2/27
I visited CG medical to begin that whole process.

Can't say enough about everyone's support during this difficult time. My good friends from Minnesota have started their visit rotation. Brad is coming down this weekend, and my wife is helping me with other visits throughout the spring. They are amazing friends, and a real God-send.

God remains in control, every step has some sort of amazing sequence of events that allowed it to happen smoothly and quickly logistically despite Jen and I asking ourselves "How can we possibly do this?" I still can't believe we got into the Mayo Clinic on 48 hours notice.

Thanks for the e-mails and words of encouragement. I read each word of each note, they help sustain Jen and I as we transition from the diagnosis phase into treatment phase. We remain strong in faith, focused in resolve and ready to get the chemo started.

2/22
Mayo Clinic consultation. Great facility, impressive staff, but I was disappointed by the degree of personalized analysis of my case. I'm a healthy 36 year old with all the potential to blow out the statistics - but my consult was little more than a standard "Here's what we see in these types of Gastric cancers..." It was a good visit to support my local chemo protocol, but of little personalized value. I need to get back to Florida and get going on my treatment. There is a battle to win, I've got God, family and friends on my side, so let's cut to the chase.

2/21
Mayo Clinic workup.

2/20 - Just a quick update - I'm running out the door for the airport....

The results of my liver biopsy yesterday indicated the cancer has spread to the liver. I've got 5 to 6 golf-ball sized tumors. I cannot feel them, and my otherwise normal condition remains intact. I physically "feel" great like every other day.

My liver function is still right on target so aggressive treatment is now a front burner item. Chemotherapy goal is to shrink the tumors for possible surgery - both in the liver and stomach.

2/19 - Starting a round of second opinions. we'll be starting chemotherapy next week sometime. Its an aggressive treatment, bound to cause a few short term bumps in the road. But its not my road anymore - and I'm willing to do whatever it takes to get well. God's peace continues to calm us each day.

Thanks for the continued prayers. We remain focused, encouraged, and ready to move quickly into the treatment phase of this disease. God remains on control - I've got some amazing stories to tell you on my next update - doors have opened for me which I cannot begin to describe and that I would not have imagined.

I may sound rushed, but I'm running out the door to catch my flight. Jennifer is by my side - and family is staying at our home in our absence. They are terrific.

Jen and I continue to appreciate the many notes, e-mails and prayers as a source of constant encouragement.

The roller coaster of good and bad days is minimal. Talking about it helps and we are comfortable and at peace with the situation.

2/19 - I had a liver biopsy today. Avoid one if you can!
The skin can be numbed, but not the organ itself. I fortunately had the head of radiology perform my procedure, so it could have been worse. I'll spare you the details. But let me just say the needle felt like a pencil stuck between my ribs. And when it hit the liver, it felt someone punched me in the gut, with referred pain to my stomach and right shoulder. Are you doubled over yet? Now do that three times. I'm not a fan of pain. Good thing it only lasted 15 minutes. Recovery took 2 hours. After it was done they told me I was pretty tough - most guys choose to get knocked out. Had I not been curled up like a baby, I might have hurt that nurse.
We learn the results of the biopsy in 24-48 hours. In the meantime, our efforts are spent working out a hectic schedule of second opinions.

Duke University - GI Oncology called - head chemo protocol person indicated support for our local chemo protocol, so no trip needed - great news. They did say its an aggressive treatment, and will likely make me quite sick, but its the highest probability path toward quick recovery, which is what I requested.

Johns Hopkins will accept our records and review them in the coming week.

The entire sequence of events is highly dependent on each preceding event. It could all change on a day-by-day basis. For example, my liver biopsy results directly impact my course of treatment (chemo vs. surgery); which in turn impacts our visit to Mayo for a second opinion. If no cancer spread to the liver, then we're radically altering course, and instead of chemo, looking for a top surgeon to perform the removal of my stomach. The urgent chemo path was to save my liver. You see all the dynamics. Having never done this before, we continue to pray for God's guidance. I would imagine we're beginning to fray around the edges just a bit.

Our church hospital minister met with my family for additional support before my biopsy today. It just so happened, he is 56 and had his stomach removed 3 years ago due to bleeding ulcers. I guess God knew the deep compassion of another gastric patient would do me well.

Despite going into this asking God for an incredible degree of clarity and focus - I cannot overemphasize the unbelievable volume of cancer information that's out there. Jen and I are trying to sort through it and do good research, since there isn't someone to walk you through the alternatives. We try and distinguish one doctor from the next, one chemo-cocktail from the next, etc. Thankfully, Jen's biology background allows her to pour over online clinical trial results with relative ease. She is literally comparing the chemicals across different chemo treatments - learning which work, which don't and which side-effects we can handle. Most of our time spent waiting between test results puts us back in front of the computer or reading books.

