Wednesday, November 28, 2012

Only 2 more treatments.

Yesterday was spent getting another chemotherapy treatment at Duke. It has been 2 weeks since I had my regular 3 consecutive days of chemo, which will definitely take some of the wind out of your sails. But I have had enough time to recover, and the last part of the cycle only involves one treatment each week, so I don't expect too much difficulty lies ahead. I only have 2 more treatments to complete Cycle 4, which is hopefully the end of my chemo treatments. As I write those words, I almost can't believe it. Two more treatments and my Clinical Trial chemotherapy routine is finished, done, complete, history.

Looking back at the calendar, my treatments started on June 20th, and since then I have received 22 chemotherapy infusions, with 2 more waiting in the wings. In many ways it has been a very long and arduous 5 months, not something I would wish on anyone. But by the grace of God, and a decent amount of intestinal fortitude on my part, I have come through the whole ordeal with amazing ease. I have lost most of my hair, and have had a running battle with fatigue, but otherwise I have escaped virtually all of the other symptoms commonly associated with chemotherapy treatments. Nausea and vomiting are the most common and widely feared side effects, and I can safely say I have not had one moment of either. I am well aware that my experience with these toxic drugs is not typical, and I actually feel somewhat guilty when I complain about a minor ache or pain. I could be so much worse. I see many fellow cancer patients in the treatment center that, on their best days, are probably not as good as I am on my worst.

Assuming that my reassessment testing, in late December or early January, indicates that the cancer is gone, I will begin my bone marrow transplant sometime early next year. But we will cross that bridge sometime early next year. In the meantime, I rejoice in how well I am doing. Back in June, there was much that was unknown. How would I react to the drugs? How effective would they be at killing my aggressive cancer? So many questions and so few answers. But here we are, approaching the end of that long dark tunnel, and we are doing just fine. I read something recently, written by another cancer patient, that rang so very true. "We have no idea what we can overcome until we have no choice but to do so." It is my hope, that by relating the details of my journey, I may be of some encouragement to others, who may be standing at the entrance to that same long dark tunnel. Yes, dark tunnels are scary. But it is possible to travel through them and come out the other end, without having to endure pain and sorrow along the way.

I cannot begin to express how important the prayers of so many people have been in helping me on my journey. Without question, the power of prayer has played a key role in the progress I have made, and the many victorious moments I have experienced along the way. As the song says "Our God is an awesome God. He reigns over heaven and earth..."

Thursday, November 22, 2012

Thanksgiving day.

Five months ago I was diagnosed with cancer and, for a while, I wondered if I would be alive to see the end of the year 2012.  I am thankful that The Lord has brought a peace to my spirit, and a healing to my body, that allows me to continue to enjoy His many blessings, which are all around me.

Some forty four years ago I met and married the woman that God had selected to be my partner for life.  Holly and I began our journey together with much joy and anticipation.  Some forty four years later, we will celebrate this holiday season, surrounded by the family that has been our extreme joy and fulfillment.  To have this opportunity, to all be together around our table of Thanksgiving, is truly a blessing.

This day will be busy. Young children will scurry about, laughing and crying and just being young children.  And the adults will  spend their time preparing the food, reflecting on times past, and wondering about things that lie ahead.  Later in the day we will all be seated around one large table, to join together in quality time as a family.  Times like this are the embodiment of that joy and anticipation we felt so long ago.  And they are the basis for the joy and anticipation of what still lies ahead.

My cancer diagnosis was not a blessing.  But it has caused me to have a much clearer perspective of the countless blessings that are all around me.  Through the years I have lost my focus many, many times, and assigned far too much importance to people and things that were actually very insignificant and momentary.  But on this day, I plan to dwell on the love and goodness that God has placed all around me.  My life is so rich and full, and I plan to appreciate every moment of this glorious Thanksgiving Day.

