Note: I will write a longer post in the next few days. For now, just the essentials.
The bone scan showed nothing, but the results of the liver scan are very bad. The main tumor has tripled in size, for example, and the satellite lesions have coalesced into larger ones. The oncologist says my symptoms (fatigue, abdominal pain) are definitely due to the cancer and not the pembro.
So the pembro isn't working and will be discontinued. The doc is reluctant to put a number on things, understandably, but says it is very possible that I will die within two months. I will try to beat that number, of course, but it's pretty clear that this is the beginning of the end. We looked at the scans, and the dark areas corresponding to tumor are beginning to overwhelm the light (healthy) parts. Hospice care is now part of the conversation.
The doc mentioned one (and only one) further treatment that could be tried. It is another type of chemo. He wasn't at all enthusiastic about it, and for the first time in the process put doing nothing on the table as an option. My decision at this point is that I'm done with treatment. I'll explain this in more detail in my long post, but the short version is the usual story. The new chemo isn't likely to work, and will make me feel a lot worse.
Don't worry about me. I'm fine, really, and totally at peace with the situation. The one in need of support is my wonderful wife, who is very strong but I'm sure could use that support.