Cancer Update 12: Post Treatment PET Scan

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Friends,

On Monday, I went in for my PET scan.  In this procedure, radioactively labeled sugars are injected and allowed to be taken up by cells in the body.  Because cancer cells particularly love sugar, the radioactivity mostly ends up in the cancer cells.  Scanning for radioactivity highlights the location of tumor tissue.

While not gone, the size of the lung tumor is much reduced. The chemo agents will continue to work for a few more weeks, and the immunotherapy will take care of the rest. Prognosis remains good!
While some concentration of sugars is apparent at the rib site, my oncologist said the rib tumor is essentially gone.
A 3D image, before and after for both tumors. The rib tumor is essentially gone. Technically, the dimensions of the lung tumor is a little smaller, but you can see that the tumor is much narrower and smaller by mass.

Earlier this morning, we met with our oncologist, and he was very happy with the results!  There is some of the lung tumor left, but the rib tumor is essentially gone.  He said we won’t need to do any more chemo, but we will continue with the immunotherapy.  Even though we’re all done with chemo, it will actually continue to work for a few more weeks. 

Since immunotherapy is so new, it’s not really known how long it we will use it.  The initial studies were done for 2 years, so he’s saying we’ll potentially go for 2 years, but he also said there’s a good chance we’ll stop early, depending on how things go.  I’ll get another PET scan in March to see how things are going.

So the news is good!  I still have limited lung capacity, which I’m looking forward to getting over, but I’m steadily improving if slowly.  My visits to physical therapy are producing improvements to my posture and strength too.

Thanks for your continued prayers!
Erik

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Severe Avian Influenza Case in Louisiana.

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Happy New Year!

This is a note about the current Avian Flu epidemic spreading among poultry and dairy farms in the US, and which has been in the news in the last few days.

In the last few years, an H5N1 strain of the flu has been spreading among commercial poultry and even dairy farms, causing a lot of trouble for farmers, including the culling of animals.  According to the CDC, 66 humans have been infected in the US during this same time period.  So far, all of these people were infected because of close contact with birds or cattle.  There is still no human to human transmission.

The reason avian influenza is in the news right now is that there is a case of severe disease in a human in Louisiana.  DNA sequencing has been done on the strain in this case, and it appears that there was significant mutation that occurred in the infected individual.  Mutation in a human host makes it more likely that the new strain may be able to infect other humans directly.  The mutations were in the Hemagglutinin protein, the protein from which the H in H5N1 is derived.

Structure of the Influenza Virus. Hemagglutinin and Neuraminidase are surface proteins that mediate infection in animal cells. These proteins are when the H and N designations come from in H5N1.

Again I want to be clear that no human to human transmission has been detected as of yet, so there is not yet any need to go into COVID mode!  However, if you work with poultry or cattle, you should be more cautious.  Wash your hands regularly, and make sure fluids from your animals stay out of your mouth, nose or eyes.  This includes milk!  If you drink raw milk, make sure you are getting your milk from a source that performs regular testing for flu.  Also, if you have back yard chickens, you should limit your birds’ contact with wild birds by keeping them in a coup with a roof, even one made of wire is fine.

As usual, make sure chicken products are cooked thoroughly before consumption.

There has also been a significant number of cases in house cats.  If you can keep your house cat indoors, it might be a good idea to do that until things die down.

The State of California has declared a state of emergency regarding this flu outbreak.  My opinion is that this is premature, since we still don’t have human to human transmission.  I will continue to monitor the situation, and will let you know if more concern is warranted.

Don’t fear, but be smart!
Erik

Cancer Update 11: “Friday”

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Last week was probably my last hard week after an infusion, as I probably won’t have another chemo infusion!  So to extend my analogy from my “Wednesday” post, it’s now “Friday”!  I should be feeling better from here on out.  My chemo oncologist also said no more immunotherapy until they see the results from my PET scan on December 30th, so I get a nice little Christmas vacation from my immunotherapy too!  My next update will probably be after the 30th, letting you know my PET scan results.

I was pretty sleepy this time, and my fatigue from chemo my have been compounded by the immunotherapy.  There are other potential side effects from immunotherapy, but happily, I didn’t really experience any of those. The sleepiness just lasted a few extra days.

