9-25-2008 Pam learned the previous treatment was not attacking the cancer as her doctor had hoped. Her test results indicated that the cancer is no better or worse than at the beginning of treatments in July. The results indicated that cancer cells have multiplied around her liver; however, the tumor has not grown. Pam's doctor remains optimistic and Pam thanked him for being on top of her case. Her original treatment plan called for 6 treatments 3 weeks apart and her doctor scheduled the interim scans to monitor progress. The new treatment plan calls for a less intense chemical (topotecan) every week for 8 weeks. Topotecan is designed to kill dividing cancer cells to prevent abnormal growth activity.

Pam is okay with this report. She had an inclination the chemotherapy was not working as planned and she is very pleased that a change in chemicals is occurring now rather than after the initial 6 treatments. Her doctor does not anticipate much change in the side effects with the switch to topotecan and remains committed to finding the most effective treatment.

We thank you for your continued prayers cards and expressions of support. They are working because Pam remains upbeat and committed to overcome this condition.

9-17-208 Pam endured the PET scan very well. She was most apprehensive about the claustrophobic environment but she overcame that feeling with a tranquilizer and singing hymns in her mind during the procedure. The entire preparation and procedure took two hours, yet Pam felt good enough after being released to go grocery shopping and fixing a big dinner. Pam rested well in the evening and had a good night's sleep.

We will meet with her doctor next week to discuss the effectiveness of the chemo treatments. The next chemo is scheduled for September 25th.

We thank you all for your continued prayers and encouragement.

9-12-2008 Pam underwent a CT scan yesterday as one of the tests her doctor needs to evaluate the chemo treatment. She did very well, with little apprehension of the procedure. Later in the day, she was in distress from abdominal pains (probably effects from the barium sulfate drinks) and feelings of general weakness and exhaustion. She cancelled two patients and spent a good amount of time resting. Today, Pam is feeling somehat better, but she still suffers from feeling exhausted with little effort. She looks forward to overcoming these effects in the next day or so.

She is scheduled for a PET scan on Tuesday, September 16th. Her next chemo treatment is set for Thursday, September 25th.

Pam sincerely appreciates your prayers, cards, calls, emails and all expressions of support. She remains optimistic while being impatient with "feeling bad."

9-5-2008 Pam feels pretty good today after her third chemo session yesterday. The lack of discomfort may be due to the continued effect of the medications she took yesterday for her treatment. Since she has had frequent abdominal pain her doctor has set up another CT scan and PET scan to determine the effectiveness of this mixture of chemicals. His goal is to heal her and will do what is necessary to be confident that the tumor is being reduced.

All your prayers, emails, cards and calls have had a very positive impact on Pam's desire and ability to keep focused on her work, Treasure Coast Singers, and church activities. These activities are therapy for her.

9-1-2008 Pam has been active with patient care and church activities on a regular basis. She has experienced frequent abdominal pain; however, pain relief medication is slow acting and leaves her tired and drowsy. This really affects her ability to drive her car and maintain her desired activity level. Her next chemo treatment is scheduled for Thursday. September 4th. We believe the pains are caused by the vigorous action of the chemicals.