The Struggle Has Ended

Greg Hewlett passed away on January 17th after nearly eight years of battling colon cancer. While we grieve his loss, we are comforted to know that he is with his Lord.

If you would like to leave your thoughts on Greg, please see this thread.

If you would like to make a charitable donation in Greg's honor, please see this thread.

Wednesday, December 20, 2006

Date and surgeon

I will be having my surgery at MD Anderson hospital in Houston.

The surgery is currently scheduled for Jan 5. This date could change due to my health - I have to not be sick from cold, etc.

The technical name for what I am getting done is thoracotomy and mutliple wedge resections.

My surgeon is Dr. Wayne Hofstetter.

(He seems about my age. Who's to say we young folks can't pull the heavy weight in this world!)

Thursday, November 30, 2006

Surprise - A lung surgery candidate

Looking at my blog, I see that I never wrote about my treatment plan. So what have I been up to? Well, I did another three rounds of chemo, only at a 21-day pace rather than 14-day pace. The 14-day was just too harsh on my body. They kept the dose the same on 5fu and irinotecan, but increased the avastin 50% to cover the 21 days.

This week, I had a CT scan as well as a new test they just started doing - a PET/CT, which is what it sounds like - a combination PET and CT. And then I met with a lung surgeon. I have had the hope for lung surgery all year. I keep being told by my clinical oncologist "maybe next time" on consulting the surgeon. But I have been getting the feeling that the possibility for surgery was slipping away and I may never even get to a position where I could even see the surgeon, much less have the surgeon agree that surgery was a good option.

Cancer treatment in a nutshell (or "why would I want surgery?")
So what fool would actually want lung surgery? Well, this one. Here is my personal simplistic way of looking at cancer treatment. There are three treatments: chemo, radiation, and surgery. Chemo is least traumatic, but typically only slows the cancer down or pushes back the line, and it eventually loses its effectiveness. Radiation can kill tumors, but not always. Also, it messes up the surrounding tissue, and you can only have a certain amount of radiation in your body. Surgery is painful and ugly, but it gets rid of the cancer, at least what was cut out. Simple as that. Many people are surprised to hear that when I woke up from my amputation for bone cancer as a teenager, my feeling was not one of panic or anger, but of relief. Losing a leg was certainly terrible, but the truth was - the cancer was finally gone. It is hard to describe to someone who has not heard the words "it's cancerous" from your doctor, just how much you want to get that stuff out at all costs. This is why the word dreaded by cancer patients is "unresectible".

So I have known all along that I needed the lung surgery. I had also prepared myself to hear the word "unresectible" today.

What I heard
I instead heard a sugeon who told me that I am a good candidate to begin having my lung tumors resected (med-lingo for "cut out"). One key reason he would say that is that it has been over three years since the primary tumor in my large intestine was removed (this is why they wouldn't consider lung surgery years earlier ). Only the primary can spawn new tumors (called metastases, or "mets"). The fact that are still "only" five mets means there is reasonable hope these are all of them or at least the majority of them. And that there may not be hundreds lurking (although that is still a possibility). Another important fact is that I am still clean of any signs of cancer elsewhere in the body. Surgeons are reluctant to put you through lung surgery if there is another tumor somewhere threatening your life. A couple other factors - my CEA is still normal (2.0) and my largest lung met after yet another three months was quite stable. So he thought now was the right time to go in and start cutting them out. He is going to start with those in my left lung (there are two, maybe three). The reason is that the left lung has the largest (1.5 cm). The other lung also has two or three nodules, but they are small enough they would be hard to locate in surgery. The funny thing is that effectively we will end up waiting for those to grow and when/if they do, then we'll get those. Reminds me of this story of Jesus.

My response
I had been preparing for some less positive messages. I had been thinking through whether I would beg and plead for the surgery if he said it was not worth it, or whether I would just trust him that "it is best". And I also thought he might still say "wait, and more chemo". What I did not expect was a cautious optimism, even confidence, on the doctor's part, along with numbers (as high as 30%) that actually show a possibility of getting rid of the disease altogether. I began immediately thinking of you all. And of my Lord who seems to be hearing our cries and answering in a way I could not have imagined. I hear many staff workers at MD Anderson joke me after seeing my history, "you've really come a long way" or "not too many people with as much experience as you". I felt some disappointment that I had not hoped more for good news. I think I have been let down so much, that I am less prone to hope. I still believe this promise in Paul's letter to the Romans, but I have also learned His "good" does not necessarily equal my personal desires. Lately I've been experiencing that it usually does not. I have often been riding on the faith in the Lord of my brothers and sisters around me. Thanks.