I had an appointment with my physical therapist for the first time in many months.  I had a laundry list of things to work on, and it will take us a while to work through them all.  I lost significant strength and muscle mass while in the hospital, so I worked on a bunch of exercises primarily designed to improve my leg and core strength, and to improve my posture, which has gone funky since my hospital stay. I’ve gotten started on doing my exercises at home and I’m looking forward to improvement.

Strengthening my upper back muscles
This looks like a wall sit, but it’s mostly for working on my posture.

Please continue to pray for improved lung capacity.  I’m still short of breath, meaning that my Vital Capacity, the volume of air that I can breathe if I exhale as much as I can, then inhale as much as I can, is still lower than it should be, and I have to take more breaths when I go for a walk.

Don’t fear, but be smart,
Erik

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Cancer Update 10: Last Chemo Infusion, First for Immunotherapy

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This is a cancer update.  Yesterday I had my last of 4 expected chemo infusions, and my first of many immunotherapy infusions.  I mentioned before that I take an anti-side effect medication for the first weekend, but I’ll be fatigued for some of next week.  There may also be some additional side effects from the immunotherapy, Keytruda.

I’ve been very cautious about getting sick up until now, since I didn’t want to have to postpone treatments.  But after next week, I’ll probably start being more free to “move about the cabin” as it were.

Writing this very blog, earlier today! Broose and his wife Penny bought me this sweet chair, which practically dumps me out of the chair if I want. Super comfy!

This last round has not been without drama.  On the Sunday right after my last infusion, I passed out twice within a few minutes of each other.  I was probably only out for a few seconds both times.  I ended up going to the ER but my visit there was actually pretty uneventful.  They couldn’t really find anything, and said it was pretty much just the chemo.  So Kathy took me home after a few hours, and I’ll just need to remember to get low right away if I get lightheaded again. We’re always thankful when they don’t admit me!

My chemo side effects have been quite mild, which I’ve been very happy about.  I threw up a lot after the first infusion, but not the others, which is great.  I have another kind of amusing side effect of chemo that I’ve never been aware of.  My skin is shedding a lot, kind of like full body dandruff!  Kathy jokes that it’s like having her own personal snow globe!  Every time I change my clothes, there’s a flurry of “snow” as I fold them!  Kathy even says that I look younger with reduced age spots!  And no, I don’t recommend this method of exfoliation! Anyone else have this side effect?

After a low weight of 165 lbs, I’m back up to 180, which is great.  I’m going to take a little pause from the weight gain until I can start meeting with my physical therapist on the 16th.  My target weight is 190 to 195, and I want to put on some muscle instead of fat!  So I’m cutting back from 2 bowls of ice cream a day to just one!!  Favorites are Mint Chip, Mocha, and Cherry from Tillamook.  This is just an interesting detail.  Please don’t leave a bunch of ice cream on my porch!

A little detail about my daily life is that we love Gospel music and I’ve have fallen into the habit of waking up to “You are the Living Word” and “Give Me a Clean Heart” by Fred Hammond. They’re great songs, with great bass lines, of course.  I try and get out of bed before the first one is over!

Back to the medical side, my prognosis remains good and my tumors are shrinking faster than anticipated.  I’ll get a PET-scan on the 30th.  For this test, I have radioactive sugar injected, then wait 45 minutes for the cancer cells to suck it up.  Cancer cells love sugar, and quickly absorb the radiolabeled glucose.  Then I get scanned in a specialized scanner and see how the tumors look.  PET scans are the most sensitive way to detect tumors and allow doctors to see even small tumors wherever they are.  My chemo oncologist expects that my rib tumor will already be completely gone, and that my primary lung tumor will be much reduced.  The chemo will continue working for awhile, and the immunotherapy will continue for to up to 2 years!

A word on immunotherapy.  As mentioned in Update 7, immunotherapy agents cause T and B cells to attack tumor cells.  Some tumor cells express a surface protein called PD-L1.  This protein causes the immune system to see the tumor as “self” by binding to the PD-1 protein on T and B cells.  Keytruda stops these proteins from binding to each other, causing the T and B cells to see the tumor as alien.  Unfortunately, this can cause some normal cells to appear alien as well, leading to some side effects.  My autoimmune disease is not expected to be impacted by all this, but I’ll need to be monitored to make sure.  My oncologist says that since my tumors have a lot of PD-L1, this therapy may work especially well on my tumors.  Depending on how I respond, I may end up being on Keytruda for up to 2 years!!

