Second opinion at UChicago with Dr. Shergill

Today we drove into Chicago for a second opinion at the University of Chicago with Dr. Ardaman Shergill. I wanted another set of eyes on the plan before we start treatment, and Dr. Sidani fully supported the visit.

Here is where things stand, in plain language.

**The diagnosis**
Stage IV colon cancer. The primary tumor is in the sigmoid colon and there are several spots in the liver. The good news, if there can be good news on a day like this, is that nothing has shown up in the lungs, the bones, or anywhere outside the abdomen on imaging so far.

**The plan we landed on**
Dr. Shergill recommended starting with a chemo regimen called FOLFOXIRI plus a targeted drug called bevacizumab (Avastin). It is a strong combination, three chemo drugs at once, and it is the most aggressive upfront option. The reason for going strong out of the gate is that I am young for this diagnosis and otherwise healthy, and the goal is to shrink the liver spots enough that surgery becomes a real conversation down the road. Dr. Sidani discussed the exact same approach so this is reassuring and they are aligned.

MRI needed for my liver - scheduled for May 5.

We are waiting on two pieces of molecular testing but will proceed the first infusion, Tuesday May 5 looks to be the big day:
1. KRAS and the rest of the standard tumor mutation panel from the biopsy.
2. A Guardant blood test (a "liquid biopsy") that picks up tumor DNA circulating in the blood.

Those results will confirm whether FOLFOXIRI plus bevacizumab is exactly the right combination, or whether a different targeted drug would be a better fit.

**What happens next**
- Bloodwork today at UChicago.
- Port placement was done yesterday so they went right into the port today and christened that penetrating my chest with that Huber needle. I survived, but I’m definitely gonna look into that prescription cream that I can use beforehand to try to numb the area.
- First infusion proceeds, as soon as the molecular results are back, likely 7 to 10 days from now there could an added component.
- A repeat CT scan in about 2 months to see how the tumors are responding.

**How I am feeling**
Honestly, relieved to have a plan. Dr. Shergill was calm, thorough, and answered every question without rushing. She and Dr. Sidani are aligned, which matters to me. I am scared of the side effects (neuropathy, fatigue, the usual list), but I would rather throw everything at this now while I am strong.

More soon. Thank you for being here.