The surgery
Is this a difficult surgery? Yes. He says it may be more traumatic than the other major surgeries I have had. (I've had four and they were all pretty bad!) But the bottom line for me is that the doctors believe that this actually gives me the only chance for cure and at least should extend my life enough to make it "definitely" worth pursuing. They will take out enough tissue that my lung capacity will be reduced to about 95% for the rest of my life. What does that mean? That would mean that when I am at the pool, I will only be able to go about 95% of a lap underwater. Seriously though, this is not good, but it is a price I willing to pay.

They were able to schedule the surgery as early as the 14th, but I requested more time off as I am very fatigued, I'm still feeling sick from the chemo and a cold I got over thanksgiving, and I'm just plain worn out right now. So I'm taking a break and we are looking at the first week of January for me to have lung surgery on my left lung.

Thursday, September 14, 2006

Quick note about result of scans and scope

Since many have been calling and I know several of you want to know how it went today, here's a brief report.

The scope was normal as expected. The CT scans of the lungs showed things are "stable". The largest tumor, which is about 1-1.5cm, is the same length, but "may be slightly narrower." The full report wasn't even ready, so I won't have the details until next week. It was enough, though, for Dr. Eng to decide that I should keep doing the same chemo I have been doing, maybe get a little more shrinkage - at least squeeze this chemo for what it is worth as long as it holds things at bay. Only she wants me to do a lower dose or lower frequency because the side effects are beating me up. Then we'll reevaluate after some more rounds. I'm going to call and try to discuss in more detail with Dr. Shapiro in Dallas tomorrow to find out what this means and how we'll proceed. The meeting today was rather short.

Thursday, September 7, 2006

I'm Back

I finished round ten. It has been quite grueling, but I pressed through all ten even though along the way there were times when the doctor (and Christine) thought I needed a break. Maybe they were right. But I had scheduled out all the weeks and planned accordingly. There was my work schedule. And there were the three different families (Julie's Susan's, and Anne's) who visited and it would have messed things up badly had I got out of sync in the weeks by skipping a week. What a silly reason, you might think. Putting my body at risk, just to keep a schedule? My only response is that a person suffering seeks to hold on to something - anything - to control. Something to accomplish. You cannot just let go of all goals when you have cancer. I have let go of so much. I still mourn over all the goals and hopes I have left behind these past few years. It feels like just about everything got tossed overboard to keep this ship afloat, in fact. But I still hold to a few goals. This was one of those I held to ... and kept.

I want to thank the many of you who have written, emailed, and called to check in on me. It is apparent that I am blessed with a strong group of people who are collectively lifting me though this. So many of the calls and notes I have left unanswered. I hope I have not lost these friends by my silence. One of the notes reminded me of this story:

A few days later, when Jesus again entered Capernaum, the people heard that he had come home. So many gathered that there was no room left, not even outside the door, and he preached the word to them. Some men came, bringing to him a paralytic, carried by four of them. Since they could not get him to Jesus because of the crowd, they made an opening in the roof above Jesus and, after digging through it, lowered the mat the paralyzed man was lying on. When Jesus saw their faith, he said to the paralytic, "Son, your sins are forgiven."

Now some teachers of the law were sitting there, thinking to themselves, "Why does this fellow talk like that? He's blaspheming! Who can forgive sins but God alone?"

Immediately Jesus knew in his spirit that this was what they were thinking in their hearts, and he said to them, "Why are you thinking these things? Which is easier: to say to the paralytic, 'Your sins are forgiven,' or to say, 'Get up, take your mat and walk'? But that you may know that the Son of Man has authority on earth to forgive sins . . . ." He said to the paralytic, "I tell you, get up, take your mat and go home." He got up, took his mat and walked out in full view of them all. This amazed everyone and they praised God, saying, "We have never seen anything like this!"

I think I have such friends.

