The waiting game.

Last Thursday we met with Dr. Kelsey in Radiation Oncology at Duke.  The purpose was to discuss the options for radiation treatment of that remaining persistent node in my abdomen.  The good news was that Lymphoma is highly responsive to radiation and he sees no obstacles to being able to treat Mr. Persistent.  The bad news was that it could involve up to 4 or 5 weeks of treatment, 5 days per week.  I had been thinking more in the range of 2 or 3 weeks so that was a bit of a shocker.  But the final period has yet to be finalized.

Then on Friday we headed back to Duke for a CT-Guided Needle Biopsy of Mr. Persistent.  The procedure went far more smoothly than I had anticipated.  There are times when you want and need to be well read and well informed on various aspects of your treatment.  This, however, was one of those instances where I felt that knowing less was probably more advisable.  Sometimes ignorance is bliss.  But I was still not looking forward to Friday morning.  Much to my surprise and delight everything went well and they wound up taking 9 samples for further study.

The pathology report on the biopsy will probably not be available until next Tuesday.  At that point Drs. Beaven, Horwitz and Kelsy (the wizards as I call them) will collectively review the results and develop a plan of treatment, most likely involving some level of radiation and then proceeding on to stem cell (bone marrow) transplant.  Whatever the result of their review, it will undoubtedly take place over the next 4 or 5 months and have a profound impact on our daily lives during that period.  We are prepared for whatever lies ahead and know that, with God's help, and the support of family and friends, we will get through this just fine.  Our family motto "We're going to beat this" is still in place and this is just another phase towards that end.

Still, the next several days, until we know more details from the wizards, will be long and filled with much anticipation.

The graduate moves on

We met with Dr. Beaven at Duke yesterday to review the results of the reassessment testing I completed last week.  After 28 weeks of chemotherapy, as a participant in a clinical trial for T-cell Lymphoma, I have completed my course of treatment.  I have graduated from the program and am ready to move on.  There was no formal graduation ceremony, and I will not receive a diploma to hang on the wall, but my body has been cleansed of that horrible disease, and my prognosis is significantly better than it was just 6 months ago.  God is so good.

Having successfully completed my initial course of study, I am now ready to move on to graduate school.  Dr. Beaven and Dr. Horwitz reviewed my test results and agree that I am ready to begin preparing for my bone marrow transplant.  But before we can start that process, a couple of other interim steps are required.  I still have that one persistent lymph node in my abdomen that has not been responsive to my chemo treatments.  While the doctors do not feel that the presence of this node represents a problem, they would like to see if they can get some additional information about it.  So on Friday of next week I am scheduled for a CT-guided biopsy of that lymph node.  Hopefully, that will provide a definitive diagnosis, which will allow the doctors to better understand the nature of the cells in that node.  The expectation is that the cells are also Lymphoma.  Most likely, the biopsy will be followed by 2 or 3 weeks of radiation treatments, to start to knock down that stubborn area.

Following the biopsy/radiation period, I will then begin the transplant process.  Back on August 24, 2012, I wrote a more lengthy post containing information about the why's and wherefore's of bone marrow transplants.  You may wish to go back in the Blog Archives, on the right of the screen, to read that post.  Certainly I will be posting more about it in the coming weeks, but we have a few things to complete before that transplant comes into focus.

Overall, we are thrilled with the progress that has taken place since my diagnosis on June 6, 2012.  The rare and aggressive cancer that was discovered almost by accident (a.k.a. God's divine intervention) has been essentially wiped out.  I can think of many pursuits, other than a bone marrow transplant, that I would prefer to undertake in the months ahead.  But for someone who wasn't sure he would even be alive to see the year 2013, having graduated from  Clinical Trial University, and now pursuing an advanced degree in Total Disease Eradication is pretty darn exciting.  And my goal is to graduate summa cum laude (with highest honor).

Persistent.