And just because I can, I want to list my blessings one by one: Holly, Brent, Adam, Annie, Gracie, Eliza, Owen, Jill, Jeff, Ben, Max and little Rose.  Thank you Jesus.

Saturday, November 17, 2012

Attitude is key.

Cancer is an ugly monster, and chemotherapy and radiation are it's twin brothers.  Surgery sucks.  The emotional toll that accompanies a cancer diagnosis is devastating, not only for the patient, but equally so for family members and friends.  I have done a lot of reading since my diagnosis 5 months ago, and I have yet to come across a single person who has felt that cancer was a positive addition to their life.  Certainly, many cancer survivors believe that a positive by product of the cancer process is a whole new perspective on who and what is really important in life.  Cancer will help you sort out the things that are important, from the things that aren't.  But I don't recall anyone indicating that they felt the cancer itself was a positive, in any way, shape or form.  It is, in short, simply a disease that threatens to take your very life.

The initial cancer diagnosis triggers an emotional roller coaster ride of epic proportions.  I know because I have been there.  Back in June, when I was told that I had a rare and very aggressive form of Lymphoma, classified as stage 4, with a 5 year survival rate of 20 to 30%, I can safely say I went into emotional shock.  Over the next several days my mind went wild.  Would I even be alive this Christmas?  How will Holly and the kids deal with my death?  Not the type of thoughts that generally occupy your consciousness.  But they are thoughts that will be present in every cancer patient's mind.  Fortunately, the process of mental adjustment and coping does not stop there.

Over the days and weeks that follow, more information becomes available from various sources, most importantly from medical professionals, that allows things to be put into a better perspective.  A more realistic, and less emotional assessment begins to evolve. That assessment may not be what the patient and family was hoping for, and wanting to hear, but it is a more considered and less emotional set of facts that will form the basis for future decisions and actions.  Every instance of cancer is different, and how it will impact the patient's body will vary from person to person.  So there is certainly no one-size-fits-all answer that will work for everyone.  That is where each individual, whether the patient, the family, or a friend, must work out their own unique method of coping with the situation.

I generally tend to be an upbeat, positive outlook kind of guy.  I am not fond of some of the bumps and bruises that this life can send my way from time to time.  But I can usually just pick myself up, dust myself off, and move on.  I am a big believer that your present circumstances don't determine where you can go, but they merely determine where you will start.  I don't control my circumstances, but I do control how I react to them.  This is where I feel the cancer patient needs to focus most of their thoughts and energies.  My initial reaction to my diagnosis was fear.  But then I got mad.  This damn monster was not going to rob me of my life.  I was going to fight this unwelcome and unwanted invader with every fiber of my being.  I might not win, but I wasn't going down without a fight.

I remembered something said by Lance Armstrong, the cyclist and cancer survivor, after he emerged from his battle with both testicular and brain cancer - "Pain is temporary, quitting lasts forever."  And I more recently read an article, where the author was discussing the prospect of quitting during times of discouragement or slow progress.  She said "It's all about knowing when it's time to quit, and when you're just quitting."  Oh yes, there may come a point when it is time to quit, and recognizing that point in time is important.  But until that point in time, you can't quit fighting.  Because quitting lasts forever.

Winston Churchill was the famous British politician and statesman, and was the UK's Prime Minister during World War II.  His steadfast refusal to consider defeat, surrender, or a compromise peace, helped inspire the British resistance, especially during the difficult early days of the War.  He was particularly noted for his speeches and radio broadcasts, which helped inspire the British people.  On one such occasion, he said
"If you're going through hell, keep going."


Friday, November 16, 2012

Whew - what a week.

This has been one very full and busy week.  On Monday, our granddaughter Eliza had brain surgery at Duke Children's Hospital in Durham.  All indications are that the surgery was very successful, although it may take several months before the long term results are more apparent and more readily evaluated.  We leave those healing adjustments to the Lord, and rejoice in the way her body is healing from the surgery itself.  The doctors released her from the hospital ahead of schedule "because she is doing remarkably well, when compared to most post-op neuro kids".  She and her family will be staying with us here in North Carolina, at least through her followup visit next Wednesday, to minimize the travel time back and forth to Duke (1 1/2 hours from our home versus 4 hours from her home in South Carolina).

