Based on the blog post title your first thought was probably, “Oh no! He has breast cancer now too?!? How improbable and unlucky can one guy be?”
What’s funny is if my oncologist called me with scan results and told me that I had breast cancer, after all I’ve seen at this point I would probably just take it in stride and say “Okay, so do I need a mastectomy?”
More on breast cancer later, but first some scan results…
The quick summary is:
- There are more tumors in the lungs and the two tumors that remained from last time are bigger, meaning that the treatment I’ve been on since mid January and was planning to do for the summer doesn’t work for me. The most concerning tumor is a new one that is 3.3 CM (little bigger than a half dollar) and is pushing against an important airway and major arteries to the lungs. It has also caused partial paralysis to my left vocal chord.
- No new signs of cancer anywhere else — hip, neck, oral cavity all look good and all other organs also look clean.
- At the end of the post I provide a much more detailed breakdown of the size and location of the tumors with some imaging.
So these are not good results, and certainly not what we had hoped for. And while it is fair to classify them as pretty bad results, they aren’t checking me into a hospital and preparing me to die. I have been feeling some changes going in my body now for a month (the scan results actually came in two weeks ago, I just haven’t known how to share them broadly). But things have always been a roller coaster of ups and downs and so when I feel things going down I just raise both hands so I can feel the air rush through my fingers and wait for the the coaster to bottom out and then start to climb again.
At this stage of the fight the goal is to prolong things…to keep the cancer from spreading for as long as possible…when the cancer springs a leak during one treatment type you try something else and hope that locks things in place for as long as possible. And so we’ve spent the last two weeks exploring what to do next that will hopefully buy us a handful of months or even a year.
The next steps in treatment:
- 15 sessions of radiation treatment on a very targeted area of the upper left lung to shrink the new tumor that is pressing against arteries and an airway
- I did my first two treatments on Thursday and Friday. I’ve been twice this week and will go tomorrow and Friday. Then 4 more days next week and 5 days the week after that, ending on June 15th
- Side effects are most fatigue, little burning sensation in my chest, and potential harsh cough. I already have a pretty tough cough and hoarse voice. Just hoping it doesn’t impact my swallowing too much!
- After radiation ends I am hopefully entering the TAPUR clinical trial for a drug called Pablociclib. Pablociclib is already an FDA approved chemotherapy drug that is administered with pills rather than through an IV. It is a drug that was approved to treat certain types of late stage breast cancer that have a specific genetic mutation. That genetic mutation is the same one found in my tumors when we did some genomics testing last year. So the idea is maybe something about how Pablociclib interacts with this specific gene can stop my cancer from spreading. Sounds really interesting to me but the new oncologist I’ll be working with on this treatment trial wanted to level set with me when she said “I’m pretty sure this won’t work but you should still try it. You really have nothing to lose and until we show it doesn’t work there is always a slim chance you might see response.”
- The goal here is to do 2 months of Pablociclib treatment and then have a scan showing that the cancer has grown by no more than 20%. That is what is defined as success.
So where is my head at on all this?
I don’t know yet. I will let you know when I have some thoughts that I can pull together into sentences but I’m not there yet.
But here is some goodness from this past week that I will share.
Camilla gave a talk in our church service yesterday. It was very inspiring on many different levels, and there were two points she made that I will be thinking about for some time to come. First she quoted a leader from our church named Bishop Christopher Waddell who said the following in his talk Turn to the Lord
Whatever change in life’s circumstance come our way and whatever unexpected path we may have to travel, how we respond is a choice. Turning to the Savior and grasping his outstretched arm is always our best option.
And then she shared some scriptures from Alma 34 on the infinite and eternal nature of Christ’s atonement. At times when she feels depleted and wonders if maybe the source of strength has dried up, peace and love and comfort flow in abundance. God’s love never runs out. It has no limit. It doesn’t get tired or frustrated. It doesn’t give up. It is infinite and eternal.
Those two ideas plus her suggestions on more meaningful and humble prayer have really made a difference for me this week.
I guess to sum up how I feel will be to quote Paul Kalanithi again from When Breath Becomes Air.
I can’t go on.
I will go on.
I can’t go on. I will go.
[additional info on the imaging and tumor sizes below]
Specifics on the tumors and imaging:
- In the February scan we saw the 4-5 tumors in the lungs shrink significantly, three of which totally went away, and the last two that were left were less than 1 CM in size. That is no longer the case. Both tumors showed up significantly larger in May’s scan, but still small on a relative basis. One tumor is 2.8 CM and the other is 3.3 CM. For comparison, a half dollar coin is about 3 CM.
- There are 4 new smaller tumors that showed up, the largest of which is 2.3 CM (about the size of a quarter).
- There is a new tumor that showed up that is 3.3 CM and is nestled right up against one of the main pulmonary arteries. This one is the most problematic. Not because of its size — my doctors told me I would need to have 100+ tumors that were 2-3 CM or several tumors that 20 CM+ before my lungs totally shut off. The problem is its location