STEREOTACTIC RADIOGRAPHIC PROCEDURE

Written by Jodee McCabe    

Thursday, 20 November 2008   6:15 AM

This last week or so has been pretty busy.  Last Friday Dan had a CT scan (yes, another one) and then Monday he had a high definition MRI to prepare for another stereotactic radiographic procedure.

Later this morning, Dan will have that procedure on his brain.  The first one back in July, treated 3 tumors successfully.  Today they will be zapping two small tumors, one on each side.  The docs say these are small enough that Dan doesn't need to be on the anti seizure meds.  We are very relieved about that b/c they made him feel terrible and pretty much killed his appetite.

The mask that was used the first time to stabilize his head just needed some minor adjustments so they did that last Friday and used it to position his head for the CT scan and will be able to reuse it today.

He needs to wait for 8 weeks after this procedure and then have another MRI to check those tumors.  IF they are gone and no other tumors have formed, then he might be able to begin the clinical study for AVASTIN.  In the meantime, he will do one more round of Sutent.  Even though it has not been effective enough, we are hoping that it will still minimize the progression of the disease while we wait to be enrolled in this clinical study.  He will be off the drug for nearly 4 weeks prior to beginning that new study.

His pain has increased somewhat.  It is mostly in his lower back but he also has some in his shoulder and upper back.  He has increased his pain med slightly by taking it in slightly shorter intervals.

Please pray for his own body to begin to figure out how to fight off the disease.  All the chemo drugs can offer is a little more time for that to happen.

Please pray for me as well.  Last night I developed a sudden sore throat.  I'm gonna try to see the doc late this afternoon.

Our first thought is always of healing.  But we know from reading Scripture and from listening to wonderful teaching and from hearing other life stories, that while God often displays His power and glory through healing, there is so much more to learn about Him, and about us,  through these trials.  We don't want to miss any of it.

Thank you to each of you for your continued prayers for us.  It is difficult to explain all that it means to us but as we gather with our family around the Thanksgiving Table, be sure that we will be thinking of each one of you as we thank God for all of His Blessings.

SECOND MRI RESULTS

Written by Jodee McCabe    

Tuesday, 11 November 2008 10:45 AM

Yesterday was our visit to the oncologist to get the results of the MRI of the brain.  We were told that there are two new lesions in Dan's brain, one on each side and both are small.  This kicks him out of the clinical trial for now.  We were very disappointed but not surprised.  It seemed logical to us based on the results of the CT scan, which had shown that in other parts of his body, while some tumors disappeared, other, new tumors had formed.

We are staying at home this morning waiting for the radiologist to call to discuss further "options". We are hoping that he will agree to repeat the procedure that Dan had early this summer (stereo-tactic radiographic surgery) to remove the new growths in his brain so that we can continue with chemotherapy.  The current drug is not effective enough and we hope to get him included in a clinical trial once the new brain lesions are dealt with.

Some of you have written and reminded us that we are not limited to the discouraging news of the doctors, however accurate it is, and to keep our minds and hearts centered on God's Word, which is full of life and hope.  We are well aware that that hope is in being a part of Christ's Body for eternity; not in an endless life here.  But it does include an "abundant life" here, which we understand to mean that God will provide what we need to endure for now as we prepare for eternity.

Our children/grandchildren have been very attentive and friends have been doing all they can to support and encourage.  How blessed we are!  As Thanksgiving approaches, we have more than ever to be thankful and grateful for.  Each one of you is high on the list!  

NEXT STEPS

Written by Jodee McCabe    

Sunday, 02 November 2008 1:00 PM

Well, it has been an eventful week and yet little has been accomplished; or at least it feels like that.  Eventually, as I related in the last update, the oncologist did get the full report from the radiologist re: the CT Scan.  The results show that the Sutent is not adequately fighting off the cancer.  The doctor called twice last week to fill us in on the situation.  He explained that we needed to keep the appt. on Friday (i.e., not move it earlier)  b/c he wanted to consult with Dr. Logan, from I.U. Medical Center and he needed that time to be sure they could connect.  We were glad he was not SENDING us.  On Thurs. he called again to tell us that Dr. Logan had no other treatment options  to offer than when we spoke with him in June.  

Our oncologist had been made aware of two new studies that were using a drug called "Avastin".  One study was using Avastin in conjunction with another chemo drug and the second study only used Avastin.  He said Dan would need another MRI of his brain before he qualified for either study.  If there are new brain lesions, he would not be able to participate.  He felt there was no need to see him again until after the MRI was done but suggested we come in on Friday to speak to the research nurse who would inform us about the two studies so we could read the information carefully and have time to consider them before we had to make a decision

When we got to the appt. on Friday, one of the studies had already been closed out.  Some  folks would be disappointed but we are understanding this as an answer to your prayers for us: to keep our paths for treatment clear.  So now we wait some more.