Please continue to pray that my tumors will become normal lung tissue and not scar tissue.  I’ve also had some shortness of breath for the last 2 weeks, but I’ve seen some improvement over the last few days.  Pray that my lung capacity improves!

Merry Christmas and Happy Hanukkah,
Erik

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Cancer Update 9: “Wednesday”

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Friends,

Today, I just have a brief update.

My 3rd round of chemo started with an infusion yesterday. For the first few days of a new round, I’m on some extra medication that counteracts some of the negative side-effects of the chemo agents.  So while I’m on those medications, I’m actually feeling really good!  Those medications will run out on Sunday, so starting Monday is when I start “Fatigue Week”, which for me has been just sleepiness.  Until then, I’m actually feeling good and can do my normal 2 short walks a day, and even do my stair exercises.  “Fatigue Week” has generally lasted just from Monday to Thursday or so, and then I’ve been turning a corner on Friday, which I expect to happen this week as well. 

I usually go on 2 short walks a day. Then I do 5 sets of stairs after my walk, trying to regain muscle mass after my long hospital stay. It’s already making a difference!

I caught a very mild viral infection this time, and had to be more strict on having visitors.  Fewer visitors, and always meeting out on the patio from now on.  Despite that, my White Blood Cell count remained fine for a person on chemo, so my 3rd round started on time.  I also finished my radiation treatments on Friday, November 8th, so I’m very happy to be done with that.  Now it’s just chemo, and immunotherapy starting with my next chemo round in early December.  People tolerate immunotherapy very well.

Because I’m halfway through chemo, Kathy remarked that it felt like “Wednesday”, like we just have to endure a few more days before the welcome end.  Everyone from students to adults in the workplace know what that feels like!

Right now, I’m thinking as if my chemo journey will end around December 14th, when I’ll emerge from my “bad week” for that round.  Then I’ll need to start working out, regaining the strength I lost while in the hospital.  It’ll take me a few months to get back to my ideal weight, and be ready to travel again.  So by Christmastime, I should be mostly back to normal.

Results continue to be very good, and my prognosis remains very good!

Thanks again for all your prayers!  We continue to pray that my tumor tissue will become lung tissue, and not just scar tissue, to maximize my hiking, backpacking and skiing abilities, some of my favorite activities!

Also pray that my broken rib will heal quickly! We still have no idea how long it will take, but it will be much longer than the usual 6 weeks, since the pieces are not sitting right next to each other yet, but have to grow together before they can mend.

Don’t fear, but be smart,
Erik

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Discourse

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This note is on political discussions, but it is neutral in perspective!   I will not advocate for any political worldview in this post.  My goal instead is to help all of us have better discussions regarding politics or anything else. I’m going to share my own method for having productive discussions.

Especially in regard to politics in 2024, the 2 sides have different and mutually exclusive worldviews, different sources of news, different definitions to terms, and even different commonly understood “facts”.  We can’t take anything for granted when having discussions on politics right now.

In my posts on COVID, in my daily life, and even in my recent post on politics, I often employ 2 questions which help me navigate conversations.  These questions are so helpful, I recommend everyone use them in every conversation about important or controversial matters.  These questions are:

1.   What do you mean by that?

2.   How did you come that conclusion?

These questions originally come from a book called Tactics, by Greg Koukl.  This book is intended for use by Christians as a tool to help them discuss the Christian worldview.   I recommend that every Christian read it.  But these questions are so useful, that they can be used when discussing any topic: worldview, politics, science, history, or anything else.  Of course, there are many variations of these questions you can use.  Here’s why these questions are so useful.

1. What do you mean by that?
Many people don’t have a clear understanding of their own view, or topics they are discussing.  It can be very helpful when starting a discussion to make sure everyone is working from the same definition of terms, or the same understanding of an issue. For example, if you are in a discussion and the topic of racism comes up, it might the very helpful to ask your conversation partner what they think racism is. 

