I am not surprised at the call from Dr. B:  The results of the CAT scan are in, and I should come down to the office.  This, of course, is shorthand for uh-oh.  My sweetie (also a patient of Dr. B) comes with me to Dr. B’s office.

There is a mass at the tail of the pancreas. It’s not localized (i.e. surgery is impossible).  It has spread to the lining of the abdomen and to the liver (in more than one place).  (Aha:  that’s the pain under my ribs.)
  
Dr. B has already arranged for me to have a scan-guided biopsy (of the liver, because the pancreas is so hard to reach). He draws blood and examines me to clear me for a biopsy in two days (allowing time to get the results of the lab work), and gives me an oncologist referral. The doctor looks stunned; I’m still in great shape (but I’ve lost more weight). (Of course, I haven’t had breakfast or lunch two days this week.)  And I won’t be able to eat before the biopsy, either.

He wants me to schedule an apointment with an oncologist (Dr. S) at the end of next week, when the path report will be in, and to call him (Dr. B) on Tuesday for the preliminary path report.

I tell my parents (who are calling every evening) and that one friend.

My brother’s sweetheart died in 2008 of pancreatic cancer. Of all the people I don’t want to have report this to, he’s top of my list. I speak to him every week, and will tell him in the usual call. I am so dreading this.

My parents want to know what I’ll say to my sister and my brother. I say I’ll tell them Saturday, during our usual family phone calls. They think I shouldn’t wait. I am in no hurry to spread this news.