Cancer Update 22: New Progress

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This is a cancer update. In Update 20, I told you that while my original tumors are responding well to treatment, I have several new tumors that are not.  Since then, we have changed my treatment approach in several ways.  I’m using a different cocktail of chemo agents, as well as some different immunotherapy agents. 

Until about a month ago, my pain was gradually increasing as my new tumors grew.  Happily, my new treatment regimen is apparently working! For the last month or so, my pain level has been decreasing, allowing me to tune down my pain meds. Additionally, a PET scan just yesterday revealed that the new tumors, which weren’t responding to the old treatment regimen, are responding well to the new one. 

This image shows a reduced rib tumor on the bottom left, but persistent small tumors in the lung above them.
In this recent image, it’s difficult to orient the photo, since even the “persistent” tumors are now gone.
In July, the rib tumor had begun to reappear.
Now, the rib tumor is now mostly gone.
This is the new intercostal (between the ribs) tumor in July. the large blob of activity just above it is a kidney, which often light up in PET scans as they filter out radioactive sugars.
The new intercostal tumor is now responding well to treatment. This tumor was not responding until we changed our treatment regimen.

The new chemo regimen is a little harder on me.  I’ve actually had to postpone a few treatments because my blood cell levels were too low. I even had one today that I will postpone until next week.  So unfortunately, this means I will be more reclusive this Christmas season, mostly staying at home.  I do occasionally have meals with people outdoors, though, COVID style!  We don’t yet know how long I will continue doing chemo.  We will discuss this with my oncologist next week.

We wish you a very Merry Christmas and a Happy Hanukkah!
Erik

Why I believe I will survive!

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Cancer Update 21: Faith

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Some people have commented on my faith.  I find that most people these days, Christians and secular people alike, misunderstand this term.  So this very long post will be about what I think faith is, and what is the grounding for my faith.  This will help you understand my perspective on my current situation.  Given that I am a scientist and a Christian, two things which many think are at odds, you may have more understanding about how I can be both of these things at once.  I will also discuss the particular reasons that I think I will survive, even in light of yesterday’s post.  You can decide for yourself if this belief is well founded.  Christians should read this because I will introduce a definition of faith that you may not have considered.  Non-Christians should read this at least so that you may understand why I have faith.  Obviously, this post will contain a lot of Christian content.  If you don’t want to read this kind of content, you can skip this post.

What is faith?

“Now faith is the assurance of things hoped for, the conviction of things not seen.” Hebrews 11:1

The famous atheist Richard Dawkins said “Faith is the great cop-out, the great excuse to evade the need to think and evaluate evidence. Faith is belief in spite of, perhaps because of, the lack of evidence.”  Many Christians even hold a view similar to this.  Their definition might be “Faith is believing in something without evidence or reason, but because of a religious leader or religious text.”

First, I’ll say that our faith should never be based on a pastor, teacher, or church, because all too often, these things can fail us.  Rather, our faith/trust should be in God alone. 

I would also say that there is really no such thing as blind faith in God, since all faith is based on something. 

The word “faith” is used in a bunch of different ways in our culture.  Biblical faith can best be thought of as “trust”.  Practically everywhere you see the word “faith” in scripture, swapping in the word “trust” can help you understand what the word properly means. My friend Rob Andrews coined the phrase “Trust based on Truth.”  We have ample evidence that we can trust in God, so our trust in God is not blind.

As for scripture, there is a lot of evidence that the bible can be trusted.  This evidence falls into categories including archeology, history, textual transmission, internal consistency, pragmatism, wisdom, and harmony with the natural world. I hold that scripture can be used as evidence for Christianity because it is trustworthy.  Some would say using scripture is not evidence, but simply blind trust in a book, while I would say that if a book is trustworthy, and the Bible is, then believing in it is not blind faith.  A defense of the reliability of the Bible is too long for this post, so I’ll leave it at that for now.

Is God trustworthy? Why can we trust God?  First, I count scripture as evidence that can be used to support our trust in God.  Some think that trust in scripture is “blind faith”.  I would argue that since there is evidence for the trustworthiness of scripture, then scripture can be used as evidence.  I understand that many of you are agnostic or atheist, and don’t hold the Bible as being trustworthy. Aside from the broad categories of evidence I’ve already mentioned, we will need to leave that large discussion to another time.