Yesterday was reassessment testing day at Duke.  Blood work and a bone marrow biopsy, followed by a PET scan, filled out our otherwise boring day.  In case you are interested, the bone marrow biopsy is not really all that bad, but if you have a choice between that and getting a tooth filled, I would recommend you should always go with the filling.  I had a biopsy three months ago that showed the marrow was clean.  I thought they might not do another one this time but they needed to confirm that it was still clean.  The results of that biopsy won't be available until early next week.

The main thing we wanted to find out about was the status of the one persistent lymph node in my abdomen.  The PET scan 3 months ago showed that everything else had been resolved (medical jargon for it is gone).  But that one persistent node was essentially unchanged from it's original shape and size back in June.  Yesterday's PET scan confirmed that everything else is still resolved, but there has again been no change in that one persistent node.  It still looks about the same as it did six months ago when we started.

That wasn't the information that we were hoping to hear, but it is still positive.  The chemo treatments have been very successful at eliminating the original cancer, except for that one node, and keeping everything in check.  And while the persistent node is not going away, it isn't getting any worse either.  All of that is good news.  We go in to see Dr. Beaven next Wednesday to review the test results, and hopefully we will find out more about what other options are available.  We will see what she and Dr. Horwitz, from the Bone Marrow Transplant team, think is the best course of action from here.

Until then, we will stay positive and place our trust in the Great Physician.  He has brought us this far and is not going to abandon us now.

Best wishes to all for a happy and prosperous New Year.

A very special Christmas

I already have my Christmas present from Santa this year.  My last chemo treatment was over a week ago and I have no more scheduled.  I have reassessment testing on Dec 27, but that is a walk in the park compared with anything I ever received in the Treatment Center.  So jolly old Saint Nicholas made an early delivery this year at the Davis house.

We have already started our holiday visits and are currently at our daughter's home in western North Carolina.  The house is all decorated for the season, and the three little ones, 5, 2 and 8 months, certainly add lots of excitement and energy to our lives.  Over the coming weekend we will head an hour down the road to South Carolina to be with our son and his family for Christmas.  With 12, 10 and 4 year old grand kids, the excitement and energy are sure to continue.

For someone who, back in June, wasn't even sure he would be alive to see Christmas this year, this is going to be a very special Christmas season.  I was recently asked if having cancer makes you appreciate things more.  The answer is unequivocally YES!  The tragic school shootings in Connecticut were yet another reminder that none of us is guaranteed one more day on this earth.  So please, for even just one moment, stop and think about those around you and how very special they are to you, each and every one.

The lyrics from an Alicia Keys song,"Like You'll Never See Me Again", express it so well:

If I had no more time

No more time left to be here

Would you cherish what we had?

Was it everything that you were looking for?

If I couldn't feel your touch

And no longer were you with me 

I'd be wishing you were here 

To be everything that I'd be looking for 

I don't wanna forget the present is a gift 

And I don't wanna take for granted the time you may have here with me 

'Cause Lord only knows another day is not really guaranteed 

So every time you hold me 

Hold me like this is the last time 

Every time you kiss me 

Kiss me like you'll never see me again 

Every time you touch me 

Touch me like this is the last time 

Promise that you'll love me 

Love me like you'll never see me again 

Joy and sorrow.

I started to write a new post, confirming that last Tuesday was indeed my last chemptherapy treatment at Duke.    My mood up until now has been one of joy and relief, knowing that I would not be having any more toxic drugs pumped into my system.

But as I was starting to write, the news about the school shooting in Connecticut began to unfold.  Words are so inadequate to attempt to describe that situation.  My mind cannot begin to comprehend the shock and the grief that has been experienced by those involved.  The days and weeks that lie ahead will entail emotional trauma beyond that which most of us will ever know.  I can't imagine what it must be like to be the parents of one of the slain children.

