My brother is currently on his second type of chemotherapy treatment for metastatic pancreatic cancer. The first, which was a conventional type, did essentially nothing but make him lose his hair. The results of the second, a targeted therapy given orally, are not known yet. However, he has been having some significant pain, probably due to a tumor pressing on a nerve. He has been on morphine and oxycodone, which gives an idea of the level of the pain.

The last time I went to Chattanooga, he was pretty much his old self, but had been having enough pain that he took his pain pills. As the afternoon wore on, his pain subsided, but so did his alertness. But the time I left, he was half dozing in the living room, occasionally waking up enough to make confused comments that conflated his dreams with the conversation the rest of us were having.

We spoke to him on the phone Sunday evening. He voice sounded terrible and he sounded confused. I think it was partly due to the effect of his therapy, which makes him hoarse, and partly due to the effects of the pain medication he’s on. He said he felt pretty bad. His wife suggested that we call back right after lunch on Monday, which we did. He didn’t answer. Later Monday evening his wife texted us that he had gone to the hospital, where they had found elevated bilirubin levels. This could be caused by a tumor blocking a bile duct.

I’m planning to drive up to Chattanooga Tuesday (the day of this post) to visit him in the hospital. I hope they know something by the time I get there.

My brother was diagnosed just before Thanksgiving, so about four months ago. The median survival rate for untreated cancer at his stage is about three and a half months. With “good” treatment this increases to about eight months.

My brother’s younger son and his new wife were planning a family week at the beach next week, but it’s not looking like that will not happen.