his symptoms. I think it's likely a combo of still being relatively fresh out of gallbladder removal / pancreatitis, this relentless leg pain and likely just the cancer itself of course is taking it's toll. He's currently couch-locked with some debilitating fatigue, flushing, belly issues and an overall feeling of "ick." But... as Paul does... I can almost bet he will get himself out of bed tomorrow, pretend he feels great, and continue to conquer the world 🩷. I honestly cannot wrap my head around how he does the things he does. I question whether or not he is human sometimes.

STOPPING TREATMENT INDEFINITELY

His oncologist has taken him off of his injections, indefinitely. The side effects are just no longer tolerable, and are significantly affecting his quality of life. (Just to name the most recent one: The gallbladder emergency was very likely a direct result of the treatment.) So... onto the next phase:

LIVER EMOBLIZATIONS SCHEDULED , Dec 11 + Jan 7:

This basically means cutting off the blood supply to the liver to ‘starve’ the tumors. The surgeon does this by injecting blocking particles (via catheters) directly into the hepatic arteries (the arteries that supply blood to the liver). This in turn deprives the tumors of oxygen and nutrients, and should help stunt the growth for a little while.

Thankfully, it's not an open surgery, but it's a painful procedure with a challenging recovery. (His surgeon compares it to the pain of kidney stones and natural childbirth — only the pain lasts longer than those 🥺.)

He'll stay in the hospital for 1-3 days to manage nausea and pain, followed by several days to a couple of weeks of home recovery each time.

There will be two procedures, one month apart, targeting each half of the liver. Recovery varies for everyone.

THE UPSIDES OF LIVER EMBOLIZATION:

• Approximately 80% of patients respond to the procedures. the hope is that it should help slow the tumor growth and maybe even shrink some of them — lessening his overall tumor burden.

• He could potentially get about a year of stunted tumor growth, and feeling better overall.

• It could help reduce the localized pain he has in his liver.

• It might help subdue his serotonin overload symptoms — flushing, stomach issues, irritability, etc. (The idea is that the less ‘active’ the tumors are once they are ‘starved,’ the less hormones they secrete, the less symptoms he should have.)

HOPEFUL:

We are hoping that starting February, he will be able to have a MUCH deserved break from treatment and procedures, and might actually get a decent 6-12 months of relief and normalcy 🤞🏻🩷.

Dayna