2/27/2009 This has been a successful week for Pam. Even after fighting a bladder infection, Pam worked with the children's vocal and bell choirs and the adult bells. She held up well and had no symptoms of dizziness or vertigo. Pam also has not gained any accumulation of abdominal fluid. It has been nearly three weeks since nearly 7.5 liters of fluid were drained. This is a good sign that perhaps the lymph nodes are permitting natural drainage regardless of the cancer cells. Finally, Pam had chemo today and her hemoglobin count is fairly steady. She has a bit more energy each day.

We believe the power of your prayers and best wishes has brought Pam to this point where she is able to fight the cancer and enjoy some quality of life. Bless you all!

2/17/2009 Since Pam had chemotherapy last Friday, she has gone from feeling really well to feeling miserable with stomach pain, vertigo and little appetite. Today, however, she learned her cancer marker, the CA125, decreased to 234 from 298. This is great news and it is the second straight decrease in the score. We have no explanation for the decrease but we believe it is a sign the chemotherapy is working. Pam's doctor seemed very pleased with this result.

Pam is looking forward to working with the children at church tomorrow. We thank you all for your prayers and continuous support for Pam's health.

2/13/2009 Pam had her first chemo since consulting at Sloan-Kettering. After considerable evaluation of Pam's cancer condition with Sloan Kettering and Pam, Pam's doctor recommended continued chemotherapy with Gemsar, the same chemical infused over the last eight treatments.
If Avastin were used at this time to starve the cancer cells along the abdominal wall, drainage of any accumulated fluid in the abdominal area would be extremely risky and could result in perforations in the intestines. Since Pam was drained of over 7 liters of fluid a week ago, the possibility of continued fluid accumulations is possible. Consequently, Dr. Iannotti will be prepared to treat this condition without extreme risk should it become necessary.

Pam's cancer is not concentrated in one location, so the Gemsar is designed to treat the upper GI area , as well as the uterine area. If this does not work, an alternative plan is ready. Gemsar seems to be the chemical which provides Pam the most comfort after infusion, despite the fluid accumulations. We remain encouraged that the CA 125 marker went down last time and a recent cytology report of the drained fluid showed no cancer cells.

Pam continues working around the cancer and keeping active as much as possible. She still experiences periods of weakness and lack of energy and does well to tolerate and overcome those symptoms.

We really are encouraged that Dr. Iannotti's assessment of Pam's treatment plans are consistent with those suggested by Sloan Kettering. The most effective factor in helping Pam is the support, love, and encouragement provided by friends, family, and the faithful members of our church.

2/5/09 Pam's oncologist will start her on avastin on Thursday, February 12th. As we learned in New York, avastin is an anti-body that attacks cancerous cells. In Pam's case, the cancerous cells around the lymphatic system will be attacked and allow fluid to pass through the peritoneum and prevent the bloating in the abdomen. It seems that avastin has not been prescribed locally for ovarian cancer due to possible restrictions imposed by the drug manufacturer. Dr. Iannotti is seeking to overcome these restrictions and clear the use of the drug with the manufacturer and verify insurance coverage. We are still awaiting the pathologist's review of the liver biopsy tissues to verify the type of cancer diagnosis.

Pam is scheduled to have the abdominal fluid drained tomorrow. This will happen if her blood test for clotting is satisfactory and that has not been a problem previously.

We are more confident in the potential success of this new treatment than we were after our consultation in New York. We also strongly believe your prayers, thoughts and wishes have led
to this next step in beating this disease. God bless you all!

2/2/2009 Pam consulted at Sloan Kettering today and met with a knowledgeable oncologist. The doctor agreed the treatment plan set up by Dr. Iannotti was the proper plan and that the right sequence of chemicals presented. Since the bloating and buildup of abdominal fluid has returned, the conclusion is the chemo is not working, regardless of the cancer marker results. The recommended plan of action is to stop the current chemo and attack the ascites, the swelling, with a chemical known as avastin. Avastin would be ingested every two weeks and Pam would take cytoxin daily. There are side effects, but if the ascites is destroyed, the swelling will go down, Pam's appetite and strength will return and she will live somewhat more normally.

The pathologists are working on the assessment of the biopsies Pam has had to confirm the type of cancer she has, ovarian or something else. The basic plan to attack the ascites will probably not change, however, since Pam has an apparent chemo resistant cancer.

The trip was worthwhile and we will return home on the 3rd. We thank you for your prayers and and support each day as we learn how to cope with this disease.