8/31/06 Gentlemen, Start Your Engines

Family and Friends,

At last, treatment has begun!

I started chemo today and was pleasantly surprised by the lack of immediate side effects. It must be the steroids talking. They give the steroids to reduce or eliminate the nausea, which works for 2-3 days, and also helps with energy.

The next hurdle comes when white blood cell, red blood cell, and platelet counts all progressively decrease, reaching their low point in 7-10 days. My ability to fight infection and my energy levels will be impacted by this. The doctors and nurses recommend continuing with normal activities, don’t overdue it, and listen to my body. I will also need to be very sure to avoid sick people, even with sniffles, during the more vulnerable blood count times.

Today after chemo we met for the first time with the surgeon, Dr. John Handy, who does both the more traditional surgery and the minimally invasive surgery to remove the tumor. There is still not enough clinical data for a complete statistical comparison, but it looks like the tradeoff for having potentially a shorter/better recovery period using the minimally invasive procedure is the increased risk of chronic pain (less than 1% for the other procedure vs. “a little higher” for the minimally invasive procedure). There is also about a 10% chance that they will need to abandon this approach mid-surgery and separate my ribs to enter under my arm, which has a slower recovery rate and more chronic pain (13.5%) than entering from the front. We don’t know yet which procedure we want, but we do know we both feel very comfortable choosing Dr. Handy as the surgeon. He has an outstanding reputation, and we liked him a great deal.

Here’s the evolving timeline, as we know it today: Another day of chemo on September 21st. About 2 weeks later I have a follow-up CT scan to see if chemo shrunk the tumor, then see Dr. Handy to make sure he is comfortable that I am ready for surgery. Surgery would be mid-October to early November. However, we’re finding that just about any timeline we get is a moving target.

A friend and cousin by marriage, Dwayne Elan, has been going through treatment for lung cancer for the past 2 years. His cancer has metastasized, and he is fighting the good fight with a great attitude and a loving support system. Please send a prayer, positive energy, or even thoughts of shrinking his cancer like a prune if you can. He likes the prune image a lot.

Dwayne shared his observations about cancer with me. One of his comments was, “when one person in the family gets cancer, the whole family gets cancer.” In other words, everyone is affected. I thank each of you for how you have offered to be a part of the healing process for me in your own way, knowing that allowing yourselves to be touched by my experience exposes raw nerves for you as well. I am particularly grateful to Gen for this, as she has been side by side, and sometimes leading me, toward healing choices. I am also most concerned about the impact that this could have on her over the long haul. She shares in all of the struggles, yet most of the support comes to me. Of course, she denies any of this, and I will be lucky to get this email out without the paragraph being deleted.

I don’t expect to have any news to share from now until about the second week in October, when we get results of the repeat scan and a more firm plan for a surgery date. Until then, your love, energy, prayers, and support for both Gen and me, as well as thoughts of prunes, are very much appreciated.