Friday, the MRI will be done.  Tues. we will see the oncologist and talk about results and our options, if any.  IF the brain scan is clear, Wed. Dan will go for a bone scan.  That is for the benefit of the study (if he is eligible) so they will have a clear record of the starting point.  Also, if he qualifies for this study, he will discontinue the Sutent he is now taking and then wait for two weeks before beginning the new treatment.  This new drug will be administered IV once every other week.  After some time, results will be evaluated.  IF he is one of the few who is showing good response, those people will be randomly divided.  Some will be treated every week and others will remain with the once every OTHER week dosage.  In both cases the dosage is higher than previously used.  If you read the list of possible "side effects", you'd be worried.

In the meantime, Dan's pain has migrated from his flank down to his sacrum.  He has pretty much been on pain meds around the clock.  There are other areas that hurt but that is the major one.

It is very possible that Dan will not qualify for this study or that by the time we comply with all the tests, that it will be filled as well.  Even knowing that, it is hard to adequately prepare to HEAR it.  We though we were prepared for the results of the CT scan but discovered it is very hard to corral emotions.

Although the MRI will be done on Friday, we do not anticipate knowing anything until next Tues. (Nov. 11).  Although the wait seems long, I cannot imagine dealing with socialized medicine where you wait for months for diagnostic tests.  We are praying about that issue as well.

We also have increasing concerns about Dan's brother, David.  He has been having fainting spells at work and they have discovered his blood pressure is very low.  They took him off a medication he had been getting for Down's Dementia but that did not help his blood pressure go up to normal range.  They tried using a halter monitor to check his heart function, but he ended up breaking it.  We are guessing it will not be very long before we need to place him in a nursing home.  We are praying that God will grant David mercy and allow him to remain in the group home and sheltered workshop until the end of his days.

Please continue to pray for wisdom for the medical people; for wisdom/ discernment for us as we make decisions regarding their recommendations for both David and for Dan; and for that "Peace  that Passes Understanding" that flows out of total trust in our Savior and King, Jesus, and ALL that He has for us in this life and the next.

CT RESULTS (?)

Written by Jodee McCabe    

Monday, 27 October 2008  8:30 PM

An update that isn't an update?  Well, it is sort of like a doctors' appt. that isn't a doctor's appt.   Yesterday we showed up at the oncologist's office.  After waiting for 45 minutes past our appt., we were ushered into the room to be told that there had been miscommunication with the radiologist's office and they needed the written report for the previous scan before they could complete their report.  What was missing was his/her comments on the liver, which, apparently, is more important than other organs in the oncologist's evaluation of the progression or non-progression of the cancer.  Apparently, what the nurse had received and passed on to us last Thurs. was an unofficial summary, not the OFFICIAL report and the radiologist did not want to offer that until he/she compared it to the first report.

There was a date on the bottom of the CD of the original CT Scan which denoted when the CD was copied and given to us.  HOWEVER, the date of the actual test was in the CT Study info on the TOP of the CD.  Unfortunately, the date at the bottom was bold in print and that is all the person who was requesting the written report looked at.  The oncology office had no "June 19" CT report so they were at a standstill.  We left the doctor's office needing to DRIVE to the other office, give them our copy of the RIGHT report (we still had not figured out the whole problem yet),  WAIT for them to complete the report and then hand carry it back to the oncologist's office.  They made an appt. for Friday to replace yesterday's appt.  

While we were sitting for 2 hours at the radiologist's (we were led to believe that the time would be much shorter or else I would have driven the 12 miles again later) I was thinking we should push to be worked in to the oncologist's office earlier...either later yesterday or maybe today.  When we returned with the full report, the nurse said there was no way for yesterday (he was already way behind, as we had witnessed by our 45 min. late appt. earlier).  But she would see about an appt. earlier than Friday and call us.

After 5 hours, minus 45 min. for lunch, in doctors' offices, we were pretty tired when we got home.  Not much got accomplished yesterday.  We left for dinner with friends at about 6 p.m. not having heard from the oncology nurse.   When we returned a couple of hours later, we had a message from both the nurse and the oncologist on the phone machine:

The liver results were similar to other areas:  some lesions were gone, others were new.  There was some mention of adding a new drug to the mix (new to Renal Cell cancer, but has been used for quite awhile for colo-rectal, breast and lung cancers) which would need to be IV injected every other week.  Our oncologist wanted to consult with Dr. Logan at IU Medical and so he wanted us to wait till Friday so Dr. Logan would have a chance to get back to him.