Second, I also count the character of God as evidence for His trustworthiness.  Some find trust based on God’s character to be blind faith.

I would argue that God Himself uses His own character as evidence that He can be trusted, or evidence that we should have faith in Him.

The Ten Commandments start out like this, in Exodus 20: “1Then God spoke all these words, saying, 2 ‘I am the Lord your God, who brought you out of the land of Egypt, out of the house of slavery.’”

To paraphrase, God is saying “I am good, powerful, and have your best interest in mind.  Plus, I did you a solid.  For all these reasons, you should follow these rules.”  God is appealing to His character as reasons they should trust Him. He’s also asking them to remember events they just saw with their own eyeballs over the past few months.  He is not asking them to trust Him blindly.  He has given them plenty of evidence that He is trustworthy before He lays the Commandments down on them. 

Repeatedly, God tells the Israelites to “remember” what He has done for them in the past.  The Jewish holidays, the monument by the Jordan, the altars on Mount Gerizim and Mount Ebal, all exist so that they will remember these things.  God wanted them to remember these things so that they will trust Him! 

I have found this very useful in my own life.  Whenever I am facing a trial or a difficult decision, I recount to myself all the times that God has pulled me up from the ledge, given me a flash of lightning so I can momentarily see in the darkness, or paved the way before me.  Remembering these things helps me know that He will be with me in my current trial!

I found something fascinating when looking for the word “remember” in the Old Testament.  From Exodus onward, God uses this word to ask the Israelites to remember Him.  But in Genesis, the bible uses this word differently.  “But God remembered Noah”.  “I will remember My covenant…”. “Then God remembered Joseph.”  Before God asks us to remember what He has done for us, He remembers His promises to us, and is faithful (trustworthy) to keep His promises!  Before He asks us to trust Him, He demonstrates that He is trustworthy!

Now to the verse that defines faith, Hebrews 11:1.  “Now faith is the assurance of things hoped for, the conviction of things not seen.”  We could read this in at least two ways.

“Now blind faith is the assurance of things hoped for, the conviction of things not seen.”

“Now trust is the assurance of things hoped for, the conviction of things not seen.”

Many Christians will affirm that the first sentence is the proper way to read it. In fact, they see Hebrews 11:1 as confirmation that this view is correct. I would argue the that second way allows us to understand the meaning of this verse.  Our trust in God allows us to see through a situation and know that God will keep His promises to us.  Our trust is in God, and He is our assurance.  It is because of Him that we have the conviction of things not seen.

I think many understand the word “faith” to mean “belief”.  Belief is a mental ascent that something is true.   While believing that God is true is certainly a good thing, I would suggest that this way of viewing faith doesn’t go far enough.  You can believe something with your mind, but trust requires that you put that belief into action. You can believe that a surgeon can safely take out your appendix, but you need to trust him to actually put on the gown and the little booties and get on the table.

What does blind faith require of us?  What does belief require of us?  I’m not exactly sure. But trust requires that we believe in God enough to live out our life in a way that honors Him, even when He asks us to do difficult things.

Read John 15.  Jesus says that if we love him, we will obey His commands.  This requires trust! 

In I Samuel 13, Saul and his army are at war with the Philistines.  The prophet Samuel had told Saul to wait for his arrival to make a sacrifice to the Lord, and then begin the battle.  Even as King, it was not Saul’s place to make a sacrifice.  Seven days went by, and soldiers started to leave.  Saul finally decided to make the sacrifice without Samuel.  In doing this, Saul took the battle into his own hands.  He decided to lay aside the promises of God, and create for himself what blessings he could.

When we trust God and choose the difficult path He has laid out for us, we choose the blessings that God has laid along the difficult path.  When we choose our own path, we are on our own.  We must create our own blessings.  We aren’t very good at creating blessings.

We encounter this kind of challenge all the time.  God asks to be honest, to be fair, to treat people with kindness.  So when we lie to a client to make a sale, we are telling God that we know better than Him how to behave professionally.

To have a mature faith, one that can sustain the great opposition of the world, allow us to be obedient when God tells us to do something very difficult, or endure suffering, we must place our trust in God alone.  Trust in anything else just won’t do.

This is my definition:  Faith is acting on the plentiful evidence that God is trustworthy.

