The Diagnosis and the Current Plan

Posted in From Al & Libbie at 10:47 am by Al

Well, it’s hardly been a quiet week in Lake Wobegon (for those unfamiliar with this “place,” it’s a takeoff of Garrison Keillor‘s introduction to his radio monologue on his weekly radio show “A Prairie Home Companion.”)

I have been trying to get this written for a couple of days, and to succeed tonight, it will need to be short.

First of all, let me explain some of what we’ve learned about melanoma, since others may be as unclear about it as we were. The tumors in my lungs are not “primary” lung cancer (i.e. cancer that originates right there in the lungs, from smoking or whatever). Some people do survive primary lung cancer. My tumors are a result of melanoma which spread there from elsewhere in the body. Melanoma is a skin cancer. If a melanoma is removed when it is still just in the skin, it is usually no longer a threat. If you know people who have “survived” melanoma, that is probably what it means-that they had the spot removed and were then fine. When mine was removed, testing indicated that all of it had been removed. If melanoma goes beyond the skin and gets into any of the major internal organs of your body, there is no cure for it (at least not yet).

My doctor at Penn called on Thursday noon (two days after the diagnosis) and I hustled down to Penn (no running this time as I took the train!) to begin my treatment that day. The protocol goes like this:

I am in an experimental program that involves traditional chemo therapy (starting this upcoming Thursday) and targeted molecular therapy (which I began last Thursday). The chemo therapy kills cancer cells, and the molecular therapy targets the intra-cell communication that has become confused and causes the cells to grow out of control. In terms of battle: killing the soldiers already on the front line and then cutting off communication to prevent the sending of reinforcements.

There are side-effects. That’s always the case! The molecular therapy may produce severe rashes, raise blood pressure and cause diarrhea. The chemo therapy has the usual potential for nausea, and both cause fatigue. I will be taking an anti-nausea drug that’s supposed to be pretty effective, so we are hoping to minimize the nausea. Both drugs are oral, which is nice, because that means I can do it at home. However, oral does not minimize the severity of side-effects. So, we’d covet your prayer for tolerance to the drugs and that the tumors would respond by dropping dead and not reforming!

The molecular therapy is experimental and has great hope for the future, though perhaps too late for me. It targets a particular problematic protein (B-RAFF) in the chain of proteins communicating between the growth receptor on the cell surface and the cell nucleus. Basically, the drug is trying to put the brakes on a protein gone wild, whose foot is stuck on the accelerator.

This is all interesting and exciting. I’ve heard from two independent sources that this is a great research program under a great doctor. The doctors (who have indeed been wonderful) are not talking cure, but perhaps life extension. Again, we are brought back to the place where we see that God is (and always has been) our one hope. If he heals by miracle or by providential means (medicine), it is he who does it. And he may choose not to heal. It does not change his faithfulness or unfailing love.

So many of you have been so good to us. I cannot say how moved we have been by the constant support and care. God has used you all to carry us. Thank you!

Blessings, Al, Libbie and family

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