Frequently asked questions!

“How am I doing?”

The last couple of weeks I have been feeling well. I have not needed any pain medication and other than sleeping longer nights and taking regular afternoon naps, my routine is pretty normal. Yesterday I exercised Jackson, my horse, for over an hour and then came home and ran the chain saw in the yard for a couple of hours. We have enjoyed having my niece, Mariam and her daughter Jill, visiting from Texas and we had a walk in the hills for an hour this morning following my regular morning body exercise and weight lifting. I have been especially trying to keep up the shoulder exercise since it helps me tolerate the positioning needed for CT and PET scans which are scheduled for next week, and then every three months to follow any changes in tumor images.

So this improvement in my quality of life is a welcomed answer to the prayers of many – hardly a day goes by without my hearing of yet another person or group who are holding me up in prayer. And I continue to have opportunities to encourage and comfort other cancer victims as well. In our Saturday morning Menlo Mens’ Bible Class, John Jenks has mentioned the last couple of weeks about how God comforts us when we have troubles, and this prepares us to share this comfort with others who have similar woes (II Cor 1:3-5). I noticed by the notes in the margin of my Bible that Walt Gerber preached on this passage in 1991 and 1996. His bottom line was, “God does not give us comfort to make us comfortable, but to make us a good comforter.”

“What’s in store for me now?”

Many people are asking what is the treatment plan for me, now that the radiation treatment is completed. Yes, I had the complete radiation treatment in one setting – less than an hour from start to finish.

Yesterday I had the 7th weekly treatment with Gemzar, which is intravenous chemotherapy. It’s given over a half hour period and has no immediate effects on how I feel. However, it does cause me to sleep more than usual especially on the day of treatment. And besides attacking cancer cells, it causes bone marrow depression. So each week I get a blood test to see if I still have enough platelets and leukocytes to continue. Both of these are running borderline low, so I may get a week off in the near future.

The other determinant on how long Gemzar will be given is in terms of favorable response of the cancer. This is measured by a marker in the blood, CA 19-9, and imaging with CT and PET scans every 3 months. So far, the CA 19-9 is dropping, which is good, and the imaging has not shown any new cancer, also good.

My medical oncologist and I continue to have open ears among experts we can access and to search the literature for any new and available chemo with better success on pancreatic cancer than Gemzar. A number of medical colleagues have contributed to this surveillance as well – thanks to you all. So far the published alternatives or additions to Gemzar all carry added toxicity and minimal benefit. In the event that Gemzar fails in the future, one of these alternatives will be considered, but in the meanwhile it makes no sense to change course.

What is my prognosis now that radiation is complete and chemo seems to be working?

From a medical point of view I am coming up to six months since the onset of symptoms (pain) from the pancreatic cancer – about half of people with pancreatic cancer die within that first six months! Beyond that grim statistic, about half of the patients with inoperable pancreatic cancer treated with Trilogy have experienced recurrences or spread of cancer within six months. And despite treatments, overall, only 4% of patients with pancreatic cancer survive beyond 5 years.

Despite these ominous statistics there are some other opinions! The word on the street (neighborhood doctors of Allardice Way) is that I look healthy, eat healthy, have my glass of red wine daily, and exercise – so I should make it for “five to ten years”.

My personal view is that I’m really blessed to be feeling so much better and my primary concern is living well as long as possible. Some weeks ago I quoted Al Weir in When Your Doctor Has Bad News, regarding medical news that shatters your dreams,. “At that point we will have a choice: will we overcome and live life fully, or will we whimper through the rest of our existence until death: I believe that God did not create us to give up life before He rings the bell. God created us to be overcomers.” Amen Al, thanks for the good word.

A scripture that comes to mind is James 4:13-17, Boasting About Tomorrow.
13Now listen, you who say, "Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money." 14Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes. 15Instead, you ought to say, "If it is the Lord's will, we will live and do this or that." 16As it is, you boast and brag. All such boasting is evil. 17Anyone, then, who knows the good he ought to do and doesn't do it, sins.

How true it is that we would like to be in complete control of our life and destiny, while our real responsibility it to know the good we ought to do – and do it.