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.
The Struggle Has Ended
Wednesday, February 4, 2009
Rally Caps
If you're on facebook, check out the group "Rally Caps for Greg." Several friends are pulling for the late-inning big hit.
You can post a rally cap image, like charter member David's below
If you're not on facebook, never mind.
You can post a rally cap image, like charter member David's below
If you're not on facebook, never mind.
Monday, February 2, 2009
Where's the problem?
Click image to enlarge.
The surgery will be on the left hilar lymph node and the little lung nodule on the left. (the two scans on the right of this overall image)
By the way, I hacked these images from the clinic computer, gmailing them to myself, from the screen in the little waiting room while I awaited the nurse to return. Don't tell anyone.
Thoracic Surgery Scheduled Feb 9
I will have thoracic surgery on Monday morning Feb 9 at MD Anderson Cancer Center in Houston, TX.
The story for how I arrived at the decision to move forward with surgery is a long one, spanning appointments with Dr. Eng (clinical onc), Dr. Hofstetter, (surg onc), Dr. Welsh (rad onc), and back to Dr. Eng over the course of the last three weeks. I've been up and down I-45 a bunch in the last four weeks.
I have right and left hilar lymph nodes that are increasing in cancerous activity and growing slowly. The hilar lymph nodes are above the heart, in Grand Central Station at the center of the chest, adjacent to the pulmonary arteries. I also have a small cancerous nodule in my left upper lung.
The options they wrestled with are:
1. Do nothing
2. Continue the "moderated" chemo plan I've been on for a year (XELODA+AVASTIN)
3. Take more severe chemo (5FU, Leucovorin, Irinotecan, Avastin)
4. Radiate both lymph nodes
5. Do surgery on one of the hilar lymph nodes and radiate the other.
They decided to offer me #5 as a reasonable approach. The background is as follows:
The default treatment for a guy like me would be to simply continue chemo. Hippcrates avers, "Do no harm." Surgery and/or radiation does a lot of harm, with uncertain benefit. If the cancer is going to kill you, why butcher the body on the way down? Good question.
* Due to my youth and personal approach, they are on board with my continued highly aggressive game plan, which has served me well so far. Three of my seven surgeries were unconventional for someone with stage four colon cancer. And yet, as we chip away at the leading tumors, it seems to me that I have been buying more years.
* There is some data to suggest that if a stage IV patient can get to NED (no evidence of disease on the scans), even though they figure there is plenty of microscopic activity, statistics show there can be extended life. So we would like a plan to get rid of both of those hilar lymph nodes.
* For a while, the leading candidate was #4. It would probably not kill the tumors completely, but would render them nearly dead for 2-3 years. And would not do as much damage to lung capactiy as the surgery. The problem is that all that radiating (beyond being painful for the esophagus) would make it impossible to ever do surgery in that area in the future. We don't like closing option doors.
* In plan #5, the surgery proposed on the left, more active, hilar lymph node is extremely challenging. Dr. Hofstetter said it is like working through a hole less than an inch across, and picking out a piece of sticky bubble gum that is wrapped three-quarters of the way around a wax-paper thin artery without tearing the wax paper. He believes it is very unlikely he can do it without having to remove half of the left lung. This will leave me with an overall estimated 49% lung capacity (it is around 80% now). He would wedge out the little lung nodule on the left while he's in there.
* Due to low remaining lung capacity, he figures it will not be wise to then remove the right one via the same kind of surgery. But, after consulting with the radiation oncologist, they think they can then radiate the right side. Dr. Eng told me she did not think they had ever taken the surgery-on-one-side-radiate-the-other approach before. We're on the edge of cancer research here! More than one oncologist I've talked to thinks this plan is a bit crazy, while others see it as a viable plan.
* If this surgery and radiation plan works, I will get to NED in a couple months.
* Then we'd follow up with more chemo just for fun.
The home run would be if Dr. Hofstetter, a surgeon I greatly respect, could cut out that hilar lymph node without removing half the lung. Then, we'd have the option for additional surgery on the right side instead of radiation. Pray for this guy's hands! I've had a couple of 9th inning home runs by other surgeons in the past.
I have been aggressive all along. Taking calculated risks, using my bargaining chips of youth, not-so-necessary organs, parts of organs, and pain toleration. That's the way I play ball. I am doing this because it is just too difficult for me to change my way of playing now. As my friend Tyler put it, "if you go down, go down swinging!" I am going to remain consistent to who I am and have been. So, Tyler, I'm going to swing for it.
As a Christian, my security lays in the resurrection of Jesus, which is a taste and guarantee of what will come for those who are in him. I do not want to recklessly test the precious freedom that comes with such security, but rather enjoy it while sharing in the fellowship of his sufferings. That probably sounds weird to some of you, but it really is at the core of my thinking about all this.