This week was also my week to return to Duke for the start of Cycle 4 of my chemotherapy.  Tuesday, Wednesday, and Thursday were spent visiting with Dr. Beaven, getting the inescapable round of blood tests, and spending far too much time with the staff in the treatment center.  The initial phase of each cycle, as specified in the clinical trial protocol, is spread over three days and involves about 8 hours of being tethered to a very impersonal and disinterested IV pump.  Fortunately, the amazing nurses provide a constant stream of TLC as they treat each patient as if they were part of their immediate family.  Over those three days I receive about 2 liters of drugs, none of which was formulated with my comfort and short term sensibility in mind.  Five days of high dose Prednisone tablets, which cause severe insomnia, and a Neulasta shot to boost my white blood cell count, and the beginning of Cycle 4 is complete.  A break of about 10 days will allow me some recovery time, before starting into the second half of the treatment routine.

With Eliza's surgery on Monday, we have made 4 round trips to Duke, which totalled about 12 hours of driving time.  Thank God for National Public Radio.   Obviously, the main focus of our attention was on Eliza and her condition and status.  Fortunately the Cancer Center and the Children's Hospital are only about a 10 minute walk apart.  So when I wasn't receiving treatments, we were with Eliza and her parents, trying to provide whatever support and assistance we could, yet not wanting to get in the way.  We were able to chase mom and dad away a few times to have some dinner, allow them a little break, and some much needed time together.

Normally, the first week of a new cycle is draining, and I feel a sort of heaviness, both physically and emotionally.  It would seem that the added stress and anxiety, associated with Eliza's surgery, would have made things even more taxing.  But in reality, it seems to have had just the opposite effect.  Spending 3 days in a cancer treatment center, being infused with a couple of quarts of toxic chemicals, does tend to make your thoughts focus on yourself and what is going on in your body.  I believe that is a perfectly normal reaction.  But this past week my focus, and prayers, were on someone else.  My time spent hooked to that IV pump was spent thinking about how someone else was doing, and not about my own situation.  So at the end of what is typically my hardest time, I feel better than ever before.  And I believe that is very strong evidence of the role that the mind plays in how we react to the effects of our cancer treatments.  We can't be totally oblivious to what is happening to our physical being, but we also can not allow it to be our sole focus.  Maintaining some reasonable level of mental balance is critical to our longer term well being.

Wednesday, November 14, 2012

Recap

I have picked up several new readers recently and felt that a recap of my battle with cancer might be in order.  One of the problems with a blog is that going back and reading all of the previous posts can be both cumbersome and time consuming.   So the following is a summary of my diagnosis and treatment progress:

I am a 68 year old retiree living in North Carolina, married for 44 years to a wonderful wife named Holly, and we have 2 children, Adam and Jill, and 6 grandchildren.  In 2000, I was diagnosed with Hodgkin's Lymphoma, received both chemotherapy and radiation, and then was cancer free for 12 years.

Based on a lymph node biopsy, on June 6, 2012 I was diagnosed with Non Hodgkin's Peripheral T-Cell Lymphoma NOS (not otherwise specified).  This particular form of cancer is very rare (340 cases reported worldwide in 2012), very aggressive, difficult to get into remission and very prone to recurrence.  A bone marrow biopsy revealed a 30% involvement and resulted in my cancer being given a Stage 4 designation, the highest (worst) level.  The prognosis was not good, a 5 year survival rate of 20 to 30%, based on the standard treatment protocol.  That was not what I considered to be a good start to my summer.