Sadly, nothing in the healthcare system does any of this for you. Our own medical procedures barely get scheduled on time - I'm finding you really have to run your own show in today's healthcare system or you'll get lost in the shuffle. I have no idea how someone does this alone. My efforts are spent balancing staying up late doing research and staying well, learning the CG medical manual and trying to remove logistical barriers so we are focused and ready to dive into treatment as soon as possible.

If the diagnosis remains on target during the next 24 hours (e.g. gastric cancer metastic to the liver), then chemo will remain the treatment of choice.

Upon return from Minnesota on Monday, 2/25, our oncologist will likely begin my chemo immediately.

Its been almost two weeks since my emergency room visit. To this day, I remain completely and totally symptom free. My weight is steady, my appetite healthy, and sleep is normal. All vitals are normal and nothing in any blood work or liver function is out of bounds.

With our faith strong, our focus intact, family and friends sending encouraging words (which is wonderful and welcome), and an aggressive treatment path ahead, we have no doubt God's controlling hand will see us through.
I'll keep you posted, and thanks for the continued support. I hope to be back at work very soon.

Thanks for your support and encouragement. Please pass along my sincere appreciation - all the prayers are a true lifeline to Jennifer and I. We continue to rest in peace that God has got this situation under control - its way too big for Jen and I to handle alone.

Things have been up and down the past 48 hours. I've got great news and not so great news.
Here's the latest:

I continue to be completely symptom free - no fever, no nausea, no night sweats, no weight loss, blood work normal, liver function normal, little that I physically feel can tell me I have a small baseball size tumor in my liver and an abnormal mass at the base of my throat. I have become a bit sensitized by all the tests, so referred abdominal pain does pop up now and then.

Jen and I are pursuing several paths at once. We joined our church's very supportive cancer care group and also are pursuing top-notch cancer specialists at 2-3 other "expert centers" around the country. God put brilliant doctors on earth for a reason, and we're going after the best. The Mayo Clinic in Rochester, MN is currently evaluating my case. Tomorrow - we talk with Johns Hopkins Cancer Center in Baltimore. Our current oncologist was a fellow at Dana-Farber Cancer Center (Harvard) and is supportive of getting several opinions before beginning the chemotherapy.

2/15
I'll be at work. My brain still works...:-)

2/14
Today was first meeting with our oncologist. He was very honest. He openly told me there was nothing to indicate why I should be sitting in front of him. It remains a complete mystery why I have this cancer. The liver tumor is likely a metastatic tumor from my stomach cancer...which means it is in advanced stages and will take an aggressive effort to treat. A liver biopsy is needed to confirm the status of tumors, but chemo should begin immediately. He said my anticipated response to chemo should be very good. Not exactly sure what that means yet. Good news - he has two other patients (38 and 61 yoa) which share my symptoms. They've been on a chemotherapy treatment for 6 months with good results.

2/13
This was liver day - to see if the cancer has spread. A CT scan on 2/6 revealed a few spots on my liver. Not a bad sign by itself. A procedure called a tagged red blood cell scan was to specifically rule out a benign tumor. This procedure extracted some blood, mixed it with a radioactive dye, and put it back into my system. It glows like a chem-lite under a gamma ray machine. It took a 3-D image of my liver. Good news would have been that the liver had illuminated with the radioactive blood, indicating the tumor was actually just a collection of blood vessels, not a metastatic cancerous tumor. But that didn't happen.

We continue to receive wonderful words of support. God's got a plan in all this somewhere - we continue to draw strength from knowing that. The many prayers said on our behalf sustain us. Jennifer also remains strong and is by my side every step of the way. I believe in the power of prayer, and stand ready to tackle this thing head-on. Although God's in control, I fully intend to pursue the most aggressive treatment possible. Thankfully, my support networks are established - and I do welcome any e-mails at this address in case anyone asks.

2/12
Today, I was diagnosed with stomach cancer.

 

Formally, its called "Undifferentiated Gastric Adenocarcinoma."

 

I have a tumor at the junction of my esophagus and stomach (GE junction). Chemotherapy seems the primary course to shrink the tumors and save the liver, even though the primary tumor is in the stomach. The course of therapy is 4-6 months....then evaluate the progress and modify the protocol accordingly.

Had I not made an emergency room visit to complain of abdominal pain last Wednesday (2/6) - this cancer would likely have gone undetected.

I shared a warm conversation with the CG Chaplain. My church also has a strong hospital ministry aware if my situation and in touch with me.

I am receiving tremendous support in getting remote connectivity to work from home. I intend to keep my brain busy - and hope to remain effective at work. Ironically, my road-warrior consulting days offered plenty of experience working remotely.

I am at peace, focused and ready. I will keep you informed and covet your prayers.

 

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