SO....we continue to wait.  The behavior of the cancer makes no sense to us but I'm sure that is part of why the researchers are having so much difficulty in figuring out how to treat it effectively.  It is sort of like shooting at a moving target.

This change of plans and the possibility of needing to be here for IV infusions has put our plans to visit my mom, in Florida, on hold for the moment.

The waiting is hard.  Please pray for our minds and hearts to be focused on God and HIS plan for us, over and above all the medical issues and decisions (It may be time for us to re-read, "Don't Waste Your Cancer" again) while still thoughtfully and prayerfully giving wise thought to our next steps.

Thanks for waiting and praying with us,

CT SCAN UPDATE

Written by Jodee McCabe    

Wednesday, 22 October 2008 4:35 PM

While I was out with a friend this afternoon, the oncology nurse called to give Dan the results of his CT scan from Tues.  The news was not good.  While some spots on the original CT scan seem to have disappeared, there are several new "spots".    We don't fully understand what it means but the bottom line is that the disease is progressing.  I don't want to guess at the ramifications of this (well, we both have, but we will try to not dwell on our imaginings) until we speak with the doctor.  He would have called today but is on vacation this week.  We have an appt. to see him early Monday morning.

With Dan feeling as well as he has, we have been fairly hopeful and this news has been a rough bump in the road.  Please keep praying for extra measures of faith, comfort, strength and peace as we look to Abba Father for sustaining grace.

NEXT CT SCAN

Written by Jodee McCabe    

Monday, 20 October 2008 19:00

We are now back home in Wyoming (our suburb of Cincinnati).  We got our first "grandchildren fix" on Thurs. and early Friday morning headed to the oncologist's office for Dan's blood test.  While we were in the office we met with the oncology nurse to discuss the most recent pain development;  a pain in Dan's R flank where the diseased kidney used to be.  Dan was worried it might be pain from the liver but the nurse thought it was muscular b/c of the way it responded to touch.  They will have a little better idea when they get the CT results.  I'm glad to report that in just the last two days, that pain has diminished some.

The purpose of that blood test was to check on Dan's kidney function before giving him contrast material for the CT.  Unfortunately, his kidney function, which was borderline on our last trip home, shows the kidney is not functioning as well now. They will NOT be giving him the contrast for his CT today b/c it puts stress on the kidney.  This means that the CT scan will not be as sharp but we are hoping they will be able to see what they need to see.  I (Jodee) have pretty much decided that from now on, regardless of the kidney function level, we will forego the contrast.  This thinking will need to be discussed with the oncologist on Monday.  The way I'm thinking, there is NO point in stressing the kidney, even if the numbers were in the OK range.  They are not going to do surgery from these results;  they just give us an idea of what is happening with the chemo.  

So this morning we are off to the radiologist's for Dan's CT scan.  It will be a few days until we have any feedback on the CT scan.  It might be Friday or it might be as long as Monday.  

Over the last half of the summer and into fall, we have received so many notices of serious illnesses; from newborns to toddlers to adults to seniors.  We have been inundated with horrible news about the state of our country politically, financially and culturally.  It is overwhelming at times.  I know you all have received many of those requests and share our grave concerns about our country as well and it makes us even more mindful of the commitment you all are making as prayer warriors.  We are joining with you for all of these prayer requests and are so grateful for being added to this long list.

I'll send another update as soon as we hear anything.  Thank you so much (again and again) for the notes, emails, phone calls and especially for the continuing prayer on our behalf. We are so very, very grateful.  

NEUROSURGEON UPDATE

Written by Jodee McCabe    

Monday, 08 September 2008 19:00

It is a testimony to how many are praying earnestly for us, that many of you have called, emailed or asked us in person, what happened at the neurosurgeon's visit.  I had not planned to send out another email b/c the end result was the same.  But forgive me for not immediately sharing the additional good report with all of you.

The neurosurgeon was as happy...or even more happy with the results of the MRI than the oncologist.  I guess I really did not fully grasp how the radiographic stereotactic surgery works but my analogy now is like a microwave.  When you cook meat in a microwave, you often let it "sit" after the microwave finishes and the meat continues to cook.  Well, I guess the radiation does a similar kind of thing in this treatment and long after the treatment is completed, the tumors keep on being affected.  

The doc said that on a scale of 0 to 10, with 0 being no result and 10 being the fastest and most positive effect, Dan would be an 11!!  That was good news.  We had been somewhat concerned about the "remnant" of the one lesion, thinking perhaps they would want to "zap" that again.  He explained that it may continue to decrease. PRAISE GOD!!  No more anti-seizure medicine, at least for now.