A note about COVID:  I’m going to make some Christians mad here, but hear me out.  During COVID, I sometimes heard Christians quote Psalm 91.  This chapter gives encouragement to believers who are in danger, demonstrating that God has the power to save them from dangerous situations.  It’s a great and true message!  But many Christians misapplied this message during COVID.  Yes, God can and does protect us from danger, probably much more often than we know.  But God also made sure the book of Proverbs was included in the Bible.  Proverbs encourages us to be wise, and to make decisions carefully.  God does not promise to keep us out of all danger.  So yes, we should trust in God, but we also need to use our heads.  Placing ourselves in needless danger is not a demonstration of our faith.  “Do not put the Lord your God to the test.”  – Deuteronomy 6:16

We can trust God for the promises He actually makes, but we can get ourselves in to trouble if we trust in promises He didn’t actually make.  We should trust God, but also use our heads.  This view is encapsulated in the phrase I use to end all of my posts.  “Don’t fear, but be smart.”

“I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.”  – Jesus of Nazareth, John 16:33

Why do I believe I will survive? Now that I’ve defined faith, the question is, why do I believe I will survive?  I will tell you that it’s not because I think I’m a good person or that I have some right to survive.  Plenty of high quality people have died before their time, even John the Baptist and Jesus of Nazareth.  I have a good friends right now who are struggling with serious health issues, and I don’t have any more right to survive than they do. I lost a very dear friend to cancer just a few days ago.  I can assure you that I have no greater right to survive than he did.

What I’m going to say next will be controversial among non-Christians, and even among many Christians.  I wrote way back in Cancer Update 4 (September 26,2024) that God told Kathy that I needed to broaden my diet while in the hospital.  At the time, I was barely able to walk to the end of my bed because I wasn’t making enough adrenaline.  I figured that I needed to eat a wider variety of fruits and vegetables so I could get more biochemicals, I was released in just 2 days!  I also wrote about how you can know if God is talking to you.

During my journey, several people that we know and trust have told me things that God gave to them suggesting that I have things to do after I have recovered.  You may ask, how do you know these people are trustworthy?  That is a really good question and is worthy of consideration. 

In the Old Testament, God had an extremely high bar for prophecy.  If a prophet was ever wrong about something, they were to be executed.  For Christians in the New Testament, the bar is lower.  Christians are to use discernment to judge if a word is trustworthy, comparing it to scripture to make sure it is consistent.  Modern Christians can have very different standards. Some are skeptical and rarely believe the things modern “prophets” say, while others are quick to believe modern prophets.  Many will say that modern prophets are only human and sometimes make mistakes. 

While I believe some modern-day prophecy is legitimate, if someone says something that turns out to false, I reserve the right to never believe them again.  They are either not hearing from God and just making it up, or they are misinterpreting what God told them and they have poor judgement.  Either way, I am under no obligation to trust them. 

Here is another story illustrating that at least some of this is legitimate.  During the early days of my illness, I was throwing up regularly, once or twice a day.  This was very inconvenient as I lost meals and even medications and lost 40 pounds.  Kathy became alarmed with how much weight I had lost and was becoming desperate to slow down this trend.  Then one night, on October 13, 2024, I had gone to bed at around 9:30.  Kathy couldn’t sleep and was praying for me about my weight loss.  At about 11:30, God told her that there was a spiritual battle happening in our house.  He instructed her to pray for me in a particular way, and even to have me pray as well.  She didn’t want to wake me up, and asked God to wake me up for her!  She came into the guest room where I was sleeping at that time to pray and wait for to me to wake up. 

Meanwhile, I had a dream.  I was tied to an incline bench, the kind at the gym that holds your upper body at an angle.  A band-saw blade was spinning around me.  The blade had the normal teeth on both sides, but also had cheese grater type blades on the flat sides. Additionally, it was covered with a diamond or glass dust.  So in every conceivable way, this blade was very sharp and dangerous!  No matter how I handled it, it would cut me badly. In the dream, I knew that the blade was starting to contract around me, and no matter how I handled it, I couldn’t stop it.  I needed someone to save me! I woke up alarmed and saw Kathy sitting in a chair staring intently at me.  She had been sitting there for 2 minutes.  We prayed together, and I haven’t thrown up again since that night!  Over the next few months, I gained back all my weight, and now I actually would like to lose about 10 pounds, like usual!