So how am I and what's next?

I have been pushing along day by day. Most of the little energy I have had, I have used going to work - to keep the bills paid and because it is another one of those purpose things, and one I happen to enjoy. The problem is that when I get home, I pretty much collapse on the sofa like I ran home from the office instead of driving. Sound unbalanced? It is. Even though they say that all you need to know you learn in kindergarten, the truth is that nobody taught me how to fight cancer.

This weekend, we head back to Houston. This time I get the full round of tests: colonoscopy, full CT, you know, the works. That's going to be a big one-two punch for this weak body. But I don't think much about the difficulty of a few days. I am more focused on Thursday, when I meet with Dr. Eng to find out the results and chart out what is next. It is odd meeting with someone to find out about your very life. I have had dozens of such appointments. I am still not used to it.

For this one, I have no idea what to expect. I am not thinking too much about the what-if's this time because there are many different possibilities, and many treatment plans that could be recommended for each. I'm praying for good results and wisdom in the direction to go. We'll worry about the details of making the plan once we hear the results and Dr Eng's recommendation. "Each day has enough trouble of its own."

Several brave souls have joined the no-hair club since I last wrote. I need to tell about them, but I'll save that for another post.

Thursday, June 15, 2006

Round five

Tuesday, I began round five of the irinotecan. We added Avastin to the mix, hoping for some additional effectiveness. I'm having to rest a lot, but seem to be doing a bit better than the previous rounds. They unhook me today. The next two days are typically the roughest, but I think I have a good start here.

I have some new members of the no-hair club. Pictures coming soon.

Rice is once again in the College World Series. They are seeded #2. Would be fun to go if I were healthy. Maybe next year.

Saturday, June 10, 2006

CT results - stable

The lung nodules are "stable". No reduction, no growth. I have taken, I estimate, around 75 rounds of chemotherapy in my life between this cancer and the bone cancer I had as a teenager. These rounds consisted of around 8 different chemo protocols. With all this experience, this was the first time that a scan revealed that the chemo treatment had not significantly reduced the size of the tumors. Disappointing. Could be a lot worse, I suppose.

Dr. Eng says stability is a good thing in their business. The chemo is holding back the tumors. The largest nodule doubled from 0.5 to 1.1 cm in two months from January to March. In the three months since then, it has not grown at all. So she wants me to continue the protocol I've been on. Six more rounds is the plan, starting this week. She also added, "and let's throw in some Avastin to the mix." This struck me a bit odd - like Emeril throwing in some garlic based on his spur-of-the-moment logic that garlic always is a good idea.

Avastin is a drug that I took last year. It is technically not chemo - it does something to the tumor blood vessels. Adding it now, she said, cannot really hurt anything and it might help some. I sure hope so. If we continue to see stability or some reduction, then she will send me for a lung surgery consult. It is a long shot, because the nodules are in different places. But that would be the best option of getting rid of the tumors. I am used to praying for long shots.

I called my oncologist in Dallas and spoke to his PA about the news. She told me that a stable CT scan report is "excellent" when it comes to colon cancer lung nodules. "Excellent"? I feel like I just won a free room upgrade on the Titanic.

Saturday, May 27, 2006

Chemo break

Dr. Shapiro postponed my chemo a week. My white blood cell count was too low. Also, he was concerned about the intestinal pain, which is likely due to irritation caused by the chemo. He said to me, "I'm going to try to talk you into taking a week off." He thought I would resist. It is true, I didn't want to give the cancer the week off, but the doctor didn't think it would make a big difference and he wanted me more healthy to hit me with the next dose. Sounded reasonable to me. The past few days the pain has indeed subsided, and the mid-week blood count showed the white blood cells climbing quickly. So we'll start the fourth round Tuesday. I'll then go to Houston the following week for CT scans and meeting with Dr. Eng at MD Anderson.

In other news, we have three new members, bringing to 15 those who are feeling the breeze...

currytop.jpg john airtop.jpg andrew vesttop.jpg scott

Check the members page to see who they are.

Monday, May 22, 2006

Membership hits a dozen

Greg's No-Hair Club for Men is gaining momentum. The satisfied membership is growing. And the entries are beginning to get creative...
DavidClemmons_aTm.jpg A true Aggie.
DavidPagan_before.jpg So David, is your boss going to join?

