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
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.
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.
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.
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.
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.
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...
john 
andrew 
scott
Check the members page to see who they are.
In other news, we have three new members, bringing to 15 those who are feeling the breeze...
john andrew scottCheck 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...
A true Aggie.
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.
A true Aggie. 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.
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