This is an example of the several times God has spoken to us during this time, and even saved my life!

To reiterate, several people that we trust have made statements to us in the last several months that I would survive.  We trust them because they have been accurate in the past.  Many of these people that we trust claim to have received these statements from God.  I believe that I will survive not because of wishful thinking, or because I am misapplying encouraging scripture to myself, or because of denial, or simple optimism bias, but because we believe that God has promised it.  You may point out correctly that my trust in this relies at least partly in my trust in the people who have spoken to me this way. I absolutely agree.  If by chance I do not survive, it will not be because God lied to me, or because He is not powerful, but rather because these people either did not really hear God, or because they misunderstood Him.

Yes, we believe that God still speaks to people in modern times, because He has spoken to us.

Why am I going through this?  Why do I have cancer when so many others don’t?  Why will I survive when many good people around me have not?  We don’t have the answers to all of these questions.  We only see a piece of the reality around us.  We can’t see everything going on, and we can’t see the final result from our perspective. My trust is not that my puzzle piece will not contain some darkness, but rather that the entire painting will be a thing of great beauty!  Because of God’s character, I believe this trust is well grounded.

Proverbs 3:5-6  “Trust in the Lord with all your heart, and lean not on your own understanding, and He will make your path straight.”

Don’t fear, be smart, and trust in God,
Erik

Why do good people suffer?

What to do when you’re suffering.

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Cancer Update 20: New Activity

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This is a brief cancer update.  In my last update, I shared some data from a recent PET scan. The recurring rib tumor had responded well to the chemo I’ve been going through for the last few months.  I pointed out some random green spots in one of the images that at the time I thought were random background spots.  Upon meeting with my oncologist, however, it appears that these spots are actually new tumors.  There are perhaps 6 in all, most quite small. 

In an image from July, 2 new spots appear on the right. At the time, these were thought to be random background activity.
From the September PET scan, some spots from July persist. These may represent new tumors, probably genetically distinct from the original ones. The original rib tumor was very responsive to the recent chemotherapy.
A possible new tumor exists behind the right kidney, between 2 ribs.

The most predominant of these is a tumor in an intercostal region between 2 ribs on my right sight.  I actually had radiation treatment on this new tumor last week.  I have a chemo infusion later this week that will change things up and be more aggressive than previous infusions.  I had a Next Generation Sequencing blood test that might have helped determine the genetics of the new tumors. Unfortunately, it wasn’t quite sensitive enough to detect the small number of tumor cells now in my blood.

As you know, new tumor activity for a cancer patient is usually not a good sign.  In spite of this, I’m still feeling optimistic for reasons I will share in a future post.  Continue to pray for wisdom for my doctors and for us.

Don’t fear, but be smart,
Erik

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Cancer Update 19: September PET Scan Results

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This is a brief but important cancer update.  I know it’s been a long time since my last update, but we haven’t had significant news for awhile.  As you’ve read before, I’m going through a new set of chemo treatments right now, in response to my July PET scan results.  I’m in my 4th round right now, with my 5th of 6 scheduled treatments happening next week.  My NGS test results from a few weeks ago show that the new rib tumor is genetically the same as the original one, so the same chemo agents should continue to be effective.

I had another PET scan on Tuesday of this week.  The results are very encouraging!

The red spot in the lower left is the returned tumor in the rib. The lung tumor has not returned.
The rib tumor is much reduced from the July PET scan. The background you see on the upper left is normal metabolism in the liver.
A 3D image of the rib tumor on the lower left. In this image, the original lung tumor would be on the upper right, but it has not returned.
The rib tumor is much improved. The other random green spots are likely random background metabolism. A CT scan done at the same time will confirm this. We will discuss these results with my oncologist on Thursday.

We will meet with my oncologist on Thursday to discuss the results and plan next steps. I don’t think we will actually deviate from the current plan.

I continue to have significant pain from the muscles in my lower right torso. These muscles are trying to stabilize my rib cage. Like occurred in March, I think my nerves are healing after my recent radiation treatments, and they are currently hypersensitive. They will get better with time.

Don’t fear, but be smart,
Erik

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Cancer Update 18: New Chemo and Radiation

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This is a cancer update.  In response to a recent PET scan, I started my second set of chemo rounds on July 10th.  This time, I plan to have 6 rounds instead of just 4.  While my new rib tumor is much smaller than the first time, we want to give it more rounds this time, so we make sure we get everything. 