The story for how I arrived at the decision to move forward with surgery is a long one, spanning appointments with Dr. Eng (clinical onc), Dr. Hofstetter, (surg onc), Dr. Welsh (rad onc), and back to Dr. Eng over the course of the last three weeks. I've been up and down I-45 a bunch in the last four weeks.
I have right and left hilar lymph nodes that are increasing in cancerous activity and growing slowly. The hilar lymph nodes are above the heart, in Grand Central Station at the center of the chest, adjacent to the pulmonary arteries. I also have a small cancerous nodule in my left upper lung.
The options they wrestled with are:
1. Do nothing
2. Continue the "moderated" chemo plan I've been on for a year (XELODA+AVASTIN)
3. Take more severe chemo (5FU, Leucovorin, Irinotecan, Avastin)
4. Radiate both lymph nodes
5. Do surgery on one of the hilar lymph nodes and radiate the other.
They decided to offer me #5 as a reasonable approach. The background is as follows:
The default treatment for a guy like me would be to simply continue chemo. Hippcrates avers, "Do no harm." Surgery and/or radiation does a lot of harm, with uncertain benefit. If the cancer is going to kill you, why butcher the body on the way down? Good question.
* Due to my youth and personal approach, they are on board with my continued highly aggressive game plan, which has served me well so far. Three of my seven surgeries were unconventional for someone with stage four colon cancer. And yet, as we chip away at the leading tumors, it seems to me that I have been buying more years.
* There is some data to suggest that if a stage IV patient can get to NED (no evidence of disease on the scans), even though they figure there is plenty of microscopic activity, statistics show there can be extended life. So we would like a plan to get rid of both of those hilar lymph nodes.
* For a while, the leading candidate was #4. It would probably not kill the tumors completely, but would render them nearly dead for 2-3 years. And would not do as much damage to lung capactiy as the surgery. The problem is that all that radiating (beyond being painful for the esophagus) would make it impossible to ever do surgery in that area in the future. We don't like closing option doors.
* In plan #5, the surgery proposed on the left, more active, hilar lymph node is extremely challenging. Dr. Hofstetter said it is like working through a hole less than an inch across, and picking out a piece of sticky bubble gum that is wrapped three-quarters of the way around a wax-paper thin artery without tearing the wax paper. He believes it is very unlikely he can do it without having to remove half of the left lung. This will leave me with an overall estimated 49% lung capacity (it is around 80% now). He would wedge out the little lung nodule on the left while he's in there.
* Due to low remaining lung capacity, he figures it will not be wise to then remove the right one via the same kind of surgery. But, after consulting with the radiation oncologist, they think they can then radiate the right side. Dr. Eng told me she did not think they had ever taken the surgery-on-one-side-radiate-the-other approach before. We're on the edge of cancer research here! More than one oncologist I've talked to thinks this plan is a bit crazy, while others see it as a viable plan.
* If this surgery and radiation plan works, I will get to NED in a couple months.
* Then we'd follow up with more chemo just for fun.
The home run would be if Dr. Hofstetter, a surgeon I greatly respect, could cut out that hilar lymph node without removing half the lung. Then, we'd have the option for additional surgery on the right side instead of radiation. Pray for this guy's hands! I've had a couple of 9th inning home runs by other surgeons in the past.
I have been aggressive all along. Taking calculated risks, using my bargaining chips of youth, not-so-necessary organs, parts of organs, and pain toleration. That's the way I play ball. I am doing this because it is just too difficult for me to change my way of playing now. As my friend Tyler put it, "if you go down, go down swinging!" I am going to remain consistent to who I am and have been. So, Tyler, I'm going to swing for it.
As a Christian, my security lays in the resurrection of Jesus, which is a taste and guarantee of what will come for those who are in him. I do not want to recklessly test the precious freedom that comes with such security, but rather enjoy it while sharing in the fellowship of his sufferings. That probably sounds weird to some of you, but it really is at the core of my thinking about all this.
Wednesday, January 7, 2009
Three more months - still stable
Hi everybody. I know it has been a long time since I wrote. I haven't been much in the mood to write. I've been continuing chemo - the moderate level - in hopes it is enough to hold the three small tumors at bay.
Today I met with Dr. Eng at MD Anderson after getting CT scans of my torso. The preliminary look (a radiologist has not yet analyzed it) showed that everything looked the same. This means things are stable and I can continue on the same path. The two lymph nodes seems about the same size and the lung nodule may have even shrunk a bit.
I asked if the criteria for surgery might have changed now that I've been stable for a year. (11 months) She thought that was a reasonable question to ask and will talk to the surgeon about it.
With this level of cancer, stable is very good. I am relieved, relaxed, and thankful to the Lord for another three months.
Today I met with Dr. Eng at MD Anderson after getting CT scans of my torso. The preliminary look (a radiologist has not yet analyzed it) showed that everything looked the same. This means things are stable and I can continue on the same path. The two lymph nodes seems about the same size and the lung nodule may have even shrunk a bit.