So: Dan started his second round of oral chemo (he actually began last Monday and with the neurosurgeon's OK, continued) and we have made the return trip to NY safely.

While back in Cincinnati, we were able to see our children, grandchildren, our Cinci Bible Study group, a couple of close friends and our Cincinnati Church Family. We extended our stay there for a couple of days for two good reasons:

1) Dan was given two tickets to a Notre Dame football game.  He and our son, Tom, drove up and had a great day together on Sat.  While they were enjoying football, I had my oldest granddaughter spend the night Friday and on Sat., we did a lot of fun things together, including reading, playing with dolls, baking cookies and shopping. Now that she is a 4th grader and busy with sports, I don't get to see her as often as the little ones, so we took this chance to have some "together time". 

2) Our Cincinnati church, Evangelical Community Church, had scheduled a picnic celebration to burn the mortgage.  God has provided and allowed us to pay off our 15 yr. mortgage in 4 years.  There was also a baptism of 6 teens (we have a pool on the property which is often used as a baptismal) which was an even more glorious event!!  (4 of those teens are quadruplets and 1 was 

their older brother!!)   We did not want to miss that!

Dan has now been on the second round of chemo for a week.  So far, his side effects remain mild and we are SO grateful!  We continue to pray for maximum benefit with minimum side effects.  Since the BEST result of the radiation and chemo only offers a short extension of life, we also are praying that by God's direction, his body's natural resources will "regroup" and find a way to fight off this disease on its own and that whatever got "messed up" in the cells that allowed cancer to take over, will be straightened out and the cancer will fail. We hope to be here (NY) for about 5 weeks.  Since I don't anticipate any new medical events in that time, I'll plan on sending out one update in about 3 weeks just to let you know how we are doing.  The next big "event" is a CT scan scheduled for Oct. 21 to see if the chemo is having any impact, so you will definitely hear about that! 

Once again we send our love and our gratitude for all the prayer and love extended on our behalf.  We both send to you what  Paul wrote to the Philippians: "Grace and peace to you from God our Father and the Lord Jesus Christ.

MRI RESULTS

Written by Jodee McCabe    

Thursday, 28 August 2008 19:00

PRAISE GOD FROM WHOM ALL BLESSINGS FLOW!!  We are home from most of the appointments and the news is good!  Originally, Dan was to have his MRI, then see the neurosurgeon immediately following and then go right to the oncologist.  It was set up that way so that we could get the explanation from the neurosurgeon and then take the report with us to the oncologist to plan the next round of chemo.  Yesterday, when we got home from Columbus, we received a phone call from the neurosurgeon's office saying that he had an emergency surgery scheduled for this morning and he would have to postpone our meeting until Tues. afternoon.  We were upset b/c we thought that might delay everything.  But we talked with the oncology nurse and she arranged to have the report read right away and faxed to the oncologist's office.

The oncologist seemed very pleased with the results from the radiographic stereotactic surgery.  Two of the three lesions are completely gone and there is only a small remnant of the largest left.  The BEST news, though, is that there are NO NEW LESIONS!!  Apparently they feel that the remnant is cauterized enough that it will not bleed...we may hear more about that on Tues., but as of now, we are moving forward with the second round of chemo.  Dan has the meds and will begin taking them again on Monday.  We are cleared to return to NY...or go to Yellowstone, if we want, only needing to return for a CT scan in late Oct. (That will be the first real measure of what the chemo is or is not doing)  We are THRILLED!! The oncologist seemed very pleased and surprised with how things are going.  It is better news than anyone in Dan's circumstances has a right to hope for EXCEPT for one who has a literal ARMY of people praying for him!!  Thank you for your prayer support as well as all of the other kinds of support that have been so freely given for us/to us.

While this is hardly evidence of a cure, it is the FIRST good news we have had in many doctors' visits and we are rejoicing!!  I hope you will rejoice  and praise God with us!! It also will allow us to return to NY for our FAVORITE time of year there...Sept., and we might even get in a kayak trip!!   Although we would love to go to Yellowstone, I'm not certain we are up to planning it.  I'm gonna let Dan make the call on that one.

I guess prayer for us, in addition to the ongoing desire to live fully in HIS will, it would be helpful for you to pray for continued minimal side effects from the chemo.  I suspect they might be a bit more intense with the second round.  We are hopeful that the chemo is affecting the cancer cells, limiting growth and maybe even diminishing it.  Better yet, would be that Dan's own body is building up its own defenses against the disease!!