NGS:
We reanalyzed my tumor using Next Generation Sequencing.  This amazing new technology allow scientists to sequencing many different pieces of DNA in the same sample.  In this case, instead of a biopsy, they took a blood sample and looked for their targets, a particular set of gene, in the sample.  Even though my tumor cells would be a tiny minority of the total cells in my blood, NGS can still find them and sequence them individually.  Happily, analysis shows that my new tumor is genetically the same as my old one, so it should respond to chemotherapy in the same way, just as we hoped.

I also took a monitoring test that finds and counts the number of tumor cells in my blood, which will help us track progress in the future.  This is a different technology called real-time PCR.  I have worked extensively with both of these technologies at my job at Quest Diagnostics, and in my current consulting business.

Chemotherapy:
The July 10th chemo itself went well.  Usually, the week after is the worst part.  I take some medications in the few days surrounding the actual infusion.  They counter act many of the side effects I might normally feel like nausea and fatigue. I stop taking some of these medications on Monday, so Tuesday and Wednesday of the following week are usually the worst.  This time, since I’m so much healthier in general than last time, my “bad week” was much better, just a little sleepiness and a little skin irritation, both very manageable. I actually started my second new round yesterday with another infusion.

Kathy and I enjoy a celebratory bag of Doritos during yesterday’s infusion. Don’t mind my pasty complexion. I pretty much always look like that. Photo credit: Kathy Johnson

Radiation:
As it turns out, my radiation oncologist says they can treat the rib tumor again, since I didn’t get too much radiation the first time.  I’ve already had my mapping session, and I start radiation next week.  This will greatly accelerate rib tumor healing.  It will likely make me even sleepier next week.  So if you call or text next week, you may not hear from me for a while! But weeks 2 and 3 will be better, because of my better overall health.  Outdoor meetings are definitely possible!

Thank you so much for your continued prayers!  It’s definitely helping!

Don’t fear, but be smart,
Erik

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Cancer Update 17: Some sobering news

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Dear friends,

I have some sobering news.  I had a PET scan on Tuesday and it appears that the rib tumor is trying to make a comeback.  My original treatment plan had just 4 rounds of chemo, and then immunotherapy after that.  While the chemotherapy worked well, it appears that the immunotherapy has not been as effective as was hoped.

As you can see in the images, the rib tumor was basically absent in the March 30th image, but has reappeared in the image from this week (July 1st).

The rib tumor is essentially gone. You can see the “expansile” nature of the damaged rib in the March image. The extra green you see is background activity in the liver.
As you can see, the rib tumor has reappeared, although still much smaller than the original size.
The primary lung tumor is very faint in this image, and the rib tumor is gone.
The rib tumor is still smaller and less hypermetabolic (Cancer cells use lots of sugar, which makes them light up in a PET scan. This is called hypermetabolism) than it was before.

We met with my oncologist this morning.  Since the chemo was effective last Fall, and the tumor is now much smaller than it was back then, he is very hopeful that it will be effective again.  While we will do another Next Generation Sequencing test to determine the genetics of the tumor, he expects that it will not have changed significantly since the first time.  So the same chemo treatment should still be effective.  Tentatively, we plan 6 rounds this time, instead of the 4 we had before.  We will likely start next Thursday.

I’m in much better shape this time than I was last time.  Last time, I was still struggling with serious complications from my pleural effusion, and the big infection I had.  This time, I’m in generally good health, much stronger, and doing well except for the remaining rib pain. The lung tumor has not returned.

All this to say, there is a lot of reason for hope.

But my hope is not just in technology.  Our God is the Maker of heaven and earth (a Hebrew idiom for everything!) and He does whatever He wants.  Man does not live by bread alone, but by every Word that proceeds from the mouth of God (Deuteronomy 8:3, Matthew 4:4).  This means that if God says I will live, then I will live.  We have already experienced legitimate miracles during our journey, and I am confident that we will experience more.  God isn’t finished with me yet!

Once I start my new treatment, I expect to be tired and somewhat immunocompromised, so I’ll need to stay close to home again.  My energy permitting, I’d love to hang out with you in the warm sun in my backyard. 

If you are a praying person, I would of course love to have your continued prayers.

