back to UNMC.

Today at 2pm Mike and I got to meet with Dr. Bill Lydiatt again at the University of Nebraska Medical Center. We established a relationship with him and his kind nurses back in February when we first received our cancer diagnosis. That is such a scary time and they helped us through those initial hours and days - and it felt good to see them again. They were pleased with how well our treatment plan has gone - and how good Mike looks.

As a reminder, Dr. Lydiatt and his brother started the Head & Neck Cancer Center at UNMC. He also knows Dr. Haughey and has cited him in his research. He could also win a prize in bedside manner, which is handy for a cancer doctor. Our meeting with Dr. Lydiatt was STEP ONE in the process. On Friday morning at 9am we will meet with the Radiation Oncologist at UNMC, Dr. Zhen.

Today Dr. Lydiatt said that "he would agree with the decision for radiation" at this point. He reviewed Mike's medical records, his surgical history and the radiation treatment plan recommendation of Dr. Haughey and Dr. Thorstad. He said that he could not tell us yet whether UNMC would honor the treatment plan because the decision will be up to Dr. Zhen. He said he will personally talk with Dr. Zhen and also bring Mike's case before the Tumor Board on Monday. (Is that not the worst name for a board that you would ever want to serve on??)

Dr. Lydiatt explained that the issues would be:

1. With extracapsular spread, they will say that chemotherapy following radiation will give you an incremental advantage. (Skilled researchers fall on both sides of this one.) He also said that patients can deny the treatment and will not be kicked out over it.

2. The other issue is whether Dr. Zhen will be comfortable doing limited radiation.

After talking with Dr. Lydiatt and his staff I would guess that there is a chance that they would treat us here. I am just guessing at this point though. The great part is that we already have a great medical facility (in St. Louis) that will deliver a treatment plan we are comfortable with and confident in - and we might have another one that is even more convenient (in Omaha). Dr. Lydiatt said that they would request the pathology slides and review them before they made their decision. He also said that sometimes decisions can be reached if it has equipoise (one of my favorite words). In the medical ethics it means that there is a state of uncertainty regarding the pros and cons of either therapeutic arm in a clinical trial.

We will find out soon enough. Please pray for a clear path, and for complete eradication of the cancer from Mike's body with no long term side affects (or short ones for that matter.)