Once again, we must tell you how grateful we are and how humbled we are to be the recipients of so much love and support.  The prayers are definitely felt and treasured.   We hope to return to NY sometime next weekend but have lots of errands to do while in "civilization" as well as wanting to spend as much time as we can with our  children and beautiful grandchildren.

BACK TO CINCINNATI

Written by Jodee McCabe    

Wednesday, 27 August 2008 19:00

It has been awhile since my last update and several of you have called or emailed to see how Dan was doing.  He has been doing really well.  We have been so blessed to have had this time in NY to enjoy the beauty here, to visit with good friends and to be away from doctors and appointments.  BUT.....the time has come to return to Cincinnati  for further treatment.

We will be leaving here early (as early as fall fog allows) tomorrow (Wed.) morning. We are making a stop in Columbus because our daughter, Megan, is having surgery that afternoon.  She had this procedure scheduled before her lung surgery, but it had to be postponed until she was able to have the lung surgery and heal from it.

This procedure is to deal with endometriosis.  (for you non-medical types out there, endometriosis is the formation of cysts all around the reproductive organs that causes pretty severe pain and if left untreated, CAN case infertility. )   They hope to do what needs doing through a laparoscope, which would make it an outpatient procedure but I guess about 1 out of 5 cannot be accomplished by that method and requires a more traditional surgical approach, which would mean regular surgery and 2 nights in the hospital.

LATER: (5 a.m. Thurs.)

Dan will have 3 appts. tomorrow.  He begins with an MRI at 9 a.m.  When that is completed we have an appt. with the neurosurgeon and we'll get the results of the MRI right then.  In the early afternoon, we will see his oncologist, discuss the results with him and decide on the next steps.  If all is well, Dan will begin the second round of chemo on Monday.  If, on the other hand,  they don't like the results from the radiation procedure he had in July or if there are new lesions in the brain, then they will have to come up with plan B.  My guess is it would be a second radiation treatment with more anti seizure meds before he will have more chemo.  We are so hoping that can be avoided.

If the results of prayer were merely cause and effect..., well, then, I'm certain Dan would be completely well right now ( and actually, he looks and feels pretty well at the moment) because all of you have been so faithfully praying for him and for us.  But we know that God has multiple purposes in our praying; much of it having to do between Him and the pray-er.  So, as once again I ask you to pray for Megan and to pray for Dan (and for me),  we are praying that God will use all of the praying you are doing for us, in your lives as well; to bless you, to draw you into a more intimate relationship with Him and to increase your faith and trust.

Thank you, THANK YOU for sharing this journey with us; for your compassion, your love and your support.

STARTING CHEMOTHERAPY

Written by Jodee McCabe    

Tuesday, 29 July 2008 19:00

It has been a little over a week since Dan started his oral chemotherapy.  We are still in NY, undecided yet about when we are returning and hoping we can hold out until next Wed. Dan has an appt. with his oncologist for next Tues., but the doc told us we could change it to later if he was doing ok, so we might move it back to a week from Friday. The side effects began just about at week one with mouth sores.  From what we have read, this is one of the most common side effect.  Then there have been some gastrointestinal issues (no need for details) but not too bad yet.   

Soon, he will be finished with his anti-seizure med.  We are hoping that when that is finished that some of the fatigue will diminish.   We are so grateful that we were able to be here in time to see my our extended family for even a little of their time at Camp-of-the-Woods!  That was a real gift. We even got to be at my great nephew's birthday party celebrated in the TeePee!  Then this week we got to share our cabin with our daughter, Meg, and a friend, and Dan's sister, Jane. During this time, we have been reading things by John Piper and Dan Cummings....all which point us again and again to God's sovereignty and love. I highly recommend reading both of these. 

1)  Dan Cummings writes a blog called,   "The Shadowlands".  The author is a 48 yr. old pastor in Michigan who was recently diagnosed with terminal colon cancer.  The blog is set up primarily as letters to his children and prayers, but there are a couple other formats mixed in.  If you go, take some tissues along.

  

http://lifeintheshadowlands.wordpress.com/2008/04/25/a-shadowlands-letter/

He has undergone radiation and chemo and will have surgery tomorrow.  If you think of it, lift him up in prayer, esp. tonight and tomorrow.

2) The second recommendation is an article called, "Don't Waste Your Cancer", by John Piper.

  http://www.desiringgod.org/ResourceLibrary/TasteAndSee/ByDate/2006/1776_Dont_Waste_Your_Cancer/

All of this has been our aim from the outset, but day to day there are so many things to distract and discourage, having things like this to read helps us to refocus our eyes on Jesus, over and above the cancer.   