Click to see all the members.

I was asked yesterday, "How does it feel that all these people around the world are uglier because of you?"
"It feels great!" I replied.
Of course, the secret that we club members understand is that there is only beauty in hating cancer and feeling the breeze.

All of this a a fun blessing to me, distracting me from the growing pain I've been having lately in my lower intestines. They say it is due to the chemo irritating where the radiation was. The pain lollipops they are giving me (same as back during the radiation) makes it tolerable, which is a good thing because I want to keep this chemo coming so it can do its job in my lungs. Round four is Monday morning. Ugh. Daily I must look to the Lord for strength to go another day. Thanks for your prayers and support. I believe this is how I find that strength to keep going.

Saturday, May 20, 2006

Three new members

Three new satisfied members are feeling the breeze: Charles & Michael Burck and David Ray.

From my sister Julie in San Fransisco...

Dear Greg,

This morning, we went over to Chinatown to see Ann at our favorite place, Charmante Beauty Salon. It is described by SF Weekly as the �best cheap haircut for Men in the city!� It is located across the street from the famous Washington Square, (a park, playground, and big cathedral) and he posed for you on a tree in the park. He did climb up himself�he wanted you to know!

I�d like to say that Charles was really excited to be a part of your club. I am confident that the lollipop and playground across the street had nothing to do with his excitement about getting his haircut!

While he was getting his haircut I was reminding him how we were going to get it cut and then Uncle Greg would put his picture on the computer for all to see�and he says, �Like in the Bible. We�re going to cut off all my hair and I�ll lose all my strength!�

Mike was on a business trip and got back this afternoon. He hadn�t heard about your club and wanted to join too, and Charles was very excited about Daddy joining with him.

Love ya, JuJu

Pics of Charles, Mike, and David and all the other satisfied members is here.

Friday, May 19, 2006

New member!

Greg's No-Hair Club for Men announces their first new member since going public. Can you guess who it is?

MarkPeck_top.jpgDear Mr. President,
It would be a great honor to be considered for membership in your club. I have attached before-and-after pictures as proof that I have in fact taken the necessary steps to qualify. Should you have any questions, please do not hesitate to contact me at xxx-xxx-xxxx.
Sincerely, ???

Click image to find out.

I'm having a no hair day

I've been noticing my hair falling out. The irinotecan has a knack for doing that. I decided I'm not going to keep brushing hairs off my desk, picking them out of my food, fretting about whether the thinning is noticeable, etc. I'm not going to give the chemo that pleasure. So I cut it all off. Chemo is my servant, not the other way around.

Check out how you can become a member of Greg's No Hair Club For Men.

Sunday, May 14, 2006

Resurrection Oranges

One of my quiet joys in this cacophonous world is receiving Image Journal in the mail. It's one of those things that is infrequent enough -- quarterly -- that I forget about it until I discover the surprise at the mailbox. Then I sit down and am ushered inward and upward as artists, writers, and poets contemplate life and faith.

In the issue I just received I enjoyed the following poem by Irish poet Eamon Grennan. I thought it was fitting to share given my post on resurrection tomatoes.

Resurrection Oranges
Eamon Grennan

Shouldering the late snow aside, the snowdrops and tight
green fists of skunk cabbage thrust up and up. Likewise
nameless threads of pale green, each with a tiny leaf-cap,
have started to shine all over the dark-drenched mulch

of dead leaves. Transparencies of air! In which the world
starts happening, taking shape from almost nothing (nothing,
and just look at us!
), and how light, that is a cataract of quiet
astonishment through the dining-room window, Cezannes

a bowl of fruit before our eyes: green pears and pale red
yellow-speckled apples, oranges lit like lamps in their own
sanctuary, all take a sudden swerve (nature mort as they are)

into resurrection, it seems that easy, so even the word
home, a fugitive bluebird, closes its wings and settles like
a native come to roost, to ripen, quiet, in one sunlit corner.