Based on the poor prognosis, I wanted to pursue and consider other options.  I wound up at Duke Cancer Center, in Durham, North Carolina, under the care of Dr. Ann Beaven, an Oncologist specializing in Lymphoma and Leukemia cancers.  I was accepted as a participant in a clinical trial.  For those with far more medical comprehension than I, the full tile of the clinical trial is A Phase II Study of Cyclophosphamide, Etoposide, Vincristine and Prednisone (CEOP) Alternating With Pralatrexate (P) as Front Line Therapy for Patients With Stage II, III and IV Peripheral T-Cell Non-Hodgkin's Lymphoma.

The trial is based on a 7 week cycle (49 days), with the CEOP drugs being given on days 1,2 and 3, and the Pralatrexate on days, 15, 22 and 29.  Neulasta shots are received on days 4 and 30 to assist in maintaining white blood cell count at an acceptable level.  At the completion of Cycles 2, 4 and 6, the patient is reassessed and progress determined.  In my case, after Cycle 2, I received a another bone marrow biopsy and PET scan.  The bone marrow biopsy showed that my marrow was free of any cancer cells.  The PET scan I received back in June indicated numerous pockets of cancer cells throughout my body (my family doctor indicated that it really 'lit up' the screen).  My subsequent scan showed no indication of cancer cells, other than one persistent lymph node in my abdomen.  In short, after 14 weeks of treatment, my body and my cancer was responding amazingly well.  2 additional Cycles were prescribed, to attempt to impact the one remaining node, with further testing and reassessment in late December.

It is obviously my hope and prayer that when I am reevaluated in December, the remaining lymph node is clear.  At that point I will begin preparations to undergo a autologus bone marrow transplant at the Duke Adult Bone Marrow Transplant Center, sometime in January 2013.  My doctor for this procedure will be Dr. Mitchell Horwitz, and the reason for pursuing this additional step goes back to fact that my particular lymphoma is very prone to recurrence.  The bone marrow transplant will add a level of insurance that there are no remaining cancer cells, lurking in the shadows, that will return at a later time.  You can read more about my transplant in earlier posts by clicking here and clicking here.

This recap covers the most of the clinical aspects of my cancer odyssey thus far.  I am a strong believer that my arsenal contains 4 distinct weapons for battling this unwanted and unwelcome invader, that has taken up temporary residence in my body.  My treatment regimen, my unique body chemistry, my attitude in confronting this monster, and my faith.  Numerous past posts have dealt with these topics, and no doubt more lie ahead.

Just as a little teaser, I recently read a quote attributed to Churchill "When you are going through hell, keep going".

Monday, November 12, 2012

Eliza update

Just got home from Duke and wanted to post a note that Eliza came through the surgery with flying stars.  The surgeon said that everything went very well and it was obvious, once he got in there, that the surgery was definitely needed.  She is in the ICU and the next hurdle is getting through the initial few days of recovery and healing.  If you are interested in following her post-op recovery, she has a blog (maintained by mom and dad) that will keep you informed.


Thank you all for your prayers, and we would appreciate it if you would leave her on your prayer list through the next several days.

Saturday, November 10, 2012

Big week ahead.

This coming week marks the beginning of Cycle 4, hopefully my last chemotherapy cycle.  Of course it takes seven weeks to complete each cycle, so I won't finish until the 2nd week of December.  That seems a long ways off, but history says it will go by quickly. Sometime near the end of December, I will go through another round of testing to reassess my status, and that is when the decision will be made whether I proceed on to bone marrow transplant, or start a new round of chemotherapy.  Hopefully Santa will bring me a totally clean cancer report, and give me a gift certificate for one successful bone marrow transplant - the things you wish for !?!?  And yes, the jolly old man is coming to visit all the good little girls and boys in only 44 more days.  Can you believe it?  Have you started your Christmas shopping yet??