The mist is still on the lake this morning...one of my favorite scenes here in NY.  We are so grateful to be able to be here!

Here is a thought for today, taken from Dan Cummings' blog:  

(A Hymn From an Olde Pilgrim)

Why should I fear the darkest hour,

Or tremble at the tempter’s power?

Jesus, vouchsafes to be my tower.Though hot the fight, why quit the field

Why must I either flee or yield,

Since Jesus is my mighty shield?Though all the flocks and herds were dead,

My soul a famine need not dread,

For Jesus is my living bread.I know not what may soon betide,

Or how my wants shall be supplied;

But Jesus knows, and will provide.Though sin would fill me with distress,

The throne of grace I dare address,

For Jesus is my righteousness.Though faint my prayers and cold my love,

My steadfast hope shall not remove,

While Jesus intercedes above.Against me earth and hell combine,

But on my side is power Divine;

Jesus is all, and He is mine. AMEN.

With love and gratitude to each of you

GAMMA KNIFE UPDATE

Written by Jodee McCabe    

Tuesday, 08 July 2008 19:00

We did take that quick trip to NY and it was worth all the driving.  

We had heavy traffic both ways with heavy rain on Thurs. but good weather coming home. We were enveloped in love by our church family, our neighbors and the Camp-of the-Woods family.  We packed in enough social outings to last a couple weeks and had glorious weather.....a true gift from God.  We got to hear the fabulous Patriotic Concert at camp and watch the fireworks from the lake.  We were prayed for many, many times and encouraged to SEE and HEAR how we are being lifted in prayer.  Wow!  

We remember that all of you are also praying continually and earnestly for us.  If there is any way that healing Dan could fit into God's will, I'm certain He will answer those prayers.  If not, then I'm confident that He will be with us each step and provide what we need.

We arrived home safely Monday night and Tues, we met with the neurosurgeon who helped plan and set up the stereo-tactic radiographic surgery.  It was more or less a formality since his contribution was finished but he said he thought we  "deserved a face to put to the bill".  It was helpful to us to hear his "take" on the whole procedure.  He did tell us that the 3rd lesion was clearer on the latest MRI and that they were going to treat that as well.  That was a relief to Dan b/c before we were told they were not certain the other spot was a lesion and they would only be doing two.  Now, at least, they would be treating all that is currently seen.

We had quite a wait till the actual procedure later in the afternoon so we went out to lunch and killed time doing Sudoku puzzles.  When Dan was finally called it was about 45 minutes past his scheduled time.  They came and got us and I got to see the room and his mask.  I could have watched on TV but there really wasn't much to watch other than them positioning the table each time they moved to a new lesion.

I waited in the waiting room watching everyone pack up and leave for the day.  I was not anxious.....I don't think Dan was either.....and I believe it was because all of you have faithfully been praying for us.  The whole thing lasted about an hour.  When he came out, he was walking and talking (good signs) and carrying his mask.  They just throw them away and the neurosurgeon suggested our keeping it.  If we need to do this again, we are saving time, money and also accuracy.   Some might feel that is betting on the negative but I like the comparison of never needing an umbrella when you have it.

There are absolutely NO side effects at this moment.  We left the treatment place and went to our friends' home for dinner!  There ARE possible side effects much later.  I guess swelling can occur even a month later.  That is why he is on the anti-seizure meds.  But we are resting in God's providence and all the prayers that are holding us up.  In two months Dan will have another MRI to check on the effectiveness.

Now we move on to the next step.  This morning we need to decide if we are going to Zion, IL to the CTCA (Cancer Treatment Centers of 

America).   We are praying and Dan will decide this morning, I guess.  Neither one of us really knows what it would entail.  We have been asking God to open doors we are to walk through and close those we are NOT supposed to go through and so far this one is still open.  KEEP PRAYING.

We cannot adequately express our deep gratitude for all of your emails, cards, phone calls, visits and prayers.  We have never felt so loved.  Some of you have known us for many, many years.  Others of you have never even met us, but have heard about us from family or mutual friends and have committed to praying for us.  Thank you, thank you, thank you.  I'll (jodee) let you know what the next step is later.....when we know.

GAMMA KNIFE

Written by Jodee McCabe    

Monday, 30 June 2008 2:25 PM

Many of you have been asking about what we found out about the "gamma knife" procedure so here goes: Today we met the radio therapist (yes, he is a doctor) and his resident.  We liked both of them.   The place we were referred to does not actually do "gamma knife", but something very similar called "stereotactic radiographic surgery".  If you really want the details, you can read all about it at:    http://precisionradiotherapy.com/fact_novalis.htm   This procedure accomplishes the same result using a different means of achieving the radiation; at least that is what I understood.  I have not thoroughly studied the web site yet, although we did watch a video at the doc's office.  