Wednesday, May 3, 2006

Better second round

The horrible first round must have been an anomaly. I think I had a stomach virus underneath everything that pushed me over the edge requiring me to be hooked up at the clinic every day. It had to be something like that because I am doing much better this second round. Dr. Shapiro reduced the 5-fu some this round, so maybe we'll be able to go back to the full dose next week. This week, I have been able not only to stay out of the hospital, but go to work the last few days. This is a relief, as I have been sick it seems for a very long time and I have not been able to work or do much of anything for four weeks.

Speaking of work, some of you have asked if I have been able to work through all of this. These past three years of treatments, I have been working about 3/4 time. I work at Texas Instruments designing DLP technology (go #96!). Much of my work during treatments has been from home (or wherever I am). I am very fortunate to have the kind of job where I can do this. In fact, I actually do some of my more productive work alone from home. I think this goes back to my education - I spent two-and-a-half years in high school doing what they called "home bound school" due to the bone cancer that I had at that time. This struggle has been very rough in a lot of ways, but I am very thankful to have a job that I enjoy. I know not many people get paid to do what they enjoy. So I count this blessing.

Tuesday, April 25, 2006

Some Easter pics

In spite of how I was feeling, Christine and I had a very enjoyable Easter this year. Her parents Carl and Sue drove down for a week from Delaware to help out and to visit. Her sister, Sarah flew down for the weekend with little Mati and Mia.

Here are some pics.

EasterDinner2006.jpg Easter dinner. Mati, Sue, Sarah, Greg, Mia, Christine. Carl is taking the pic.
GregChristineEaster2006.jpg Greg and Christine after Easter service.
GregMatiKazooBand.jpg The Greg and Mati Kazoo Easter Band

On resurrection and tomatoes

cherry_tomatoes.jpeg I have been thinking a lot lately about the resurrection of Jesus. Thus, Easter had special significance this year. I gave a short address at church Easter morning about this. You may listen to it by clicking : On Resurrection and Tomatoes (streaming audio, 4 1/2 minutes).

- Al's been thinking, too, about the resurrection.
- Here's something I wrote on Easter earlier in my treatment (2004).

Thanks, Bill and Rollin, for editing and setting up the audio link.

Saturday, April 22, 2006

First round complete

I am just now recovering from the first round of chemo. This was as rough as any round I have had. That's why I haven't written in a while.

The week of the chemo I was very sick. The following "rest" week, my intestines would not hold anything - I lost every bit of fluid and food I could get down. As a result, I spent every day this week at the outpatient clinic hooked up to IV fluids and potassium. The doctor was concerned at the slow recovery. I was bummed because in the long term, I don't want them to stop, delay, or reduce the chemo. And in the short term, I wanted to get back to work and catch up with things at home after a week of being sick.

Things are finally better today. So I get about two days of break and then the next round begins Monday. I'm ready to go. And I am simply hoping that this past round was a fluke and not a sign of incraesed problems to come.

Tuesday, April 11, 2006

A custom protocol for a feisty patient

After seeing Dr. Shapiro on Wednesday (Dallas Presby) and before seeing Dr. Eng on Thursday (MDAnderson), the two of them had chatted and figured the chemo I needed to take next is Erbitux+irinotecan. Erbitux (a.k.a. cetuximab) is the drug that landed Martha Stewart in prison relating to its FDA approval and resultant effect on stock price. With FDA disapproval, the stock price was supposed to fall. The next year it was actually approved because of how well it works. "It works" in the area of cancer is not the same as in electrical engineering - I think around 10-15% of patients see response. One great thing about Erbitux is that it seems to "reinvigorate" irinotecan when used in combination - giving irinotecan a new chance to work when by itself it had stopped doing so.

I was not too happy about this decision - I was not ready to give up on one or both of the previous chemo protocols I have taken. So I started asking some hard questions about this in my meeting with Dr. Eng. You might say I argued. Hard, even. Christine was shocked. I think I was, too.

