One Year Survivor

It's been exactly one year since I received my cancer diagnosis. I remember that day in Oakwood hospital like it was yesterday. My prognosis at diagnosis was a 50% chance of survival at one year. The past year has certainly been a roller coaster both physically and emotionally. Although I've endured some very difficult cancer therapies, the joy experienced with Deb and the twins has far outweighed them.

God is our anchor and we fully accept His plan for us.

Nate

The Next Step

After weighing a number of clinical trial (i.e. experimental drugs) and radiation options, I elected to participate in a phase I trial for the drug Pazopanib (produced by the GlaxoSmithKline pharmaceutical company). This drug isn't brand new, as this trial opened in July of 2007. I am one of the last patients to enroll in this trial of approximately 40 people.

This drug is designed to stop the growth of blood vessels. Cancer cells require new blood vessels to supply the energy required to grow. The intention of this treatment is to prevent the tumors from growing by taking away their food supply. In addition, the blood vessels produced by cancer cells are much weaker than normal blood vessels and can break down. I primarily selected this treatment because all 8 melanoma patients enrolled in this study responded positively to Pazopanib. In addition the side effects are considered to be quite low. The trial lasts about 10 weeks, but if I get a positive response I can stay on the drug as long as I like.

I had my first treatment on Tuesday (12/2), which required a full day at Karmanos. Everything went well aside from having to spend 12 hours in a hospital bed. The oncologists are careful to monitor how patients respond to phase I drugs, which required repeated blood tests. It has been a few days since getting my first treatment and thus far I have not had any negative side effects.

Overall I feel like my condition is improving slightly. My cough has decreased significantly. However, I am still very fatigued and cannot spend more than a few minutes walking and/or standing at a time. I spend about 75% of the day in my comfortable chair.


Thanks for the continued prayer support. Please keep our family in your thoughts and prayers as the next couple of months will be pivotal in my battle with cancer.

BTW... It has been great to run into old friends from high school on facebook. Thanks for the words of encouragement and support.

Nate

Facing the Beast

I've had 6 CT scans over the past year to track the growth of my cancer. Although I've received the summary reports for each of these scans, none of my doctors had shown me the actual images from the CT scanner. When we met with the radiation oncologists from U of M Hospital they took us through the latest CT scan of my largest tumor in my liver. It was overwhelming to see how large this mass had become. The image below is a cross section of my torso at the stomach (I've labeled things to make it easier to orient the image).


The cancerous mass in my liver is not currently blocking any of the ducts of the liver that effect liver function, but the size of the tumor is putting pressure on other organs like my pancreas and stomach. Hopefully the next round of treatment will reduce the size of this mass.

Thank you so much for your continued encouragement, thoughts, and prayers.

Nate

Rough Last 2 Weeks

I caught some kind of upper respiratory infection a few weeks ago. Since then I have had a persistent cough that has culminated in severe back pain. I had to go back on medical leave and the past few days I have spent mostly in bed. I have medication that relieves the pain. Deb and my parents have been with me this week, helping me during the day.

We are not certain what path of treatment is next for me. I have a clinical trial consultation on Nov 3rd at Karmanos. We have also investigated targeted radiation therapy at U of M and will be meeting their doctors on Nov 4th.

Today is Halloween... Landon's costume is a Transformer (robots in disguise) while Morgan is dressing up as a ballerina.

Nate

Scan Results after Biotherapy Treatment

Deb and I had our follow up visit with Dr. Flaherty this morning to discuss the results of my MRI (brain) and CT (abdomen) scans. The good news is that there is no evidence of metastatic tumors in my brain.

Unfortunately we didn't get the positive news we had hoped from the CT scan. The tumor in my liver remains ~ 9cm in diameter, which is slightly smaller than a grapefruit. The official analysis of the scan states the liver tumor is larger than my last scan (July 11), but the reported measurements are nearly identical. I suppose it really doesn't matter if it is slightly larger or not, since I still have to deal with it regardless. The pre-existing tumor in my lung remained the same size as before ~ 3.5cm in diameter, which is slightly smaller than a ping pong ball. However, an additional tumor in my lung was detected in this scan, also measuring 3.5cm in diameter.

