As many of you family and friends Rick has been diagnosed with pancreatic cancer. More than 85% of pancreatic cancers are classified as exocrine tumors. Within this category, the vast majority of tumors are adenocarcinomas. Adenocarcinoma accounts for 90% of all pancreatic cancers. It begins in cells lining the pancreatic duct. Adenocarcinomas may form glands, or a collection of cells surrounding empty cells. Rick has a tumor measuring approximately 2cm near in the head of the pancreas at the bile duct so although Duke Cancer Center doctors have told us not to focus on stage as much as rather the cancer is resectable (can be surgically removed). They are at this time giving us between stage 2 and 3. We are hopeful that Rick started experiencing problems early enough and with a wonderful primary physician (Dr. Eugene Linfors) and all the wonderful team at Duke Cancer Center that have been assigned to him that we are have a plan and on the way to Rick having a good prognosis. We have busy with doctor and lab appointments. We have had the CT Scans, blood work and various procedures that will have him on the way to treatment soon. HIs problem at this time is his bilirubin level. For the ones that see him he is very jaundiced, due to his bilirubin level at 22.9 and the treatment cannot start till it is at a level 5 or below. Rick has had three ERCP (Endoscopic Retrograde Cholangiopancreatography) procedures. This is to treat the blocked bile duct and the last stent inserted was a larger metal stent but we have not seen the change yet so it may be necessary this week to insert a caterer to drain the bile externally. So he is experiencing pain, fatigue and severe itching. Trying to manage all that with meds, lotion and some good rub downs. The plan with his team at this time is as soon as the bilirubin decreases to a level to lower his liver and other organs being compromised is to start with 5 1/2 weeks of chemo and radiation treatment with a target first of August. This is to help kills cancer cells from further spreading and dividing. With pancreatic cancer this is the biggest issue. After this treatment they are planning for him to rest and get prepared after 3 to 4 weeks to have surgery. His surgeon team is planning on the Whipple procedure; it is the most commonly performed surgery to remove tumors in the pancreas. This is a procedure that is luckily successful for tumors in the head of the pancreas and involves the surgeon removing most of the pancreas (leave the tail since it is cancer free at this time and your body requires on 10% of functioning pancreas), gallbladder, small portion of the stomach and small intestines and the lymph nodes. The surgery can be 8 to 11 hours; a lot also depends on any possible veins involved so a vascular surgeon team will be on hand during. His hospital stay can be 9 to 11 days with 3 months recovery time and then they plan on 6 weeks of chemo therapy intravenously. So as you can see we have a long and tough road that will take us in to mid February 2014. But we are blessed with so many friends and family to walk this path with us. We want to thank all for your prayers and already the wonderful offers of assistance.