This question is also very helpful if you just don’t know very much about the other person’s view.  You can simply use this question to learn about their view.  You can have a very productive discussion just around asking this question and learning their view.

    If things get heated, you can always just go back to asking clarifying questions until things cool down.  Discussions work best when everyone is calm and adrenaline is low!

    The flip side is this.  When going into a conversation on a contentious issue, you should have a firm understanding of your own view, the words you will use, etc.  If your conversation partner asks you this question, you should be able to answer them!

    It’s actually very common in today’s discourse for people to not be able to answer this kind of question.  People often assume that their own view is the commonly held one, only to discover that other people don’t agree.

    2. How did you come to that conclusion?
    It is almost universal that people make a claim in a conversation like this, and then the other person makes a counter claim.  This is actually a bad way to communicate and leads to a lot of misunderstanding and heated rhetoric.  It’s also a lot of extra work.

    If you are having a conversation with someone, and they make a claim, you don’t have to make a counter claim.

    For example:
    Person 1: Trump is a Nazi!
    Person 2: No he isn’t!

    Or

    Person 1: Harris is a commie!
    Person 2: No she isn’t!

    In both examples, Person 1 makes a claim. In this form of discussion, the person who makes the claim bears the responsibility of providing evidence for their claim.  But far too often, Person 2 doesn’t require any evidence and instead does Person 1 a big favor, relieving them of the burden of proof.  By making a counter claim, Person 2 is actually accepting the burden of proof! Now it is Person 2’s responsibility to back their claim!

    Don’t do this!
    Person 1: Trump is a Nazi!
    Person 2: No he isn’t!
    Person 1: How do you know?

    Person 2 has accepted the burden of proof and now must back their counter claim. Don’t do this!  Don’t do the other person’s work for them!  Instead, make the person who made the claim back the claim!

    Do this:
    Person 1: Harris is a commie!
    Person 2: Really? What makes you think that?

    Now Person 1 has to give their reasons why they think Harris is a commie.  In conversations like this, most people don’t actually have evidence for their claim.  If you just ask them to back their claim, they usually can’t.

    Person 2 can save a lot of time and effort by making Person 1 do their own homework. Almost always in today’s dialog, Person 1 can’t back their claim.  This is because most people learn these things from dubious sources, like a friend, the water cooler guy at work, or an obviously biased news program.

    Here’s the flip side.  What if you are Person 1, and you want to make a claim?  Don’t make a claim unless 1 of 2 things is true.  First, you have a good source for your claim. Or second, you are willing to go find the source after the discussion is over.  If this discussion is with someone you see often, it’s no problem to go get the source and then discuss it again.

    Using this question often does 2 things. If you’re Person 1, it will keep you accountable to not make claims you don’t have evidence for!  It’s OK to say nothing in a conversation!  It may be better than to get yourself into a situation in which you or your view look silly.

    Again, it’s OK to make a claim without evidence IF you’re willing to go find it later.  This can open up a chance for another conversation, which may actually work out well for you.

    If you’re Person 2, it saves you A LOT of effort.  You don’t have to work so hard to prove the other person wrong, because you aren’t responsible for the evidence! Of course if Person 1 does have the evidence, then you need to provide your own evidence, or even change your view if it turns out to be wrong!

    Your goal is the truth!
    VERY IMPORTANT! Your goal is not to win an argument! Your goal is actually to arrive at the truth!  If it turns out that your conversation partner has better evidence than you, it may mean that your view is wrong!  It’s obviously OK to abandon your view if it’s not true! 

    I really think that if everyone used these 2 questions all the time, we would have much more productive discussions.  People would be much more careful about the claims they make, and we would waste a lot less time on fruitless and rancorous discussions. You can start using them now, and train your friends bring receipts to your next discussion. You’ll be having more productive and less heated discussions in no time!

    Don’t fear, but be smart,
    Erik

    For more on being persuasive, see my COVID era post on science communication.

    Cancer Update 8: 2nd Round of Chemo, New Walking Stick

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    This is a super brief update! I’m in my first week after my second infusion. I was concerned that since it’s my second round, that it might be worse than the first. But Kathy reminded me that I’m in much better shape going into the second round than I was during the first.