My emotional battles and struggles, as I endeavor to understand and cope with my cancer, are very real and very complicated.  But they do not compare to those of the families and friends of those who have lost loved ones in this senseless tragedy.  May our thoughts and prayers lift up all of those in need, and may our Heavenly Father be with them all.

Only one more.

One more treatment remains.  Next Tuesday will be my last regularly scheduled chemo treatment and I can't even begin to tell you how much I am looking forward to having that behind me.  Back when I completed Cycle 2, I went through reassessment testing and found out that most of the cancer had disappeared, except for one persistent lymph node in my abdomen.  I have now completed 2 additional cycles, and will return to Duke on December 27 for another round of reassessment testing.  We will then meet with Dr. Beaven on January 2, to review the test results and determine what the next phase of treatment will be.  I am believing that the remaining persistent node will be completely gone, or at least reduced far enough to be considered almost gone.  Either of those findings will most likely permit me to proceed with the bone marrow transplant process, probably sometime in January.  However, should that one persistent node appear to not be responding, I will probably have to start some additional chemotherapy treatments, until it gets taken care of.

Having the doctor tell us that I am finished with the chemotherapy phase of my treatment will be the best Christmas present I could possibly receive.  It has been 6 months since we started taking our 25 day trips to the Duke Cancer Center, where I have been stuck, poked, tested and poisoned by some of the best in the business.  And while the result of all that abuse, upon my already aging body, has been quite positive, I am ready for it to be over.  Enough is enough already!  Last week Dr. Beaven said l was the most upbeat and positive patient that she has.  But I am tired of being tired.

I have been amazingly fortunate to have been able to avoid most of the side effects of my chemotherapy.  The two main areas where I have been impacted are hair loss (not a real issue to me) and fatigue.  For the last 6 months I have just felt worn out, all the time.  I have read and heard about how chemo can have a cumulative effect, and I believe that I am finally experiencing some evidence of that reality.  In the last 3 or 4 weeks my energy and stamina levels have fallen even further.  Hauling 4 trash bins of yard debris to the curb for pickup leaves me drained.  I am still upbeat and positive, but I am tired of being tired.  My hope is that after next week, I can begin to start recovering and my body can actually have a chance to start the rebuilding process.  Yes, the bone marrow transplant will undoubtedly knock me back down to some degree, but having 6 or 8 weeks to recuperate will be a welcome respite.

Trust and faith.

I read something at church yesterday, and was struck by how very true it is.  "Allow us to be still, in the midst of what our minds cannot fully grasp, and what our lips cannot fully explain."  And that, in turn, reminded me of the scripture:

Be still, and know that I am God.  Psalm 46:10

Only God's knowledge is perfect.  Only He knows what our future holds.  My mind is capable of understanding and comprehending much about my cancer, and it's implications on my life, and the lives of those around me.  But I reach a point where my capacity to grasp and discern are simply inadequate.  I reach a point where I can no longer understand or comprehend.  That is when I have to begin to trust in Him.

Trusting is not easy; in fact it is quite difficult.  One definition of trust is "to give to for safekeeping".  To truly trust in someone else, with something that is very important to you, requires tremendous faith in that someone.  

Now faith is the substance of things hoped for, the evidence of things not seen.  Hebrews 11:1

I have faith that my Heavenly Father loves me, and has His perfect plan for my life.  I have faith that the God who created the heavens and the earth, is the same God that knew me before I was formed in my mother's womb.  And I have faith that He will deliver me from this disease that was discovered in my body 6 months ago.  I don't know exactly how that deliverance will manifest itself, but my faith in Him allows me to trust that He is in control, and will see me through this ordeal.

Can my mind fully grasp this conviction, and can my lips fully explain it?  No!  Do I struggle with it on a daily basis?  Yes!  But fortunately my Lord of Lords, and King of Kings, reigns over heaven and earth for eternity, and He alone is worthy of my total trust and faith.  And a long as I know that in my heart of hearts, I can sleep well at night.