But what is taboo when your life is at stake? And what harm are questions seeking understanding anyway? The way I learn and enjoy discussion with many of my friends and coworkers is to ask hard questions, often playing devil's advocate. To me, it is a sign of respect. And it seems to generate the best overall ideas. But not everyone likes it. Some people hear it as disrespect. Or a waste of time. But like I said, when life is at stake...
To my pleasant surprise, Dr. Eng was not taken aback at all. She took all the time I needed - and she listened well, as evidenced by her restating my questions better than I could express and the fact that her answers directly addressed these questions. I expect and pay for medical treatment. But I considered this engagement a bonus.
This is not to say she did not counter me. She said that the model for understanding how chemo works is that when you have finished its prescribed course, and the remission is short (in my case, really only 4 months), then you consider that it is losing its effectiveness and you need to move on to another drug. Back and forth we continued in this surreal interchange. And then, as surprised as I was that the debate was even taking place, I was more surprised that she began to reconsider. She even began to agree.
"Wait, wait," I protested. "You're the expert! I have no idea what even I've talking about." Surely the instincts of Dr. Shaprio and Dr. Eng have more validity than my novice way of thinking. On the other hand, we are all humans. I have been following one case for three years, thinking about it daily. They had to digest a ream of my records in a short time while treating dozens (hundreds?) of patients.
In the end, Dr. Eng did not simply say "ok". She took my concerns and fashioned a counter-offer. I was thinking along the lines of the more recent protocol, which kept the lung nodules out of the CT scan for the many months I took it. She thought we should instead go with the original 2003 protocol: 5FU + irinotecan ("FOLFIRI" in oncolingo). Maybe there was still some oomph left in the irinotecan. And she wanted to go with intravenous 5FU - it will be easier on my liver than the oral form. So maybe I won't have to discontinue it as I had to do with the Xeloda in Spring 2004 for that reason. I asked her several questions trying to discern whether this new plan was some sort of appeasement (i.e. let the crazy guy do what he wants). That's not it, she responded. She thought this was a good plan and drew it out in a flowchart that reminded me of a DLP system diagram. So I was convinced.
Here is the custom protocol: 8 straight weeks of FOLFIRI in 14 day cycles, immediately followed by a CT scan. If the nodules remain stable or reduce(!), keep the chemo coming. If not, we haven't wasted too much time and can try the Martha Stewart recipe. Dr. Eng seemed eager about the plan. I was encouraged myself, as odd as that may sound considering the overall bad news. It was a good thing.
I then spent an hour at Salento - a coffeeshop in the Village with wireless - while Christine walked around. As the live jazz guitarist played, I poured over my blog, which is becoming a great tool as my memory refresher. As I read, I became even more convinced this is a worthy plan. Irinotecan, I was reminded, was involved in the dramatic destruction of my tumors back in 2003. Again I was reminded how far we have come. In just 2 rounds, my primary tumor was found with surgery to be reduced to 20% viability (translate: 80% dead). And in 3 more rounds, my huge liver tumor had shrunk so much that my surgeon said "stop the chemo, this man is surprisingly fit for surgery". Following the liver resection, Dr. Hoff took me off the irinotecan because it had done its job. He instead had me take the Xeloda alone to prevent further tumors. So maybe that irinotecan was pulled from the lineup with some hits left to give. Time to pinch hit. (Replaying a batter after being pulled is not against the rules. In fact, I'm figuring out there aren't really any rules here). I'm hoping irinotecan will be my Kirk Gibson.
Yesterday, I took the irinotecan at Dallas Presbyterian. Today I am reclining at home connected to the 48hour fanny-pack pump of 5FU. Dr. Shapiro stopped by my chemo chair yesterday during the irinotecan drip to chat. Apparently he and Dr. Eng have been talking. "Is Dr. Eng just appeasing me here?" I asked. "No, he assured me. We actually like the feisty patients". Cool.

Friday, April 7, 2006

Lung biopsy positive for cancer

Yesterday, I discussed the biopsy result with Dr. Eng at MD Anderson. It is indeed colon cancer that has spread to the lungs. I had actually heard the news the day earlier from my Dallas congologist, Dr. Shapiro, because they had talked. All conventional thinking says this is not curable. But Dr. Eng is not quite ready to throw in the towel. In fact, if the chemo works well, she is not ruling out the prospect for surgery in the future to remove the nodules (that is really the only known way to get rid of them permanently, but conditions for surgery are tough to meet). She has two (only two, but more than zero) patients who are clear 1.5 and 3 years out from where I am now. We have to keep in mind that 4 of the 5 available chemo drugs for colon cancer were approved later than 1998 and 2 of them were approved in 2005.