    When I got out of the hospital, I could barely walk 25 yards and get back home! Now, I can walk about a quarter of a mile uphill, to a nearby street corner. Kathy was right! Aside from some sleepiness, this round is indeed much better than the first. This makes me optimistic that my 3rd and 4th rounds will be better still, especially since I’ll be done with radiation at that point.

    I’m able to hold down food, and I’m stoked to report that I’ve actually gained 5 pounds over the last week! My job is literally to eat and drink right now, so I’m glad I’ve been successful! Pray that I can continue to gain weight, and that my broken rib will grow back together nice and straight!

    Also please pray for my wife Kathy. Patients get all the attention, but caregivers bear a great hidden burden during this time. Pray for perseverance and peace!

    My good friend Chris McGaugh made me a new walking stick! He made it from Douglas Fir, my favorite tree, and delivered it this morning.

    InterVarsity folks, the rock set into the top of this custom walking stick is from Campus by the Sea!

    Don’t fear, but be smart,
    Erik

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    Cancer Update 7: Start of Round 2, How do Radiation Therapy, Chemotherapy, and Immunotherapy work?

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    I’m going to share a brief update, and then give you some information on how my treatments work!  In my private discussions with some of you, there is some curiosity about radiation, chemo, and the immunotherapy that I’m using to get well.  So I thought I’d give some details on those things.

    I also want to say before I start, that I’ve also learned from several of you that you are going through your own journeys with major health problems right now, including cancer.  Know that I am praying for you!  May God take care of you just as He has been taking care of me!

    Update:
    My first infusion was October 3rd. The nurse told us that the worst days were 4-10 days after infusion and she was right! I was miserable and wiped out the following Tuesday!

    I’m doing much better now, and enjoying the break. My next infusion is this week, on the 24th. I’m half way done with radiation treatments on my primary tumor, and my last radiation is on November 8th. So my last 2 infusions will happen after radiation is over. So this next one will likely be the worst, but the last 2 infusions are likely to be easier than the first 2!

    My last infusion is on December 5th, and I’m looking forward to feeling much better in December.  Hopefully by Christmas, I’ll basically be back to normal.

    My pain is low enough now that I’ve started to work myself down from the opioids, which is lowering some of the negative side effects from an already low dose.  The doctors are pleased at this news! I’m also able to eat more, so I’m working on gaining some weight. 

    We are so thankful for the support of friends and neighbors that we continue to get.  Your prayers have been an important part of my progress, so keep it up!

    Radiation:
    Radiation is a common cancer treatment because it’s less invasive than surgery, but it’s still quite effective at killing cancer cells.  It works by damaging the DNA of cancer cells, leading to the self-destruction of the cells. 

    X-ray radiation is the most common.  An emitter looks like a giant microscope and moves around the patient, firing hundreds of X-ray beams in sub-lethal doses.  Only the tumor receives a lethal dose of X-rays. The CT scan measurements are exact and treatment plans are done by a physicist for each patient. In fact, a physicist and doctor need to be present and approve how the machine is lined up with the tumor every day before they start the radiation treatment!

    An X-ray therapy instrument. The large piece with a glass pane right behind the patient’s head is a CT machine that does a mini-scan every time I go in, to make sure that my body is properly aligned with the map that they have. The gray plate on the right detects the x-rays from the CT machine after they go through the patient.

    Inside the instrument, an electron beam is created by a cathode ray tube, much like the ones that used to be in the old tube televisions.  The electron beam strikes a tungsten plate  The electron beam is absorbed by the plate and transformed into X-rays that are emitted by the tungsten plate.  These X-rays then pass through a lead aperture that shapes the beam into just the right configuration for the shape of the tumor at that angle.  This aperture is made of lead “leaves” that actually move to shape the beam as the emitter moves around the patient.  Yes, I can actually see the aperture changing shape as the emitter moves around me! 

    Inside the instrument, an electron beam (B) is created by a cathode ray tube (A), much like the ones that used to be in the old tube televisions. The electron beam strikes a tungsten plate (C). The electron beam is absorbed by the plate and transformed into X-rays (D) that are emitted by the tungsten plate.