Don’t fear, but be smart,
Erik

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Cancer Update 16: Improvement and Travel!

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A brief cancer update today!

As I said in my last update, March was a difficult month. Despite some great test results, my nerves were growing back and causing some extra pain in my torso.

April and May were much better! I had steady progress in my nerve and muscle pain in my torso every week! I also started doing exercises in the pool, under the instruction of my physical therapist. The climax of this was a bunch of traveling that I would not have dared to attempt a few months ago!

A week few weeks ago, I went to Virginia to visit my parents. My sister lives there too, and my brother came out from Montana as well. It was great seeing everyone, and they were happy to see that I was doing well! I was a little concerned about walking through the airports and lifting my bag into the overhead, but all of that stuff went well! I was very pleased!

Kathy and I on the plane waiting for takeoff.
Broose, Gretchen, and I in Virginia. So great to be together!

Then, just last week, we took a road trip to Oregon! I was even more nervous about this trip, because it involved a lot of driving, which has been difficult for me in the last few months. Thanks to the good lumbar support in my wife’s Highlander, the trip went well! This was a milestone in my recovery, and demonstrates that I am ready to do more than I have been doing so far!

Driving back from Oregon, between Klamath Falls and Weed. Yes, that’s the magnificent Mount Shasta in the background. Before this trip, I hadn’t driven any farther than Orange County!

I’m very thankful that everything went well!

My next PET scan is at the end of June, and I will let you know the results!

I actually plan to go back to work part-time this month! I’m looking forward to getting back to normal life!

Thank you so much for your continued prayers!

Don’t fear, but be smart!
Erik

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Cancer Update 15: A Great Test Result, Suffering Part 2

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This a cancer update.  I’ll talk about continuing challenges with recovery, a great PET scan result, and I’ll revisit my post on suffering.

Overdoing it: In my last update, I wrote about my triumphant climb up a local peak, using my newly added lung capacity after a cold.  The next day, however, I was surprised to discover that my sore torso muscles were even more sore.  As an aside, my physical therapist said this should be no surprise that after walking only on sidewalks for months, a lot more muscles are needed to walk on a rugged trail!. 

It’s been a month since then, and my abs, back and side muscles on the right side continue to be very grumpy, keeping me from going on my longer walks, and occasionally even preventing me from sleeping.  I’ve sometimes been discouraged by the regression of some of my capabilities, and I’m even trying to re-dial in my pain meds. 

Kathy suggested that maybe my nerves near my broken rib are healing, and maybe this is causing some extra pain, kind of like how a cut may become more sensitive a week or so after it starts healing, as the nerves in the area start working again. This seems to be true.  I have some patches of skin that used to be numb that are no longer numb, and others that now feel normal!  So my nerves are recovering!

March PET Scan: I just had a new PET scan on Monday, and the results are great!  The tumor on my rib is basically gone, and the primary tumor in my lung is now very small, just a faint reminder of what it was!  This is obviously great news!  I’ll have another scan in June.

The lung tumor is much reduced, now with low levels of increased sugar uptake.
The rib tumor is essentially gone. You can see the “expansile” nature of the damaged rib in the March image. The extra green you see is background activity in the liver.
The primary lung tumor is very faint in this image, and the rib tumor is gone. I had to guess where the rib tumor was!

Suffering, Part 2:  This section contains significant Christian content.  Way back in October, I wrote a piece on suffering.  The slow recovery of my torso muscles has caused me to reconsider this topic, and I’ve realized recently that the piece had a few key missing parts.  A video I saw recently offered a commentary on those missing parts.  The below video is humorous and charming but is also required watching for what I write next:

The little English girl is complaining about her great suffering to her mother.  She implies that she wants her mother to relieve her of the great burden of carrying her backpack. 

As adults, we know that her life will face many more challenges in her future than just the carrying of a 4 pound pack.  In fact, we know that in order for the little girl to learn to face these challenges, she may as well learn to carry her burdensome load to school. In order to build her character, the little girl must, in fact, carry her backpack to school. 

