ANTHONY R. VIZZARI | ARCHTOGRAPHIST

This is a slice from my FDG PET showing one of the tumors in question. It doesn't look like much, but it's something! These fused scans kind of remind me of Francis Bacon paintings... I've always been a big fan. I guess that's a plus? We had a very long day (13hrs) at the Hospital in Bad Berka. I underwent a number of scans, and labs, followed by a consult by Dr. Baum. The meeting with Dr. Baum was indeed illuminating. For a more accurate recap, it would be too complicated and a bit long winded for a blog post. In layman's terms, it looks like my disease is a more extensive than the new nodes seen on recent MRI and FDG PET (there are also a few hot spots in the liver). PRRT is not an option per Dr. Baum, since these tumors are much more aggressive and will not respond to PRRT (receptor negative on Ga-68, but very hot on FDG PET, if I have that right). Dr. Baum thinks surgery would only be a temporary measure and is suggesting I investigate various inhibitors wit...

...this is a icture of a two headed calf that has nothing to do with this post... After getting to Berlin, we spent most of the day catching up on sleep. In the evening, we had a nice long stroll, followed by some good Indian food (lots of veggies). After last time, we learned if looks traditional German, or uses "brat" anywhere in the name, it's not for us. Also, we stay away from places with oversized beer mug signs and "little chef boy" motifs. We are headed to Weimar via train. Tomorrow is the big day at the clinic in Bad Berka to see what happens next. It will most likley be a LONG day.

FDG-PET: Note the large tumor lesion with an SUV +/- 60. FDG-PET: Note cross hairs on the "potential" primary tumor in the pancreas. I am out of the hospital in Germany and the good news is that I will not have to return for 12 months… the bad news is that I need to have surgery soon. It turns out that the large potentially 90% benign lesion IS NOT BENIGN after all… This wouldn’t be so bad except that now, it appears as though I don’t have a pure NET, but some type of rare unidentified hybrid (both in the liver and primary). This was revealed by the FDG-PET scan. These suspect tumors have massive FDG uptake. (-a scan that is available in the US an none of my doctors thought to order…???) This “mixed-tumor” didn’t happen overnight, it has been like this from day one, but we only now have the information to deal with it. My disease is no worse than when I walked into the hospital, but the information we have changes the plan, and potentially the prognosis, greatly. Luckily, th...

Berlin Photoautomat Chemical Booths: From our "grand tour" of Berlin. Location 1-7 (8 was not open in the winter.) Back to back booths in a Berlin neghborhood (loccation #9). Even though it was midnight, and 25 degress, people were still using the booths non stop! Me, Andrea, Carole and Siobhan (from London's Photomovette). Our Lady of Sorrows: Pedro Roldan Circa 1670: Bode Museum, Berlin After a few great, albeit very cold and snowy, days in Berlin we are now back in Weimer. In a few hours I will be headed to Bad Berka for my in-patient check-in. According to my schedule from Dr. Baum, I am supposed to start the PRRT treatment tomorrow (Monday). I will then be stuck in the hospital ward for a little stretch! We saw much of Berlin and toured nine photobooth locations throughout the city. Our friends from London came to visit with us for a few nights, which added to the fun. It was spectacular to catch up with them and see friendly faces. Via taxi, train, and many mile...

My 68-ga Scans: the full disk is amazing... note the bottom row. See that the large tumor is not illuminated. More to follow. UPDATED (Q/A with Dr. Baum via Email - at end of post) 02/10.2010: Disclaimer: Trying to get to Berlin, so please excuse the typos: Yesterday I had my visit with Dr. Baum and the (68ga PET/CT scan) here in Germany. The results were interesting! After over a year of searching in the US, the primary tumor was found here in Germany in the tail of the pancreas. It is very small, around 1CM in dia. Also, Dr. Baum believes that the largest tumor in the dome of my liver (6.5CM) is actually 90% benign with a metastasis (NET / cancer) growing in the center and edge. This is very rare and Baum has only seen it one other patient in over 4200 cases. We will do more tests (FDG PET Scan) to confirm next week, but it makes a lot of sense. This conclusion was made by how that tumor reads on the scan. It has to do with receptor uptake, etc. Others could probably explain it bett...

1947 Memphis Studio: Taken with what I beleive was a P.D.Q Camera... similar to photobooth technology... somewhat. The blog has been silent this last week. Things have been beyond hectic trying to get my act together to disappear for a while (even if it is only for a week, or two?) I wish I had some great parting thoughts... but alas, I really don't. I don't even have any great German (found) photos? But I did recently find this image(above), which I love! All I can say right now is, I'll keep you posted!

found photobooth photo - hand tinted The Grind: Last night was a late one, with multiple events… one at the Standard Club, which is a beautiful venue, but NOT fun for the installing of photobooths! It’s hard to get the equipment in, and of course, they’re very particular about things… Nevertheless, both events were a hit, flawless, and now done! In a few hours, off for yet more photobooth event madness! Day to Day: Sadie, my Step-Grandmother, is currently in the end stages of pancreatic cancer. This was quite sudden… with that said, everyone is very upset about the situation. At this point, it doesn’t look like there’s much to be done? For me, I often think so much about cancer, and my own fate / death, that I feel a little better prepared for this situation. But no matter how much you prepare, it’s hard to accept this fate for anyone. It’s especially difficult when it causes distress for those who you love… Right now, there’s little I can say or do, except to acknowledge the circum...