    These X-rays then pass through a lead aperture (E) that shapes the beam into just the right configuration (F) for the shape for the tumor at that angle. This aperture is made of lead “leaves” (G) that actually move to shape the beam as the emitter moves around the patient.

    Yes, there is a risk that the X-rays themselves will cause a new cancer tumor to form, but the likelihood is that if one does, it will take many years for the new tumor to cause a problem, after the patient will have passed away from natural causes.

    Proton beam radiation is much less common and much more expensive than X-ray treatment.  Protons can more easily be concentrated on the tumor and are less likely to cause a new tumor.  For these reasons, proton therapy is more commonly used on younger patients, to avoid the likelihood of producing a new tumor within the patient’s lifetime.

    Chemotherapy:
    Normal human cells have many molecular checks to their growth, making sure the cells don’t get out of control.  Cancer cells have mutations that turn off these checkpoints.  This is why cancer cells grow rapidly and can become dangerous.  Chemotherapy agents selectively kill cells that are growing rapidly.  Since cancer cells are growing very rapidly, chemotherapy agents kill them first.  Unfortunately, some normal cells in the body grow faster than others, like hair, gut, and blood cells.  This is why patients can lose hair, experience nausea and digestive problems, and suffer from low blood cell counts, or even become immunocompromised. 

    The good news is, on balance, chemotherapy is usually very effective at killing cancer cells, and many people have been saved through the use of these agents.

    As I said in my first 1st update, Next Generation Sequencing (NGS) testing can help doctors know if a patient will need to use certain chemotherapy agents.  My tumors don’t happen to be particularly interesting in this regard, so I’m just getting a “normal” first try set of chemotherapy agents.  NGS has definitely increased the survivability of cancer by helping chemotherapy work on the first try!

    Immunotherapy:
    The PD-1 protein exists on the surface of certain T and B cells of the immune system.  They work to inhibit the function of these cells in most conditions, making them tolerate “self” cells in the human body, helping to prevent autoimmunity.  If a person has cancer, “turning off” these proteins can make these T and B cells no longer recognize cancer cells as “self”, and attack them!  Immunotherapy agents like Keytruda inhibit the PD-1 protein, causing the immune system to attack some tumor types, like the cancer I have, non-small cell lung cancer.

    Prayer requests:
    I’m doing much better eating, and my goal is to maintain my weight through the next round of chemo, and to gain some after that.  Pray that I will be able to eat enough calories for that!  Thanks!

    Don’t fear, but be smart!
    Erik

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    Cancer Update 6: Why Do Good People Suffer?

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    Why do good people suffer?

    This is a long post with a lot of Christian content.  If you don’t want to read about Christian topics, then you should skip this post.

    When we suffer, or when we witness suffering, it is natural to wonder “why do good people suffer?” I have certainly heard stories that beg for an answer to this question.  Since my diagnosis in early August, I have certainly wondered the same thing at times.  Why am I going through all this?

    This also has theological implications. I am a Christian, and believe in God.  I’ve always tried to be a good person, and I think I’ve succeeded.  But I’ve been in pain for more than a year, and have had a very rough 2 months. If God is real, why would He allow this to happen to me? 

    God never promised His followers that they would not suffer.  Indeed, this world is broken, and as His followers live in this world, they should expect to suffer along with everyone else.  In Luke 14, Jesus urges his followers to count the cost of following Him:

    27 “And whoever does not carry their cross and follow me cannot be my disciple.”

    So why would God allow suffering?  There are several possible reasons:

    Freewill:
    God designed us to be free creatures, and make our own decisions.  These decisions can cause ourselves or others to suffer.  God cannot eliminate suffering without also eliminating our own freewill.

    To grow our character:
    It is a reality of our nature that we do not grow and mature when things are going great.  When things are good, we tend to do the same things we’ve always done.  But when we suffer, we try and figure out how to change what’s happening to us. This may lead us to reexamine how we are living and make changes to our attitude or lifestyle. We don’t really grow unless we are suffering.

    Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance. Let perseverance finish its work so that you may be mature and complete, not lacking anything. James 1:2-4

    … we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us. Romans 5:3-5

    To allow us to focus on important things:
    Suffering allows us to focus on what’s important.  Occasionally in Southern California, we have a nearby fire that forces us to get ready to evacuate.  When this happens, everyone has to look around and decide what they really want to keep, and what they could live without.  For many, the list of keeper items is short, mostly pictures and computers.  Everything else can go. 

