December 30, 2008

Yesterday afternoon we made the trek to the Oncologist, Dr. Dane Dickson, for my first visit. It was a little scary to step into a new aspect of life; a cancer treatment center. Right after we were seated in the waiting room a younger woman came from the treatment area. She looked miserable and gray. I looked at Denise and said this doesn’t look very good. Shortly after that a 34 year old guy came out with a couple of family members. They were working with the receptionist trying to get an appointment in Idaho Falls to have a portacath (a surgically placed IV access point) put in so he could begin his chemotherapy next Monday. He was scheduled to begin radiation tomorrow for a cancer in his digestive system. I have so many things to look forward to and I realized that things could always be worse.

After getting into the exam room with Dr. Dickson he didn’t waste any time giving us the bad news. He told us that adenocarcinoma's are a general classification of cancer, meaning that it comes from organs that have tubes. He said it could have come from any of the many organs in the body. The activity in the chest CT and lack of activity in any other organ makes the pathologist’s best guess that it came from the lungs. He quizzed us as about where we had lived, how long we had lived in various homes, how old they were and their location; and exposure to smoke, chemicals, coal dust; smoking habits. He came around to the conclusion that the best guess for how it started was chronic exposure to a variety of possibilities, occupational exposure being the only realistic area of origin.

He told us initially that there is not a real good prognosis for curing lung cancer. Surgical removal is not really effective when cancer has moved out of the lung into the lymph nodes. The removal of the lung in this case can actually make it more difficult to fight the cancer and has not proven to be an effective treatment. It is a course of action only if the cancer is contained in a portion of the lung. He told us that due to the depth in the lung tissue that radiation is also not effective and would be more harmful than beneficial. The only realistic avenue available with any hope at all would be chemotherapy. About this time Denise and I are both thinking he’s going to tell us to go home and get ready to die.

He then said: “OK, you’ve got the worst now let me take off my doctor hat and talk to you as Brother Dickson”. He told us that yes, lung cancer of any variety is deadly; it’s difficult to treat and recurs in many cases. He continued “so we still need a miracle here”. “As a doctor I can give you everything in medicines capability to control and stop this process, but much of the results depend on the Lord’s plan for you”. He went on to tell us that he has witnessed some successes in lung cancer remission. In fact, he would dare to compare their lung cancer survival rates with anyone in the country. He also told us that my health would make a big difference. The treatment plan models have much better outcomes with patients who still have healthy body systems that can help with the fight and recover from the chemo treatments.

We had a good discussion with him. We asked about going to Huntsman’s Cancer Clinic in Utah. He encouraged us to do whatever we felt we needed to and showed us documentation that we were getting the most popular treatment for this case. f He told us that Huntsman’s is a research institution. Their focus is on clinical trials. If they have a trial currently running in the area of your cancer they may take you into it. One of the drawbacks is that you don’t know if you’re receiving the new experimental therapy, and if it works, or if you’re in the control group receiving the standard therapy. Also, is the standard therapy the most current recommended treatment or are they comparing to an older model so their outcomes will look better? He told us the he could easily set us up to go visit them. Usually, if you don’t fit into a trial or want the risks they will go through a work up and send you back to Rexburg for treatment. He brought in his computer and explained that there have not been a lot of ground breaking advances in cancer treatment recently. Research in the recent past took two different tracks, one toward the inclusion of a third drug into a reasonably effective double drug treatment and the other toward a double drug program using a different combination of two drugs currently in use. His research and experience had shown that the triple system has shown better results as a first line treatment with the double system being a good backup or second regimen if the preferred treatment was ineffective. This treatment plan is determined by a group of scientist who are appointed to look at all the existing therapies and determine what treatment plans are best for given populations. They come out with a treatment algorithm that everyone in the industry follows where they look at your type of cancer, its metastatic involvement, your health status and then branches into the 3-4 therapies that are working.

We felt good about his explanations, his demeanor and concern for me as an individual, his integration of the spiritual component in the healing process or potential failure. We want the very best and are confident from the recommendations received and our visit that we will receive just that.

The next step is to get ready for chemo. I need to get a portacath although his nurse thought we could do the first treatment with a regular IV. There is protocol that has to be followed if one is on blood thinners before they can do a surgical procedure, however small. We will get to work on that today. I am scheduled for my first chemo next Monday, January 5. We will be there at 8:30 that morning and have been told to plan on being there all day. Each drug has to be infused separately taking 45 minutes to 2 hours each. So the usual treatment will be a half day but they want to do some more education that day also.

The treatment will be in a monthly cycle. Each Monday for 3 weeks I will go for another treatment. The 4th week will be a recovery week. Then the next cycle will begin again. They will do 3-4 cycles then repeat the chest CT to see how the lung has responded. From that point we will decide whether to do another cycle, to move on to the second line chemo drugs, or move onto a maintenance plan. Dr. Dickson thought we would likely have to do at least 2 to 3 cycles.

So that is where we’re at. I have appreciated the amazing support of all of those around us. It has been phenomenal; I am truly humbled to think that so many people care so deeply. I am not comfortable with that much attention. Nor do I feel like I have given the appropriate level of concern for others who have faced this battle. I think that it is one of those things that a person has to experience to truly have compassion and understanding for. There are so many who have faced and continue to face chronic disease processes that cause difficulties for years. The trouble with my legs and feet that led to this discovery has given me a small picture of what those people face. I will have much more empathy in the future. My prayers will take on a more concerted effort to seek the Lord’s attention to our difficulties. We believe in Miracles! We have already witnessed many miracles and small joys through this trial and expect many more. Thank you all for your faith, fasting, and prayers in our behalf. We have felt the power in them and priesthood blessings.