We saw the surgeon Friday and the exam room was full of white coats with big smiles. All the doctors are really happy with Scott's post-surgical progress, which pleases us a great deal, too. He's getting a lot of walking exercise and even clocked six miles one day. He's very motivated to do well — such a good patient.

We also saw the oncologist at Cedars on Monday. We discussed a lot of different options and have come up with a plan. In February, Scott will have a Gallium 68 PET/CT scan at UCLA (it's only available at four places in the U.S.). The Gallium 68 scan is the best technology available to detect tumors and metastasis. Scott's previous scans showed only regional metastasis, but the Gallium scan is better. If the scan only shows the little bit we know is left in his chest, then we may elect to do radiation to that area. We will not likely do any more chemotherapy as it is not very effective. Radiation is known to be pretty ineffective itself but the benefits of both chemo and radiation may not be easily measurably apparent. Other people who have had this type of cancer and who have had radiation and chemo have had a longer survivability than those who did not do radiation and chemo. This, however, is not great science. A randomized controlled trial using chemo and radiation would be best, but unfortunately, that is impossible with such a rare cancer. There just aren't enough subjects.

If the scan comes back with what we are expecting (that little hunk of tumor in his chest) then beyond possibly radiating that little piece, Scott will continue to get octreotide injections to try to keep the tumor from growing. Our oncologist at Cedars then suggests CT scans of the chest and MRIs of the abdomen every three months. If growth is detected in the coming months, years then we can think about doing a therapy called PRRT (peptide receptor radionuclide therapy). In other words, radioactive medication that goes right to the site of the tumor and binds with it. This medication is currently in a phase 3 trial at Cedars-Sinai but Scott is not a candidate. Only those with intestinal carcinoids are being included in the Cedars trial. But it's available in Europe and in Houston (for a hefty price). Our hope is that he will do well on the regular octreotide injections and then when/if he needs the PRRT, hopefully it will be more widely available in the U.S. Our doctor at Cedars thinks this is a good plan.

Sorry for all the mumbo jumbo details, but some people have asked me very specific questions, so I thought I'd try to break it all down. One thing to remember and to not lose sight of: SCOTT HAD A SUCCESSFUL SURGERY!!!! This alone has added many years to his life. Beyond that, it's important to remember that this is a chronic illness, not a death sentence. Much like other chronic illnesses (like diabetes for example), it must be managed. Scott is strong and has a great attitude. We will continue to fight this thing and will continue to look for the best therapies and best treatment options for both quality and longevity of life. And to quote Dr. Wolin again, "You don't have one foot in the grave and one on a banana peel." 2014 is going to be a great year for L-I-V-I-N!