Rest beside the weary road

And ye, beneath life�s crushing load, whose forms are bending low,
Who toil along the climbing way with painful steps and slow,
Look now! for glad and golden hours come swiftly on the wing.
O rest beside the weary road, and hear the angels sing!

It Came Upon A Midnight Clear, Edmund Sears, 1849

Schedule for surgery, etc

The surgery is confirmed for February 18. I am (relatively) very glad to be having this because the way cancer works (in my amateur yet ever increasing understanding), chemo can shrink and stabilize cancer and can kill very small tumors. But in order to be cured, you have to get rid of it all. In many types of cancer, such as mine, this means physical removal of all cancerous cells. As horrible as surgery is, it is minor compared with the alternative. Come to think of it, I guess that's the whole idea.

The area of concern is physically located within the pelvis. Dr. Rodriguez-Bigas says it is like trying to do surgery in an ice cream cone from the top. The problem is that there are so many important organs, nerves, and miscellaneous anatomical tubes crammed into the cone. That is why he will be doing it together with an extra pair of hands - those of Dr. Wood, who is another surgeon at MD Anderson. They way I understand it, he is a specialist in these ice cream cone surgical techniques.

On another note, Dr. Hoff's team has decided to continue my chemotherapy to keep hammering on the tumor, increasing the chance of success of the surgery. While I have always decided in the past to do my chemo at MD Anderson, I have decided to do the next two rounds at UT Southwestern in Dallas. In the case of trouble and complications, I believe it is important to stay "on the radar" of the team at MD Anderson. But I'm going to do it here because these rounds are going well in terms of any odd reactions, and because I am getting very fatigued and sick and the travel is getting difficult. The MD Anderson and UT Southwestern people have agreed to this arrangement.

While I am quite frustrated due to my lack of strength and my feeling sick these days, it will be better to be at home for these coming holiday weeks than driving back and forth on I-45. So I am glad this plan has worked out the way it has.

Here is the plan:
December 28 - chemo round 5 in Dallas with backpack chemo hookup for 48 hours
Jan 10 - chemo round 6, same deal
Feb 8 - CT scans to get final look before surgery. If no surprises or new cancer, surgery will go forward
week of Feb 15 - set of meetings with lead surgeon Dr. Rodriguez-Bigas, Dr. Wood, and Dr. Hoff
Feb 18 - Surgery. Recovery is 5-7 days in hospital, followed by 5-7 days in Houston area
Feb 19 - I turn a hard-fought-for 37.

Pushing the envelope

We're trying to pack up to get back to Dallas, but I thought I'd give a brief update on how the meeting went this morning...

Dr. Rodriguez-Bigas is willing to do the surgery. As he put it, he's willing to "push the envelope" in my case. The surgery is difficult, involved (probably two surgeons) and has many risks. He said two years ago he wouldn't even be having this discussion, but with the newly available chemo agents, taking out isolated metastatic tumors like this one may be worthwhile towards hope of long term survival.

I'll write more later, but surgery plans are in the works. It looks like it will be Feb 18. I think they are going to have me continue with at least two more more rounds of chemo before then.

More details later...

Getting by with a little music from my friends

I have always felt so fortunate to be surrounded by family and friends with such musical talent. I grew up going to bed listening to my mother play piano through the walls. My sister Julie grew into quite a pianist continuing to study performance into her adult years. And Susan's voice can calm a soul as turbulant as mine.

My roommate at Rice gave me informal guitar and mandolin lessons, as did a close friend from MIT, Kohichi Tamura. One of the favorite memories of my life was living in a house as a student in Boston with a collection of roommates from Berklee school of music, Boston Univ classical music program, and New England Conservatory. I wish I had recordings of those ad-hoc jazz sessions resonating throughout that 200-year old wood house.

Our friend from Rice, Judy Wu, who has been a help to me from her job as physician assistant at MD Anderson, just released her first CD. We just missed the relase party last weekend here in Houston. Yesterday, she stopped by with the CD to my outpatient room while I was receiving chemo. You can listen to some of it (and order it) here.

And my friend Nils Jonsson, whom you have heard about in past posts, has a few unpublished recordings of music he has written and performed at his church. Two of my favorites are a jazz tune, Can't Believe You Love Me, Too and a sacred praise chorus, I Believe. One evening while I was in the hospital recovering from surgery, Nils came to visit and wheeled me down into the atrium, where he played these and other tunes on the grand piano as I and several other random people whose lives were entangled with cancer listened. It was one of those good memories sprinked among the darker ones.

It may be a tired saying that music can reach deeper than mere words, but I don't know how else to put it. The Bible speaks of young David playing for his king, Saul: "Whenever the spirit from God came upon Saul, David would take his harp and play. Then relief would come to Saul; he would feel better, and the evil spirit would leave him."

These friends have made me feel better. And these days, I need this more than usual.

Meeting with surgeon Thurs morning

We will meet with the surgeon, Dr. Rodriguez-Bigas, first thing Thursday morning. Long term, it is important that we surgically remove this tumor. From speaking with his R.N. today, I am thinking he is going to bring up all the risks (there are many) and question whether it is worth it. However, he does like to say "I never say never and I never say always." I think he may be willing to do it. At least I sure hope so.

One other note. His surgery schedule is full all January. So the earliest that surgery is possible, should he be willing to do it, is the first week of Feb.

Some good news

Some good news.

The scan results are in. The chemo is shrinking the lower abdomen tumor. This is not a given with my type of cancer so it is encouraging. We are not taking this for granted and thus are very thankful.

The longest dimension reduced from 2.8 to 2.0cm. A little 3-D math tells me that could be a reduction to half the previous size (I don't know the other dimensions). Dr. Hoff said it shrunk pretty remarkably given I've only had three rounds.

Now it is time to talk to a surgeon. Dr. Hoff and Dr. Vauthey have decided that Dr. Rodriguez is the best surgeon to do this. The problem is that it is an unconventional surgery, thus he may not want to do it. Typically, for colon cancer, surgery is only done on the primary tumor and on the liver if it has spread. As I've said before, Dr. Hoff thinks with the new chemo drugs that have come out in the last couple years, there is some hope that beyond those locations, the cancer may still yet be stopped. It is also a difficult surgery. But I am young and (relatively) healthy and am willing (actually eager) to do it. These things Dr. Hoff said are significant. He said to hope for "goodwill" on the part of Dr. Rodriguez. So there's my prayer request. The next thing that has to happen is for Dr. Rodriguez to agree to perform the surgery. If he does, we're probably looking at a mid-January operation.

I'm trying to get a meeting arranged with Dr. Rodriguez tomorrow, when he is in clinic. Dr. Hoff said it would be good to meet with him face to face about this.

I begin round four of the chemo today this afternoon. Dr. Hoff wants to keep pounding on the cancer - no breaks allowed.

Step by step certain things have to happen, and they have up until now. This is yet one more step.

Results tomorrow

Some updates...

Tomorrow morning I meet with Dr. Hoff to find out the results of the scans I had on Thursday. We'll find out how well this chemo is working.

I will likely also begin my fourth round of chemo tomorrow. It is the same brew minus the Avastin, which the body needs to completely recover from in order to have surgery. I will once again (possibly for the final time) have the fanny pack for 48 hours delivering 5-fu to my body.

As Christmas nears, I remind you of my post a year ago yesterday... the Twelve Days of Chemo.

Lisl Tyson's husband Steve has put together a tribute site to her.