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.