On the mend

fiona_liamIn December last year my scanxiety was once again relieved as I was handed the report showing no evidence of disease. Three in a row—thank God the chemo was doing its job. Since then we’ve enjoyed some chemo-free time, spending close to five weeks on the coast. It was wonderful to spend time camping with family. Fiona, Grace, Marcus and I were joined at various times by Matt and Elizabeth, and Luke, Sharon, and Liam. How nice it was to enjoy hammock time with Liam, walks on the beach with Fiona, swims in the ocean, scrabble with family and friends, and the occasional fish.

pigeonhouse1Things felt better on a number of fronts. On my birthday in August, I declared that I wanted to lose a lot of weight before Christmas. I weighed in at 96.6kg on my birthday and 82kg at Christmas (currently 83.5 and still in the healthy weight range, despite Christmas eating habits!). Special thanks go to Michelle Bridges and her 12 week body transformation. One day early in the holidays, our family and close friends climbed Pigeon House Mountain. I don’t think my lungs have ever been so seriously tested. I thought I was going to keel over on the way up. But I made it to the top!pigeonhouse2Coming down was way easier, except for the impact on my ankles and knees, and the fact that I could barely walk for days afterwards. Who would have thought? Shuffling round the block two years ago—and now mountain climbing! Thank God.

My feet have continued to give me some grief with the neuropathy and the impact on muscles, tendons and ligaments around the ankles and calves. For this reason Fiona and I have been contemplating getting into some kayaking. Even if my feet aren’t working properly, we could enjoy paddling around rivers and lakes.

My new church responsibilities are seeing me travel to the Weston Creek region of Canberra most days. I’ve contemplated getting on a bicycle and enjoying the paths around the lake each morning and evening. So far I’ve only contemplated it because I will have to find a bike with some suspension if I’m going to enjoy it. My old thing is a bit hard on the body parts!

Last week Fiona and I enjoyed our first mid-week day off ever (I think). Well, 2/3 day off anyway. We went for a drive in the country, taking in Poachers Pantry, and stopping for a pizza in Gundaroo. It was excellent to spend this time on our own together, and we both agreed it would be even better if we were doing it on a motorcycle!

Please join with me in rejoicing at my health improvements. God has been very kind. I’d better go off to the gym now to do my circuit class with a bunch of others who are recovering from cancer.

(first published in macarisms.com on 19/2/14)

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Anxiety increases

I’ve now officially lost count of how many courses of chemo I’ve had. Somewhere over 30 is the answer. I just keep on putting more and more poison into my body! People have asked me whether it gets easier. That’s difficult to answer. I struggle more with anxiety now. As the day approaches, the blood tests, the smell of the ward, the needles, the confinement, the knowledge of what’s to come. It all seems to increase my anxiety.

The last couple of treatments I’ve displayed more physical anxiety symptoms. My temperature goes up and I start sweating. The nurses bring me an iced water, I raise my feet, and I try to relax. It’s easier if I can pass the time quickly, but I can’t stay focused on anything. I need to shut my eyes. It would be easiest if I fell asleep. I ask the nurses to speed up my dose, to get out of there more quickly.

I pray about my anxiety, but God doesn’t necessarily take it away. Still, it’s good to talk to him about it and I know I can trust him whatever I may be feeling.

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NED or AAC?

IMG_1667This week I had my first visit to the oncologist in a few months. I used to describe this man as my pessimist specialist, but in recent times he’s been brighter, given me encouragement, and offered the occasional smile. Yet he remains my helpful reality check.

I’m not sure what I expected him to say during this last visit. Perhaps, I wanted to hear that ‘my cancer journey is now over; I can get on with life again; no more treatment; chemo is a thing of the past’. If so, then I must have been in a dream. He can’t tell me this, for the simple reason that he can’t know this to be true. I lack that special CMS—Cancer Monitoring System—that would tell me exactly what is going on inside me, what needs to be done, and how long it will take!

The last scan declared me to be NED—No Evidence of Disease. This means that the imaging is unable to detect any tumour. My oncologist will not be drawn into overstating what this means. Put simply, he reminded me on Wednesday, that this doesn’t mean I have no active cancer in my body. He spoke of me again as a chronic patient, who will continue to require long term treatment, and potentially multiple strategies of treatment.

So what now? I stay on the chemo regime that I’ve been on now for eighteen months. I will have 3 weekly infusions of Alimta and Avastin, until such time as I cannot sensibly tolerate the toxicity or that it proves no longer effective in dealing with any cancer. Throughout this time, I will need to monitor the effect of the drugs on my heart, blood pressure, liver, kidneys and other vital organs. I will continue to have roughly quarterly scans to track any developments with cancer.

In my case, while it is true from an imaging perspective that I am NED, it seems wiser to take the attitude that I am AAC—Assumed Active Cancer (not Adam Ashley Cooper, though I’d love to be able to represent Australia in rugby!).

This is an important reminder to me not to put my faith in medicine. I need to continue to trust God and seek to make each day that he gives me, count for eternity.