I asked if the criteria for surgery might have changed now that I've been stable for a year. (11 months) She thought that was a reasonable question to ask and will talk to the surgeon about it.
With this level of cancer, stable is very good. I am relieved, relaxed, and thankful to the Lord for another three months.
Saturday, October 11, 2008
Mostly Stable
The scans showed that my three small tumors (two chest lymph nodes and one in the lung) have increased "slightly". For example, one went from 5mm to 6-7mm. This is not considered significant enough to switch to the heavy chemo. This means I can stay on the more tolerable chemo through the holidays. I wish it had shrunk, but I am also happy to be able to continue living in the manner I have been, with just the Xeloda/Avastin. Dr. Eng suggested I continue doing what I'm doing. Taking a break doesn't make much sense because I am tolerating this lighter stuff so well. And changing to anything else does not make sense either. In the dark world of stage IV, "slight" increases are considered good.
Christine has managed pretty well in her pain in Dallas while I went to Houston for the checkup, thanks to the couple of you who checked in and helped her out during the week.
Christine has managed pretty well in her pain in Dallas while I went to Houston for the checkup, thanks to the couple of you who checked in and helped her out during the week.
Wednesday, October 8, 2008
Master-of-things-web needed
Is there anyone out there who is a master of web-stuff who could help me automatically transfer this blog from its MovableType home to an easier to manage blog foundation. I was thinking of using blogger. I'd like to retain the archive articles and comments. I have some ideas how it can be done, but am not adept at writing scripts that access the web.
On a related note, I'd also like to be able to format all these articles (around 350 in this journey) for hardcopy-friendly formatting.
Any help or pointers?
On a related note, I'd also like to be able to format all these articles (around 350 in this journey) for hardcopy-friendly formatting.
Any help or pointers?
A Prayer of a Sick Person
The hospitable couple in whose garage apartment I am staying invited me Sunday to St. George Antiochian Orthodox Church in Houston. In the liturgy book, I ran across a beautiful prayer, which I have allowed to guide my heart this week, especially in anticipation of finding out Thursday how the cancer's doing.
A Prayer of a Sick Person
O Lord Jesus Christ, our Saviour, Physician of souls and bodies, who didst become man and suffer death on the Cross for our salvation, and through thy tender love and compassion didst heal all manner of sickness and affliction;
Do thou O Lord, visit me in my suffering, and grant me grace and strength to bear this sickness with which I am afflicted, with Christian patience and submission to thy will, trusting in thy loving kindness and tender mercy.
Bless, I pray thee, the means used for my recovery, and those who administer them.
I know O Lord, that I justly deserve any punishment inflicted upon me for I have so often offended thee and sinned against thee, in thought, word, and deed. Therefore, I humbly pray thee, look upon my weakness, and deal not with me after my sins, but according to the multitude of thy mercies. Have compassion on me, and let mercy and justice meet; and deliver me from this sickness and suffering I am undergoing.
Grant that my sickness may be the means of my true repentance and amendment of my life according to thy will, that I may spend the rest of my days in thy love and fear: that my soul, being helped by thy grace and sanctified by thy Holy Mysteries*, may be prepared for its passage to the Eternal Life, and there, in the company of thy blessed Saints, may praise and glorify thee with thy Eternal Father and Life-giving Spirit. Amen.
* "Holy Mysteries" is an early church term for sacraments.
BTW, does anyone know the date/origin of this prayer?
A Prayer of a Sick Person
O Lord Jesus Christ, our Saviour, Physician of souls and bodies, who didst become man and suffer death on the Cross for our salvation, and through thy tender love and compassion didst heal all manner of sickness and affliction;
Do thou O Lord, visit me in my suffering, and grant me grace and strength to bear this sickness with which I am afflicted, with Christian patience and submission to thy will, trusting in thy loving kindness and tender mercy.
Bless, I pray thee, the means used for my recovery, and those who administer them.
I know O Lord, that I justly deserve any punishment inflicted upon me for I have so often offended thee and sinned against thee, in thought, word, and deed. Therefore, I humbly pray thee, look upon my weakness, and deal not with me after my sins, but according to the multitude of thy mercies. Have compassion on me, and let mercy and justice meet; and deliver me from this sickness and suffering I am undergoing.
Grant that my sickness may be the means of my true repentance and amendment of my life according to thy will, that I may spend the rest of my days in thy love and fear: that my soul, being helped by thy grace and sanctified by thy Holy Mysteries*, may be prepared for its passage to the Eternal Life, and there, in the company of thy blessed Saints, may praise and glorify thee with thy Eternal Father and Life-giving Spirit. Amen.
* "Holy Mysteries" is an early church term for sacraments.
BTW, does anyone know the date/origin of this prayer?
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