A blurred landscape photos for no good reason... We have our tickets for Germany. -Flying into Frankfurt arriving the morning of February 6th. On the 7th, we take the train to Bad Berka. Scan on the 8th. If the scan looks ok, we will proceed with surgery in Omaha with Dr. Botha. But before heading back to the US, we'll take the train to Berlin, and fly out from there on the 13th. If the scan is not so great, i.e., too many tumors in the liver to operate of extensive disease, we will see if I can stay for PRRT treatment. I'm not sure if this is an option at this time with respect to scheduling in the hospital, etc.... I still need to work out some logistics... that is, how does my surgeon in Nebraska review the imaging from the scan? When will a report be completed? That's all for now...

A messed-up strip from one of my booths on route. I kind of like it... when the chemicals get old, they start to do weird, unpredictable things. The following is a question / answer via email between me and my surgical team at UNMC. First, I just want to say, that the staff at UNMC is absolutely awesome about answering my questions in a punctual manner. I have also forwarded them my questions for Dr. Baum in Germany, but they were not sure about my questions for Dr. Baum, with respect to the 68-GA scan. This is not surprising because it’s not offered here in the US. Nevertheless, it seems as though some doctors here in the US are becoming aware of the importance of the 68-GA scan and PRRT. It’s probably not a silver bullet for everyone, but has had some great results –at least from what I have learned from other. Letter to UNMC (To My Nurse Coordinator & Dr. Botha) From me: Dear (x), I have my appointment with Dr. Baum, but have some additional questions I've been trying to ha...

Photo: We've finally started to get the ball rolling (at least on the web) for our new integrated photo studio ("312photo"). I'm building a dedicated page as well, but for now, check this one out. These are Paul's photos, and maybe even some of Michael's? We're going to be changing these images a bit in the next pass. I've also been doing some work over the last few days on the email and print collateral to get things moving along. The 312 blog has been much neglected, as well as our Facebook and Twitter accounts. There's much more to be done, but I'm excited about it. It makes sense, why can't we offer some "Zany" photography services along with our photobooths? Hence the "Outside the Box..." For those who don't get it, you know, out side the box, that is, the photobooth! More to follow on this venture in the future... I'm hoping somehow we can integrate more classic and alternate photographic mediums into th...

(A cropped image from our photobooth at "Berlin" Nightclub in Chicago. I thought is was fitting for the post... You know, Germany and all! Note the "Crazy Eyes...") I have an appointment for the 68 ga scan & consult with Dr. Baum in Bad Berka, Germany for February. We're looking for tickets now... I think we'll try to fly into Frankfurt and out of Berlin. This way, we can see the city, and the trip will feel a little less "Cancer-y" My informal budget calculates that the trip will cost about $9,000. Ouch! This includes the scan ($4,300), airfare ($1,600), trains, food, lodging, and a modest photo budget (of course). Another patient told me that the scan was 1,800 EUR, which is closer to $2,700. I'm still waiting on the exact amount from the finance department. The number they gave me, initially, was a loose figure of 3000 EUR. So, -TBD. Read this... Changing role of somatostatin receptor targeted drugs in NET: Nuclear Medicine’s view

Circled is the left lobe of the liver. This piece would eventually grow to become a full sized organ, if all goes to plan. It has a few tumors throughout, but manageable via wedge resections. Here you will see my largest tumor, outlined in red. 6-7CM. Note the IVC (inferior vena cava), and next to it, the 2CM tumor outlined in red. This needs to be dealt with before it grows into the IVC . UPDATE: 1 year of scans was "officially" reviewed. It appears as though the tumor growth is stable in the liver, that is, minimal. So, that's good. Also, another NET patient asked me about the possibility for future resections after the liver takes its new form (post 2nd surgery). The answer, from what I have been told: You are limited in some cases, but you can still resect if necessary. RFA, Spheres, etc. is a more likely option though... Also, if all goes to plan, the liver grows back to its full size and you have a 100% functional liver & tissue. Dr. Botha showed me an exampl...

I have scheduled my Octreoscans (OTS) and MRI for December 21st. It's 3 days of scans, which means 3 days in Omaha again. The OTS scanner / method is supposed to be better at UNMC. This time I think we'll drive to take advantage of the antiques! We saw some great furniture there last time that we would have loved to take home for the Wisconsin house. I have also recently been in touch with Dr. Baum in Bad Berka, Germany. I'm sending them my files for review. Dr. Baum thinks I might be a candidate for PRRT. (watch the videos... an hour total...but full of amazing info once you get past the history in the beginning.) Their scanners are amazing. If nothing else, I think I should go there for a scan to get a better picture of what is happening. From what other patients have told me, a treatment package is about 10,500 EUR (about $17,000 USD). Of course, there is also lodging and airfare. I think the scan alone is about $3000 USD. So, I need to start saving my pennies now, espec...