(first published in macarisms.com on 16/8/13)

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Don’t take your next birthday for granted

weddingA good friend once said that wedding anniversaries were more significant than birthdays. He made a good point that I’ve since repeated to others. Birthdays just come around year after year. You don’t need to do anything. Whereas wedding anniversaries take work. You need to keep investing in the marriage or you might not get to your next anniversary.

Yesterday was my birthday and I received many wonderful greetings—mainly via Facebook, the new greeting card! Many of the comments were very similar and they made me stop and think about whether he was entirely right. Let me share a few:

Happy birthday Macca! Praise God for another year. Hope you have a great day!

have a great day… thanking the Lord you’re still here with us and for your ongoing ministry…

Happy Birthday Dave! It is wonderful to celebrate another year!!!

Happy, happy birthday! Thanking God for the gift of the last 365 days and all that has happened since your last trip around the sun. Lotsa love

Happy birthday Dave! Thanks to God for another one!

Happy birthday cus! Glad you’re here to see another one.

Happy Birthday! May God bless you! And give you many more!

What thankfulness that you can celebrate another birthday! Have a great one!

Happy birthday Dave! Thanks to God for another one!

Happy birthday Macca! Glad God gave you another one.

I don’t expect everyone receives birthday greetings like these. I’d describe them as joyful and thankful, with significant undertones of sobriety. They are a reminder that birthdays don’t just come around. There were no guarantees last year that I’d celebrate another this year. Mind you—there aren’t ever any guarantees, for me or for you. I see the last year as a gift from God. It’s his grace that has preserved me for another year.

And I’m praying that his grace will sustain me for many more birthdays—and wedding anniversaries—for years to come.

Thanks for all your greetings!

(first published in macarisms.com on 13/8/13)

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When it’s good to get bad news

I used to think that bad news was always bad news. How could it be anything else? But I see things differently now. Sometimes we need to hear bad news to have any chance of hearing good news. My cancer is a case in point.

The bad news: you have cancer.
More bad news: you have a non-small cell lung cancer.
Still more bad news: there is a tumour on the left lung and it has spread.
Even more bad news: you have an ALK+ mutation that is driving the cancer.

No one wants the news they have cancer. It’s always bad news. But the bad news pointed the way to hope. Subsequent bad news provided a specific pathway to hope. It has been indispensable to treating the cancer accurately. My diagnosis and my subsequent prognosis were seriously bad news that I needed to hear.

I know people who have not wanted to know what’s wrong with them. They’ve had cancer, but have not been willing to have it accurately diagnosed. Some have endured the wrong treatment. Others have avoided dealing with it until it’s been too late, and nothing could be done to help them. Some have died from cancer, when an early diagnosis would have saved them.

It’s the same when it comes to God. We don’t want to hear the bad news. We don’t like to hear that we’ve pushed God aside, that we prefer to live independently, that God will hold us to account, and we’re facing God’s judgment. This is bad news, it’s uncomfortable, it’s distasteful, and we’d prefer not to hear it.

I’ve discovered that it’s good to hear this bad news. We need an accurate diagnosis of our rejection of God. We need an accurate prognosis of the consequences of our rejection. The bad news prepares the way for hope. Unless we understand our desperate state before God, then we will not understand what God has done to turn things around. The bad news of our independence and judgment prepares us to hear the good news—the gospel—of hope through Jesus Christ. There’s hope for a renewed relationship with God in this life and beyond. God has the cure. It’s freely available.

Don’t ignore the bad news. It can help you to hear and grasp the good news that God wants you to enjoy.

Bad news
Since we’ve compiled this long and sorry record as sinners (both us and them) and proved that we are utterly incapable of living the glorious lives God wills for us,
Good news
God did it for us. Out of sheer generosity he put us in right standing with himself. A pure gift. He got us out of the mess we’re in and restored us to where he always wanted us to be. And he did it by means of Jesus Christ.
(Romans 3:23-24 from The Message, my headings)

(first published in macarisms.com on 11/8/13)

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God have mercy

Today I sat by the bed of a friend in hospital. He too has lung cancer. On the outside he looked weathered and aged. He was frail and broken. And yet he radiated an inner contentment. He wasn’t looking for distractions. The television was off. There were no games or books or magazines or electronic toys. He preferred to reflect and to pray. Life had a potency for my friend. He meditated on life and death. He’d spent many hours contemplating these words by Jesus:

Whoever believes in the Son has eternal life.  (John 3:36)

Now this is eternal life: that they know you, the only true God, and Jesus Christ, whom you have sent.  (John 17:3)

My friend knows eternal life—now. He knows God, because he knows the one whom God has sent, Jesus Christ. He spoke joyfully to me about Jesus. His eyes were filled with tears of wonder and thankfulness as we spoke.

Looking at my friend reminded me of the unrelenting surge of disease, decay, and death. But listening to my friend pointed me to the one who has overcome it all. He knows that the hope he holds is real. Death holds no fear for my friend. He’s facing life’s harshest moments with a contentment that can only come from God.