Kathy and I have felt strongly for some time that the challenge we are going through right now is training for what will come later.  But I won’t always have cancer, and Kathy won’t always need to cook and clean for me, manage my medications, run all the errands, and do the extra paperwork necessary to get us reimbursed for our medical expenses.  We probably won’t have to carry a burden like this again in the near future, but we will probably need to help others carry their burdens.  In fact, we have a friend who was diagnosed with cancer just a few weeks ago.  We have encouraged him and prayed for him often in the last few weeks, with an authority that we wouldn’t have had without our recent challenges.   Your suffering will give you extra authority to help others.

Suffering changes us.  As a general rule, people who suffer either start to degrade and become worse and more miserable, or they become wiser, more seasoned, and more useful to those around them.  They become bitter or better.  How you respond to suffering will determine which way you go.

If you’re suffering, don’t do the following:

Fixate on your problems: Focusing on the negative is depressing and self-defeating. While facing reality often requires us to face negative aspects of our situation, fixating on them is not healthy, and can keep us from progressing.  Wishing things were different is a waste of time.

Blame others for your situation:  Yes, others may have contributed to your situation.  But you can’t control their behavior, and they may not be willing or able to help you get out of it.  Focus on what you can do instead, and what support you may be able to get from those who may be more helpful.

Plot revenge:  It’s a big waste of mental effort ruminating on how to get revenge on those that harmed you.  Your effort is far better spent considering how you can help yourself.  Plus, we can’t all be Edmond Dantès.  Most of us are not clever enough to pull off the perfect crime.  You’ll probably end up in jail.

Hide from God. It’s actually OK to be angry, even at God.  Read the Psalms to see how open David is with God.  It’s actually much better to be honest and open with God than to hide from Him and not pray.

Instead, do the following:

Continue to be grateful for the good things in your life.  Gratitude is the super weapon of a balanced life. Remembering the good things in your life helps you stay positive and have the proper perspective.  Thanksgiving is not a preview for Christmas.  Use it to remember the good things in your life, even if you have cancer.

Learn to accept help.  Type-A people like me like to get stuff done.  But you may find yourself in a position where you have no choice but to accept help from others.  It’s ok.  We all need help sometimes, and accepting help from others will also make you more gracious when others need your help.

On the other hand, don’t complain if your loved ones can’t help you.  Remember that your caregivers carry a special burden during this time.  They deeply want to help you, but they often feel helpless to do so. Try and reserve your complaints to things they can help with.  Telling them everything may add extra burdens that they don’t need to bear.

Ask, what can I learn from this?  I know a lot of people that have prayed for patience.  What they don’t realize is that God doesn’t usually give us patience by magically bestowing patience on us. Instead, He puts us in a situation in which patience is required, then gives us the perseverance to endure it. After the challenge is over, we find that we can endure a lot more than we could before.  Your suffering is probably like this, slowly and secretly teaching you new ways to face life’s challenges and making you a stronger person.

Ask, how will my experience help others? Am I learning things that others may benefit from knowing? Who in my life may be willing to accept this information? Who can I help right now?  Helping others is a wonderful and productive distraction from your suffering.

Ask, did I contribute to my suffering?  Can I undo some of the things I did?

What can I do to change my situation? Take responsibility for your situation and do what you can to change it.

What can God do to change my situation?  This is a trick question.  He can do anything He wants to, but we tend to forget that.  He may not take away your suffering, but He can bring people around to support you, give you great ideas to fix things, give you perseverance, give wisdom to your doctors, and yes, even heal you.

Pray.  Prayer is not a last resort.  It’s a first resort.  God can do a lot of things that you can’t.  Prayer is also the primary way that God transforms you into a better person.  When you are suffering, prayer is essential.

Forgive whoever may have wronged you.  Sometimes we have been wronged, even deeply wronged, by others who have caused us suffering.  But being angry at them and saying “if only they hadn’t done this to me” is of very little value.  In fact, it’s very likely to do much more harm than good.  Someone once said, “being bitter against someone is like drinking poison and expecting them to die”. Even if they’ve harmed you greatly, and even if you have a right to be angry, you have to let go of your anger for your sake.  This is very difficult. So difficult that often we can’t do it without God’s help.  Start by praying for them (Matthew chapter 5).  It becomes very difficult to hate those you are praying for!

Believe me when I tell you that I haven’t mastered the above list.  I write this as much to remind myself as to tell you.  I have had to remind myself of the above many times in the last few months.