Still, this news is not good at all. Chemo does not tend to work as well in the lungs. And when tumors affect the lungs, you get fluid in them - very bad. But I'm ready to get going with some more treatment to kill these little guys in my lungs. Chemo begins Monday morning in Dallas - IV at the clinic with home pump for 48 hours. Every 14 days. Four rounds. Rough days ahead.

It is very important for this chemo to work well. The plan is a bit risky - I'll tell you more about it later. My protocol is unique.

Two things were impressed on me in my discussions with these doctors. (1) It is very rare for someone diagnosed three years ago with Stage 4 colon cancer to even be here (diagnosis was May 03). I am renewed in thanksgiving to the Lord that everything has gone so well - three difficult surgeries that went perfectly and incredible response from chemo. I am so happy to be alive. One reason Dr. Eng and others want to stay aggressive is because I am already a unique survivor. I thank you all for your prayer for me these past three years. (2) I need some more miracles. Please pray for significant tumor response to the cancer.

Saturday, April 1, 2006

Biopsy complete

The biopsy went by without any problems. I was more awake than any other biopsy or other procedures I've had with Versed/Fentonil. Thus, I watched the whole thing as he guided the needle into my chest. Very weird.

We'll discuss results at a meeting with my new oncologist, Dr. Chen, on Thursday.

Monday through Wednesday, Christine will be getting an IV treatment for migraine at home. It is supposed to work well for those who have been stuck in a constant migraine. It is typically inpatient, which is why they have tried many other things first. But it can be administered at home with a little training from the home health care nurse.

Christine and I are taking a weekend away, so I'm keeping this brief.

Wednesday, March 29, 2006

Biopsy schedule

Lung biopsy is tomorrow morning at 7:30am. We meet for pre-procedure consult this afternoon. This will all be done at MD Anderson. Meeting for results with Dr. Eng is scheduled for next Thursday, April 6.

Your many notes and prayers are an encouragement to us. I have been surprised to be so full of hope. I am praying with the Psalmist: " The LORD will fulfill his purpose for me; your love, O LORD, endures forever- do not abandon the works of your hands. (Ps 138)"

Sunday, March 26, 2006

Colorectal cancer awareness month (get a colonoscopy!)

March is colorectal cancer awareness month. I am doing my part by being very aware of the disease right now.

You, on the other hand, can go to all sorts of web sites like this one to get info, prevention stuff, statistics, run in 5k's, download posters, read White House proclamations, blah blah blah.

But if you want the bottom line, here it is - if you're over 50, you ought to have had a colonoscopy by now. If you're not yet 50, then start planning now. It takes years for a polyp to develop into cancer. Detect and cut it out early - then you have a 90% chance of survival. If you don't, then it will be detected late like mine. Then you'll be all regretful, they'll feed you chemo, they'll start sticking tubes in your rear on a regular basis, you'll have to send your paychecks to the hospital, and all sorts of ugly things will happen. You really don't want that.

Do me a favor - if you're older than 50, go get the colonoscopy. Wives, nag your husbands. Husbands, nag your wives. Bug your parents about it. Ask your friends. Trust me. It's not that bad. Really. I actually look forward to the drugs they give before it.

I'd love to hear that my cancer scared somebody into doing something they ought to have done already and saved their life. Email me the good news when you do it.

And for a relevant laugh, read this. It's a column by Dave Barry that I ironically read a few weeks before I was diagnosed.

Saturday, March 25, 2006

Al's blog

When I drove back alone Thursday night after hearing the news, I spent a lot of time on the cell phone. I thought my heart had been completely ripped out that afternoon, but apparently there was some remaining because more was ripped out when my friend Bill told me that Al Groves had recently been told that his melanoma had spread to his lungs and that the doctors said it was incurable. Al got his news just two months before I got mine.

Al was a professor of mine at WTS. We have grown to be friends as he suffers from fibromyalgia, which drains him of energy as it does Christine, and he has been a faithful supporter of mine in prayer over my trial with cancer. Now we have more in common than either of us had hoped. I cannot tell you how encouraging it was today to talk with this brother who, due to his own trial, personally understands my situation and speaks with such wisdom to my situation as a friend.
He has a great balance of heart and mind in his service to the church. He has been a pastor as well as teacher and theologian. I had sometimes entertained the idea that I wanted to follow in his footsteps. Now he is applying his theology to suffering with cancer. Following him there wasn't what I had in mind!
Like me, Al has been keeping a blog. ( I love one of the stories on the blog: Al is surrounded by a wonderful circle of friends and family. So when he was unable to walk due to chemo symptoms, the call went out for wheelchairs. This was the result.