The bottom line is IL-2 biotherapy was ineffective in treating my Stage 4 Metastatic Melanoma. We are now going to look at my experimental drug options (known as Phase 1 trials). Deb and I will be meeting with doctors from Karmanos who specialize in selecting specific drugs for cancer patients who haven't responded to existing therapies. This meeting will be in the next 2 weeks and treatment will start soon after. If I decide not to enroll in a Phase 1 trial or if I have to wait for a trial to open, there are chemotherapy drugs that are available, but these would only be for slowing the progression of the cancer.

As you may imagine, Deb and I returned home with heavy hearts this afternoon. We had felt that my recent improvements in health would be reflective of my internal battle with cancer.

HOPE STILL REMAINS
- I have a very small risk of near-term organ failure
- I have a number of options in my next "at-bat" against cancer.

Please keep us in your prayers as we have difficult decisions to make in the next few weeks.

Nate

Pushing Scans and Results Back a Week

Ever since I returned home from my second stay in the hospital for IL-2 treatments Deb and I have had in our minds that my follow up scans were on Friday October 3rd. When I was getting all of my paperwork together on the evening of October 2nd, I noticed that my scans were actually scheduled for 7am that morning! Deb and I couldn't believe that we missed this. I guess we just got on with our life during this period of time and didn't think too much about these tests.

My MRI and CT scans have been re-scheduled to next week. We will be reviewing the results of the scans on October 14th with Dr. Flaherty. Basically everything has been moved back 1 week.

I am feeling the healthiest I have been since my diagnosis last December. Nearly all of the residual pain in my left lung has vanished. My strength and stamina grows every day. Last weekend our family spent time at a cottage on Lake Michigan. I bounced on a trampoline with the twins, took them on a kayak ride in the great lake, and we all climbed up / ran down a sand dune together. I thank God for giving me the strength to make such joyful memories.


Thanks to all for keeping us in your thoughts and prayers. Please pray specifically that the scan results will be unbelievably positive.

Nate

Update on Nate

I have been back at work for 3 weeks now. I have had a few days that I have worked a short afternoon, but I'm close to having enough energy to get me through the work week. My overall condition seems to be improving week by week, but I have struggled with aches and pains in my back. The back pain doesn't feel like the lung fluid I had previously.

Our weeks are still busy with BSF, small group, and band practice.

We are taking each day as it comes without taking any future ones for granted. We still have about 3 weeks before we find out the effects of the IL-2 treatment.

Back To Work

Nate is doing much better and is returning to work tomorrow! This is perfect timing since tomorrow is also the first day back to school for the kids and me. He is still feeling some fatigue but that's it. We have felt almost normal this past week and have enjoyed our time home with the kids.

Fatigue

Nate's been having a hard time with fatigue. He was hoping to return to work today but is going to have to put it off at least for another week. He goes to bed between 9-10 each night which is extremely early for him and wakes up between 4-6 a.m. He naps once or twice a day and spends all of his waking time on the couch taking it easy. His appetite is great and he is trying hard to put some of the weight back on that he lost during treatment. He has decided to abandon the vegan diet he was on during chemo in order to do this. He is also experiencing itchy rashes and a numbness in his upper left leg along with uncomfortable swelling in his liver area. It is uncertain if these are caused by the treatment.

I want to mention that in July we did find out that his liver tumor had nearly doubled in size in the six weeks post chemo. We also found out that his lung tumors had shrunk considerably and are now hardly detectable. More good news was that the cancer had not spread anywhere else.

His next scheduled appointment is Oct.7. IL-2 requires a long time to determine if it is having an effect. He was told to call and make an appointment if he had any concerns so I imagine we will do that if he does not improve this week. Please pray for him to have a great turnaround this week and to be energized and ready for work come Monday as this would really help raise his spirits.

A Slow Week of Recovery

It has been a week since I returned from the hospital. My recovery from the second week of IL-2 has been much slower than the first week. At the end of my first recovery week I had enough energy to play 18 holes of golf (riding in a cart). I am no where near to having the strength to do that now. I can do about 1 hour of light activity (i.e. cooking) before I run out of energy.

I am hoping that I can recover my energy by the end of the week so I can return to work. Meanwhile, I am spending lots of time on the couch watching the Olympics.