Although I wish the docs would quit "surprising" us with all these changes, this change has a big benefit:  Dan will NOT need his head to be screwed (literally) into a metal halo.  Today they molded a custom plastic mask-like frame to his face.  When they do the procedure next Tues., they will place the frame on his face and then screw the frame to the table.  It will have the same stabilizing effect that the halo has with NO screws into his skull!! Tomorrow he will have yet another CT scan and a high resolution MRI so that the docs (the radio therapist and the neurosurgeon) with the aide of computers, can plot out their plan of attack.  Then Tues., he will meet the neurosurgeon and later that day they (the radio therapist and the neurosurgeon) will do the procedure.

Dan has already begun taking an "anti seizure medicine" as a preventative measure and on next Tues. will also begin a short course of steroids (ooops...no Olympics for him!!)  This is b/c there is some danger of swelling in the area of treatment, although Dan's lesions, last we saw them, were very small and that decreases that risk somewhat.   Since the actual procedure is a week away, we are toying with the idea of taking a quick trip to NY for just a little break from all this craziness.  That means driving in holiday traffic but I think it will be worth it.  We shall see.  It might depend on how these drugs affect him. Unless there are big changes in the tests tomorrow (I'm still praying for the lesions to disappear!) there probably won't be another update until after the procedure next Tues.   Thanks again for all of your notes, cards, emails, Scripture verses, suggestions and especially all the prayers!!

INDIANA UNIVERSITY CONSULT

Written by Jodee McCabe    

Wednesday, 25 June 2008 02:12 PM

First of all, let me apologize for the "test" email.  That was a mistake.  I'll try to not repeat it. We have just returned from Indiana University Medical Center and our consult with Dr. Theodore Logan.   He differs in opinion (from the oncologist here in Cincinnati) about the treatment of  Dan's brain lesions and feels quite strongly that they should be dealt with immediately.  He recommends a gamma knife which is radiation that is pin-pointed onto the lesion.  He also seemed to think that Interluken2 was a possibility post radiation when the oncologist here did not seem to think so.  

The  risks involved and the side effects are so great, though, (for the Interluken 2) that Dan is not big on the idea, even though for the small percentage of people for whom this works, it is by far the longest remission.  We are going to be praying about this....IS this something we should strongly consider?  It involves a week in intensive care, a week out, then another week in intensive care.  After two months a CT scan to see if there is any response.  If there is, then a month later it begins again.   Apart from those points, the prognosis and treatment options were the same.   

The other two meds we would consider ALSO have significant side effects and are not pleasant but Dan seems more willing to try one of them.  B/c none of these options offer much in terms of results, we are going to Zion, IL to visit The Cancer Treatment Center of America.  They are not known by and not endorsed by ANY of the doctors we have spoken with so far.  As a matter of fact, the moment we mention the word, "wholistic", they all seem to react with a glassy stare.  While it could possibly be nothing more than a placebo-like treatment, I feel we have nothing to lose in investigating it while moving forward with the recommended medical treatment Dan feels he can tolerate. Even after re-reading this, I'm not certain it will make sense to many of you.  

My brain is feeling a bit numb (again) and even with both of us having been there, asking questions and listening and taking notes, we barely get it. We meet with Dan's oncologist again tomorrow and will try to make some definitive plans to begin treatment, hopefully starting with the gamma knife.  If there are any new, major developments, we will let you know. so....Please keep praying for us....for clear minds, for ears to hear and eyes to see God's leading, for strength to face each new challenge, for peace in the midst of turmoil and uncertainty, for courage and wisdom in sharing the Gospel of Jesus Christ with others, and for Christ's love to fill us and overflow to those around us.If it is in His will, we would so love for Dan to be completely and miraculously healed.  But we want MORE than that and boldly approach God's Throne and ask for it.  Ephesians 3:14-21 says it all.  As Paul prayed for the Ephesians, please pray this for us: 

Ephesians 3:14-21

English Standard Version (ESV)

Prayer for Spiritual Strength

¹⁴ For this reason I bow my knees before the Father, ¹⁵ from whomevery family^[a] in heaven and on earth is named, ¹⁶ that according to the riches of his glory he may grant you to be strengthened with power through his Spirit in your inner being, ¹⁷ so that Christ may dwell in your hearts through faith—that you, being rooted and grounded in love,¹⁸ may have strength to comprehend with all the saints what is the breadth and length and height and depth, ¹⁹ and to know the love of Christ that surpasses knowledge, that you may be filled with all the fullness of God.
²⁰ Now to him who is able to do far more abundantly than all that we ask or think, according to the power at work within us, ²¹ to him be glory in the church and in Christ Jesus throughout all generations, forever and ever. Amen.