And there’s nothing presumptive about my friend. He understands that God doesn’t owe him anything. He has no rights before God. He’s not claiming any religious or moral superiority. My friend simply knows that God is a merciful God.

We prayed together. We asked God for many things. And I was humbled to hear my friend say these words:

God, have mercy on me, a sinner.

Years ago Jesus told a story about two people with very different outlooks on God and themselves. I was reminded of this story today, as my friend and I prayed together.

To some who were confident of their own righteousness and looked down on everyone else, Jesus told this parable: ‘Two men went up to the temple to pray, one a Pharisee and the other a tax collector. The Pharisee stood by himself and prayed: “God, I thank you that I am not like other people – robbers, evildoers, adulterers – or even like this tax collector. I fast twice a week and give a tenth of all I get.”

‘But the tax collector stood at a distance. He would not even look up to heaven, but beat his breast and said, “God, have mercy on me, a sinner.”

‘I tell you that this man, rather than the other, went home justified before God. For all those who exalt themselves will be humbled, and those who humble themselves will be exalted.’  (Luke 18:9-14)

(first published in macarisms.com on 17/6/13)

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NED

Dave & Fiona‘No evidence of neoplasm.’

This was the final sentence of the radiologist’s report on my CT scan from Tuesday. I went straight to wikipedia. Neoplasm wasn’t a word I’d been using. And my guess was right. There was no evidence of a tumour. Seriously? I don’t think I ever expected to read that. No evidence of cancer? I was stunned.

It’s exactly eighteen months this weekend since I was admitted to hospital, had my first CT scan, and discovered the tumour on my lung. It was about 24mm at the time. I’ve had two surgeries, twenty six courses of chemotherapy, and a number of CTs in this period. We’ve seen the tumour increase slightly to 26mm, then reduced to 18mm, to 12mm, and to 7mm in February this year. It went from a golf ball, to a pinball, to a marble, to a pea. A friend was praying it would shrink to a mustard seed next! Seems like it has. Whatever may or may not be there is too small to be seen by a CT scan. :)

We’ve discussed this with a couple of oncologists now. They were both amazed by how things have gone. My regular oncologist, who is very careful and conservative, kept saying this doesn’t normally happen with my type of cancer. I told him I was quite happy to be abnormal! Both oncologists have stated the importance of continuing with the chemo for now. The tumour is not evident on the CT scan, and this is a great outcome, but it doesn’t guarantee that I am cancer free. Cancer cells are microscopic. They could be anywhere and everywhere without having developed an observable tumour. The fact that my cancer was discovered at Stage 4 once it had already spread, and that cancer cells were discovered in other places, is a reminder not to make assumptions.

This scan result is the best result I could have received. To be described as N.E.D. – No Evidence of Disease – is a wonderful result. But it carries with it a huge amount of uncertainty. It’s like the results of a satellite image of a national park revealing no evidence of an escaped criminal. Higher resolution would be needed to gain more certainty. But even then he could be hiding behind a rock or under a tree and not observable. They cannot be sure with me. Even surgery, biopsies, and other types of scans have their limitations. They can identify cancer, but they can’t rule out it’s existence.

Our plan is for me to continue with chemo for a while and ask more questions. We’ll seek advice about other options for assessing how I’m going. We’ll seek to monitor the toxic and damaging impact of chemo. It’s clearly been the recipe for attacking my adenocarcenoma, but it’s leaving its mark on my body as well. I’m experiencing some neuropathic symptoms again, energy levels are low, fitness is harder to maintain, and I’m on medication to counteract significant side effects.

In short, the journey with cancer continues. In some ways I expect it will be harder. Until now I’ve had certainty. I’ve been sure of having cancer because I’ve seen the evidence. Now the evidence isn’t there. I assume there is still cancer present, and will act accordingly, but I can’t be sure.

My scan results are great news and I’m filled with gratitude to God for bringing me to this point. I thank you for your love, support and prayers. God has been listening and answering our prayers. He’s been kindly giving me time and opportunity to serve him. I’ve been praying since early last year that I would get to see Matt married and that I would get to be a grandfather. [I didn’t tell them this!] There’s now four weeks until Matt and Elizabeth get married and Luke and Sharon are halfway through their pregnancy. God willing, Fiona and I will also celebrate thirty years of marriage this year. Awesome. Thank you God for the days that you give me!

God has done a lot of work in me over this past eighteen months. In particular, he’s been strengthening my hope. Not hope in a cure necessarily, but a hope beyond cure. Hope that gives me reason to live, however many days I might have. Hope in life now and in eternity. Hope that is real even if cancer should one day overrun my body. Hope that sustains me through the ups and the downs. Hope grounded in God keeping his promises in Jesus Christ. My desire is for each one of you to know this hope. God is good.

Thank you again for your friendship, support, help, and generosity. As we continue this journey please rejoice with us and please keep on praying that God will remove all traces of cancer from my body. Please pray for wisdom for the medical specialists and for us as we decide what paths to take.

(first published in macarisms.com on 31/5/13)

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