Don’t fear, but be smart,
Erik

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Cancer Update 14: Progress from an Unexpected Source

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As you know, I’m done with chemo and radiation treatments, but I’m still recovering from complications stemming from my cancer. I have some medium news and some great news to share today!

Rib progress: First the medium news. I wanted to find out how close my broken rib was to being intact, so I asked my chiropractor to take an X-ray of the area and send it her radiologist.  The results were different than I expected.  First, there is some confusion about what ribs were affected.  Some radiologists say the 8th rib, some the 9th, and some both.  This radiologist says both.  The great news is, the 8th rib seems to be intact, and is pretty much healed.  The 9th rib however is a much more complicated story. The next paragraph and photos may be TMI for some.  If you’re easily grossed out, you might want to skip them.

I always thought the rib was merely broken and the cancer had damaged the bones on either side, creating a space in between them.  This may have been true for the 8th rib, but the 9th is another story.  Instead of breaking the rib, the tumor got inside the rib and pushed material outward, creating a kind of bubble of material, see attached photos. My bone cells may remodel this rib back to looking normal, or they may just leave it be. Only time will tell. 

Figure A shows a hot dog shaped area of “expansile” bone around the 9th rib, clarified in Figure B.

The continuing damage to my 9th rib may explain why I have persistent tenderness in several of my torso muscles, making things like bending over and sitting in an office chair for long periods difficult. Physical therapy is definitely helping, but it will take a while for my muscles to adapt.

Lung capacity: Now for the great news!  Until last week, I hadn’t had a cold in years.  On the few occasions that I coughed or sneezed, it was extremely painful.  My ribs have been much better for the past few months, and I finally caught a cold last week.  I did A LOT of coughing and sneezing, but it wasn’t nearly as bad as it might have been earlier.  As it turns out, all that coughing helped break up material in my lungs and helped them dry out.  After my cold, my lung capacity had improved a lot!  My cold was a blessing in disguise!

I have a device called a spirometer that kind of measures my lung capacity.  After my cold, I could max out the spirometer easily!  So on Sunday, Kathy and I decided to see if I could climb a local small peak, Mount Calavera, on a hike I often do with a neighbor.  We went up slowly and methodically, but I only needed to stop twice and we made it to the top!  I actually see this as a big milestone!

Climbing the steep east slope of Mount Calavera. Brought my trekking poles so I didn’t lose my footing!
The view of the ocean from the top was particularly gratifying! On September 13th, I could barely get out of my hospital bed without passing out!
My wife Kathy is always by my side!

Fear not, but be smart,
Erik

Cancer Update 13: Gradual Progress

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It’s been more than a month since my last update!  To recap, a PET scan showed that the primary tumor in my lung has shrunk a lot and the secondary tumor on my rib is essentially gone. While it seems to me like progress since then is more gradual than I’d like, I definitely see some nice milestones as I look back on the month. While I’m done with radiation and chemo, I’m still getting immunotherapy infusions.

First, I was able to quit taking my last opioid medications a few weeks ago!  This granted me the wonderful freedom of being able to drive again!  My first solo trip was to grab a carne asada burrito with some friends.  I’ve really enjoyed being able to drive myself around again (not too far!), and Kathy has enjoyed a little time to herself at home!

I’m continuing with my physical therapy.  My posture is much better, and I’m not so hunchy anymore.  A lingering issue is that the muscles of my right lower torso are still quite grumpy.  My PT thinks it’s because they are trying to stabilize my rib cage because of the broken rib.  While my muscles are loosening up and I’m making progress, I won’t be totally back to normal until my rib completely heals.  My oncologist thinks the remaining pieces are about a centimeter or 2 from each other now, so it will still be a while before they come together completely.  It’s still a challenge to pick up something off the floor, or to pick up something heavy. 

My lung capacity is not back to normal, but I have made big progress.  We go for a walk in our neighborhood almost every day.  When we first started, I could only make it about 25 yards before I had to come back.  Just yesterday, we walked our pre-cancer route, which is 2 miles, with 2 uphill sections.  I have to take it slow sometimes, but it’s very nice to know I can go that far.  When I return to work, I’ll need to be able to walk quickly around airports to travel again!

That’s all for now.  I may not send out another update until after my next PET scan, which will be late March.

Keep praying for better lung capacity, that my rib would heal quickly, and that my torso muscles would settle down.

Don’t fear, but be smart!
Erik

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