MRI UPDATE

Written by Jodee McCabe    

Tuesday, 17 June 2008 19:00

I don't even know how to start this.  When we went to the doctor's this afternoon, I was dreading it b/c I was fearful we could hear more bad news.  Once again, it was even worse than I had feared.  The MRIs showed that Dan has multiple other lesions on his spine and 3 in his brain.  This disqualifies him for the Clinical Trial we had been told was his best hope. Normally, the first thing that would be done with a lesion in the brain is that they would attack it with radiation.  However, with this disease, b/c it is all through his body, they do not want to do that b/c the radiation could make those already-messed-up-cells resistant to the chemotherapy.  Their reasoning is (I guess) that  IF Dan responds to the chemo, the drug will take care of the lesions in his brain as well.   If NOT, then it won't matter anyway.  It is a rather harsh logic but I guess reality. Again....we are stunned.  Even expecting more bad news, we were not prepared.  

We are still going to the consult at Indiana University but I did not get the sense that our oncologist believes we will hear anything different than what we heard there today.   What he believes is left for us to "try" is the standard treatment for renal cell cancer which has very "mixed" reviews.   Having said all of that,  I thought as I was listening to him.....kind of like Charlie Brown hears some folks (wah, wah, wha.......) I was thinking;  science doesn't seem to offer us much hope....but then much of "science" thinks we originate from slime, so why would we limit our hope to their opinion?  I think there is a Psalm that says:  Some trust in chariots and some in horses, but we trust in the name of the LORD our God. 

It might be a stretch to compare this with medicine but I don't think so.  The idea is that some trust in what is in the here and now (horses and chariots in King David's day;  doctors and drugs in our day),  but we are choosing to TRUST in the name of the LORD our God.  That did not mean that Kind David did not use horses or chariots.  It was just that he was fully aware that that alone was not enough.  He knew God was sovereign.  We know that as well and are so wanting to rest in that knowledge.   At the moment our emotions are pretty raw  We would be so grateful for prayers for increased faith and for the strength and courage to persevere through all of this while honoring God and continuing to live in the joy that He has promised for us, even in the midst of sorrow and hardship.  Please pray for wisdom and grace to know how to tell our grandchildren.  And please keep praying Phil. 4: 4-8  and 1:9-11 for us. 

Philippians 4:4-8

English Standard Version (ESV)

⁴ Rejoice in the Lord always; again I will say, rejoice. ⁵ Let your reasonableness be known to everyone. The Lord is at hand; ⁶ do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. ⁷ And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.
⁸ Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Philippians 1:9-11

English Standard Version (ESV)

⁹ And it is my prayer that your love may abound more and more, with knowledge and all discernment, ¹⁰ so that you may approve what is excellent, and so be pure and blameless for the day of Christ, ¹¹ filledwith the fruit of righteousness that comes through Jesus Christ, to the glory and praise of God.

Thank you again for all the prayer and love and support.  We need you and appreciate all of you.  

Bone Biopsy

Written by Jodee McCabe    

Thursday, 12 June 2008 

Today was our first visit to the oncologist to get the results of the bone biopsy.  Once again, the news was not good.

The biopsy confirmed that the spot on his pelvis is metastatic renal cell carcinoma.  There are also spots on his lungs and liver.  The type of renal cell carcinoma is "clear cell" which is an aggressive form.  It is not curable.  There are "newer" treatments that sometimes stem the disease process.  There is wide variation in response to those drugs and also in the side effects.

We have cancelled our trip to Oregon and Alaska for the time being.   The oncologist thinks we should be in a clinical trial and to be able to do that without re-doing all the labs and the CT scan, we would need to start right in the middle of when our cruise is in process. Even if we don't, I (Jodee) felt he should be beginning the standard medication regimen and be here to be monitored for a while.  We are attempting to get a consult at Indiana University Medical Center and should find out on Monday when that will be.

We both liked the doctor very much so that is helpful.  As you can imagine we are pretty overwhelmed at the moment.  We are determined to remember that God, who is our ABBA FATHER, is in control,  no matter what things look like, and He can be trusted.  None of us is promised more than this moment and we want to use each one to honor Him.

Please pray for us and for our children and grandchildren as we walk through this together.  We are so grateful for each one of you and for all the prayer and for all of the support you give us.