Friday, March 24, 2006

Not what we expected

The nodules have grown. Still small, but significant growth. My new oncologist, Dr. Cathy Eng, tells me the cancer has spread to the lungs. One of the nodules is just big enough to biopsy -- 11mm. We could wait some more to observe, but she wants to stay aggressive and get right to finding out exactly what we are dealing with. Lung biopsies can be tricky, but she assured me that young healthy people - I guess that's me(?) - usually tolerate them with not much problem.

The biopsy will be in 1-2 weeks. We're probably looking at more chemo soon after that. But that's getting a little ahead of ourselves. In one of the many lighter moments we had during the day, Christine reminded me how to eat an elephant - one bite at a time.

I had stayed with the Rasmussens Wed night and Sally came with me for the appointment. It has been great spending time with them at this time. Christine has been right there with me - she teleconferenced in for the appointment, and talked me through the landing as I drove back from Houston last night.

Yes, quite the bummer.

There have been some exceptional cases where such nodules hold steady for a long time. In at least one of Dr Eng's cases, she saw them go away completely with chemo - three years out now. We hope that will be the case for me and look forward to that. But regardless, Christine and I have been having a good time reminding each other of the plan...

I will extol the LORD at all times;
his praise will always be on my lips.
My soul will boast in the LORD; let the afflicted hear and rejoice.
Glorify the LORD with me; let us exalt his name together.
(Ps 34:1-3)

Wednesday, March 22, 2006

Berry or banana?

When I reported Monday morning for the CT scan, I was looking forward to the question "Do you like berry or banana flavor for your barium drink?" I'm always ready with one of the bad jokes from my hospital repertoire. I usually go with "Neither" or "Do you have the chalky one that tastes like antifreeze." One of those will usually get a chuckle from the nurse. Then I get to do one of my favorites. When I'm on the table they always intercom to me from the radition-free control room, "Is everything ok, Mr Hewlett?" To which I like to respond, "About as ok as a guy can be with a needle in his arm and a tube up his rear."

But Monday, I was pleasantly surprised to find out, there was no barium or tube -- only to be reminded that they just wanted to look at my lungs.

If you recall, I am coming for my three-month checkup a month earlier because they were concerned about something they saw in my lungs in the last CT scan. They hoped it was nothing, said it usually turns out to be nothing, but here I am to find out.

I find out tomorrow. Please pray with me for some good news. Also, remember Christine - I left her in Dallas today (I drove down twice this week) because she had another bad migraine - really the same one she had on Monday that kept her from coming down then, too.

Wednesday, January 25, 2006

More cautious optimism

The CT scans are mostly clear - no definitive evidence of cancer. And the blood marker, which indicates cancerous activity, is normal. However, there are a few very small nodules in my lungs that were of some concern. They want me back in 6-8 weeks to scan again. These are not the same spots as a couple nodules that showed up a couple years ago but since disappeared. I asked Dr Hoff, who has seen hundreds of patients in remission, if such spots typically turn out to be cancerous or not. "More often than not," he said, "they turn out to be nothing."

Of course, I would have liked more certain results - but I learned a long time ago that there is no certainty with cancer.

Certainty must be found elsewhere.

Thursday, January 19, 2006

First checkup tomorrow

Three months are complete. The time has come for me to be scanned by those skilled at looking for and finding trouble. Early tomorrow morning I will have my first remission testing. Then Monday I meet with Dr. Hoff to find out the results. It is his last day of seeing patients before he moves back to Brazil. I am very disappointed that I will lose my doctor, who has been most excellent as the director of my treatment. But my hope is that his leaving will not matter to me because I will have no need for him.

When I approach an event that has undetermined outcome, I will typically prepare myself for what I will do in response to various outcomes of the event. My heart will not allow my mind to do this tonight.

Instead I pray. Lord, have mercy on me and keep my body clear of this disease.