SIX WEEK FOLLOW-UP

This week various scans have been done on my body and the blood test tumor marker repeated to assess my response to treatment. The timing has been six weeks since the radiation treatment was given and 12 weeks since the chemotherapy began, not to mention it’s 16 weeks since many of you joined in prayer for healing of my cancer! The radiation oncologist, Dr Koong, is in charge of my PET scans which are the most sensitive imaging indicator of therapeutic response, therefore he considers this a “six weeks follow up”. Both the medical oncologist, Dr Colocci, who manages the chemo and the CT scans and Dr Koong agree that it’s impossible to attribute any observed improvement to one treatment or the other, and on my part, I don’t discount improvements in answer to your many prayers. While it’s traditional to do CT scans for follow up, I am told that they give little information about favorable response – often showing no change for months despite obvious improvements by other indicators. So the primary indicators for follow up are the tumor marker in the blood, CA 19-9, and the PET scan.

What we learned from the visit with Dr Koong yesterday is that the response to treatment are very favorable – he says as good as could be expected. This goes along with my feeling better, both in terms of being pain free and also increasing restoration of energy. So I am still taking naps on most but not all days, and my productive hours per day are expanding. And I’ve once again begun to bounce out of bed at 5am feeling ready for a full day. Even after shoeing Jackson yesterday, I didn’t feel exhausted. All these are indications of good improvements in my well being over a few weeks ago.

For those of you who want the specifics of the critical tests, my tumor marker (CA 19-9) has fallen from a peak of 5400 in late May to 4600 July 11 and 2000 on August 2. The medical opinion is that this is as good a response as one could reasonably expect, and the plan is to continue chemo at least as long as my bone marrow can tolerate it, and so long as the CA 19-9 and PET scans show continued improvement. In general terms the PET scan, which shows the presence of an injected marker wherever there is cancer, shows no new hot spots indicative of spreading cancer and the primary tumor has about half the uptake that was seen just before radiation. Dr Koong interprets this also as an optimal response. Praise the Lord! Another set of follow up tests is scheduled for 6 weeks from now.

Otherwise, life if full and includes many blessings besides my medical improvements. Last weekend we attended the Albania Health Fund Board meeting at the beach-front home of our Board member in Pacific Grove. Bonnie and McKenna explored the Monterey Bay area while we met to discuss the work that God has called us to in Albania. This is a challenging kind of ministry and we are fortunate to have a diverse group of gifted directors, mostly doctors but also an attorney and one businessman. Bill and Bobbie Johnson, who pioneered these efforts when the Albanian borders opened in 1991, continue to guide the work with their Godly wisdom and their passion for the medical and spiritual health of the people of Albania. Besides extensive efforts in medical development in the medical school in Tirana, we also are involved in the introduction of Christianity and principles of morality and ethics in medical practice. Predictably, the most responsive groups are the students and residents. And our biggest reward is to see these young doctors adopting and advocating for integrity of lifestyle and genuine improvements in medical care. In the medical library, which we have developed near the medical school campus, we have also made Christian literature available and the students have organized weekly Bible studies on their own initiative. Although no religious practice was allowed for several decades before 1991, we have recently been advised that among the 1800 medical students (six year curriculum) that about a third have come to know Jesus and claim Christianity as there religion. Besides our work with the medical students, Campus Crusade for Christ and a number of other student Christian ministries are very active in Albania.

Some of you have expressed surprise that last weekend I was also elected president of the Albania Health Fund (AHF) Board. Actually I agreed long ago to be ‘president elect’ - long before I knew that pancreatic cancer would be part of my life. So prior to our recent meeting I consulted with my doctors and some of the Board members and came to the conclusion that it was still OK to proceed with the work plan of AHF. Of course the improvements noted above go a long ways towards affirming that decision. According to the bylaws, AHF has annual elections, but by tradition the same person has been elected president for several years running. The Board has been discussing whether that should be 3 or 4 years – and so far as I’m concerned a 3 or 4 year cancer remission would be a welcomed gift from God and I’d love to spend that time carrying on the work of those who have gone before.

One big event in my annual calendar that I cancelled some months ago was my horse pack trip to the Immigrant Basin in the Sierras. Many of you know that I have been the outfitter and cook for a group of women horse fanciers for the last several years. In light of my treatments and associated fatigue, I bowed out of that one a couple of months ago. Sorry not to be there – hope you gals survive on your own cooking! Tent camping was on my mind this week as I was reading a part of Dave and Jan Dravecky’s book, “Do No Lose Heart”. He was speaking of the Bible passage in II Corinthians, chapter 5 which refers to our bodies as being like a tent – such as in mountain camping. Our bodies are likened to an imperfect and temporary dwelling. (Glad to hear from my doctors that my body may last longer than at first they expected!) To give you the gist of the passage, I quote from the Message by Peterson…

“So we’re not giving up. How could we! Even though on the outside it often looks like things are falling apart on us, on the inside, where God is making new life, not a day goes by without his unfolding grace. These hard times are small potatoes compared to the coming good times, the lavish celebration prepared for us. There’s far more here than meets the eye. The things we see now are here today, gone tomorrow. But the things we can’t see now will last forever.

For instance, we know that when these bodies of ours are taken down like tents and folded away, they will be replaced by resurrection bodies in heaven – God-made, not hand made – and we’ll never have to relocate our ‘tents’ again. Sometimes we can hardly wait to move – so that we cry out in frustration. Compared to what’s coming, living conditions around here seem like a stopover in an unfurnished shack, and we’re tired of it! We’ve been given a glimpse of the real thing, our true home, our resurrection bodies! The Spirit of God whets our appetite by giving us a taste of what’s ahead. He puts a little of heaven in our hearts so that we’ll never settle for less.”

So while I do miss being in the mountains, and I am thinking of my friends in the unfurnished shacks and tents, which are so familiar, don’t forget the best is yet to come! And hopefully I’ll be able to join you on the horse pack trip next August – tent dwelling and all.

Meanwhile another big event is scheduled this Saturday to honor the retirement of my friend and ob/gyn chair, Ted Fainstat, my colleague of more than 30 years, first at Kansas University and then at Stanford and Santa Clara Valley Medical Center. About 170 of Ted’s closest friends will gather at the San Jose Fairmont to honor his many years of faithful work as a mentor, teacher and chair of this vital department. And these same attendees are among my good friends, so this will be a highlight for me as well. If you add them up, my life in recent weeks has been filled with reunions, family gatherings, graduations and all kinds of opportunities to enjoy family and friends. How thankful I am despite my cancer to be able to fully partake in these many special events! Again, thank you for continued prayer and the encouraging cards and calls – each day is a gift from the Lord to which you contribute.