This coming Monday is also the day of Eliza's surgery.  She too will be at Duke, just a couple of buildings away from the Cancer Center.  Monday she has her surgery and Tuesday, Wednesday and Thursday I have chemo treatments.  Eliza's parents, Adam and Annie, will be staying in a hotel nearby until she is released from the hospital, hopefully about Friday of next week.  At that point they will bring her here to our home in North Carolina, just 1 1/2 hours from Duke.  That is much closer that the 4 hour drive to their home in South Carolina, and will be much more convenient for followup visits after her release.  Fortunately we are all pretty good at "going with the flow", so much like my cancer, we will take things one day at a time.  The family motto for my cancer is "We're going to beat this", and that seems fitting for Eliza and her situation - we're going to beat this too.

I know that I don't even need to ask, but please keep the Davis family in your thoughts and prayers next week.  We all put our trust in the Lord, but we are human and have been known to worry a time or two.

Wednesday, November 7, 2012

Prayer for Eliza

On Monday of next week our 10 year old granddaughter Eliza will undergo major brain surgery at Duke Children's Hospital in Durham.  After several years of visiting doctors, and numerous tests, she has been diagnosed with a Chiari Malformation, which is a structural defect in the cerebellum, also involving portions of the skull.  Most children who undergo the surgery do quite well and have improvement of their symptoms.  While the doctors say they are confident this surgery will have a positive effect on her quality of life, the prospect of surgery on the brain and skull, particularly in a child, is scary.  And when it is your child, or grandchild, the worry and anxiety are heightened dramatically.



During my treatment for lymphoma, I have sensed the powerful presence of God Almighty throughout my journey, and felt the undeniable power of prayer.  There is no doubt in my mind that He will be with our sweet Eliza, and her family, during every step of her treatment and recovery.  I ask that everyone who reads this blog, and keeps me in their thoughts and prayers, add Eliza to your prayer list. We know that she will be in the care of a highly skilled and capable medical staff at Duke.  But knowing that we have a team of equally committed prayer warriors, lifting her up to The Great Physician, will mean so very much.  May God bless each and every one of you.

Friday, November 2, 2012

My shadow.




Recently, while taking one of my walks around the neighborhood, the sun was shining, and I noticed my shadow on the pavement.  It was right there with me, whether I walked slow or fast, straight or crooked.  I strolled on for a while and began to think of other things, forgetting about that shadow.  But a short time later I noticed it again.  It had not gone away just because I wasn't conscious of it - it was still there.  And then it occurred to me that my cancer is much like my shadow.  It is always there, even if I am not thinking about it.  It is always in my body, striving to exert it's terrible influence on my cells and my tissues.  It is always seeking to destroy my very being, and my life. 

I can only speculate on how many times each day I consciously think about my cancer.  It may be just a fleeting thought, or it may occupy my mind for a more extended period.  That feeling of fatigue may elicit a momentary thought about it's cause.  Or taking a pill in the morning can cause me to consider why that tablet is  necessary.  And at still other times, for no particular reason, my mind will begin to consider my current situation and my longer term prospects.  I can safely say that, since my diagnosis, my cancer has occupied far more than it's fair share of my attention.  It is for this reason that cancer patients desperately need to find other things to get involved in, that will keep their minds busy, and away from their disease and it's implications. 

But even when my mind is absorbed by other thoughts, just like my shadow, my cancer is still there.  I have said to Holly that I have this sense that there is always something lurking just over my shoulder, as if a dark cloud is hanging above my head.  It is very difficult to put into words, but the sensation is very real.  And regardless of the focus of my thoughts and emotions, my cancer is always with me.  It is currently as much a part of me as my right leg, my lungs or my liver.

As I considered the similarity between my cancer and my shadow, and their ever present nature, it dawned on me that God Almighty, my Redeemer and Healer, is also omnipresent and with me at all times.  Whether I think about Him or not, He is with me.  He was with me before I was formed in my mother's womb, and He has been with me for every second of my existence in this life.  Just like my shadow, He is always there.  So in the future, when I see my shadow, it will be my reminder of God's constant presence in my life.  And that is a far more comforting perspective.