    Timing:
    We don’t have the full picture, and God knows far more about what is happening now, and what will happen in the future. Very often, we want things to be different, but it’s just not time yet.  The right thing at the wrong time is actually the wrong thing.  There are things happening that we don’t see.  The right timing can make all the difference.

    The Mercy of God:
    In the Sci Fi movie Minority Report, police can predict the future, and will arrest people for crimes they haven’t committed yet. The question of the film is, is it ethical to prosecute someone for something they haven’t done yet? Observing God’s actions in the Bible, the answer is clearly no. God allows human evil. He will punish evil, but because of His love for us, He waits a long time to do it, sometimes longer than we want. He is waiting for us to turn away from evil, to repent, so that He can have mercy on us.

    In the book of Jonah, God sends Jonah the prophet to preach to the Assyrians in Nineveh (now the city of Mosul in Iraq). The Assyrians were the most vicious and cruel conquerors of the time. Jonah justifiably hated the Assyrians.  But God loved even the Assyrians and wanted to give them one last chance before destroying them. God withheld the punishment of the Assyrians because He wanted to have mercy on them!

    Read the short book of Jonah to find out what happens!

    To activate us:
    We had a friend and pastor who was one of those “crotchety with a heart gold” types.  He was usually grumpy, but he was also usually working hard to help people make their lives better.  He had a special gift with the military recruits at Camp Pendleton in particular.  When he passed away, we wondered, “what are we going to do without him.”  Then it struck me.  He had been teaching others to do what he did for years.  It was time for all those people he taught to start putting that training into practice.  Sometimes suffering helps us get going and do the things we’ve been trained to do.

    I don’t know:
    Another pastor was diagnosed with a brain tumor.  He was in pain for several years before he died.  To this day, I have a hard time with his death. I’m sure some of the above reasons apply, but I still have a hard time explaining it.  We have to admit, with our limited perspective, that we simply don’t know why some suffering happens.

    Does God understand our suffering?
    God knows firsthand the injustice of human suffering. We may think that God doesn’t care about our suffering because He’s up in heaven far removed from us.  But if Jesus was God in human form, then God experienced all of the suffering that we do.  His family was forced to flee as a baby and lived like refugees for years in Egypt, he lost a parent, he went hungry, he was lied about and betrayed by friends.  Finally, he was tortured to death using the most painful execution method in history.  When we think about the things we have suffered, we have to remember that God knows exactly what that’s like, because He has suffered them too. He knows firsthand the injustice of human suffering.

    So why did He go through all that?  Hebrews 12:2 says:

    2 …Jesus, the author and perfecter of faith, who for the joy set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God.

    This verse says that Jesus suffered all that “for the joy set before Him.”  What is that?  What joy was set before Him?  Jesus suffered all that so that He could get you! He wanted an opportunity to have you in His Kingdom!  Not you as an abstract person, one of 8 billion people on the planet, but you personally.  This is why he was satisfied with what He did, all He suffered.  Because He gained the opportunity to have you, the opportunity to have you choose Him!

    Many of you don’t believe in God, or can’t accept the idea that He exists.  I have a challenge for you.  If you really want to know, I challenge you to ask Him to show Himself to you. 

    A warning!  God doesn’t do parlor tricks! He won’t do something simply to satisfy your curiosity!  But if you sincerely want to know, I guarantee that if you ask Him, He will show Himself to you.

    If even one of you is in the Kingdom of God with me because of my suffering, because it caused you to think about life and death, it will be well worth it.

    “For momentary, light affliction is producing for us an eternal weight of glory far beyond all comparison.” 2 Corinthians 4:17

    Don’t fear, but be smart,
    Erik

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    Cancer Update 5: 1st Chemo, Tumors Shrinking

    All Articles, Cancer,

    I came home from the hospital on September 15.  It’s been great to be home! My focus has mostly been on healing, following directions, and getting ready for my chemotherapy sessions to start.  An ongoing issue has been that I lost weight in the hospital, which I should try and get back before chemo.

    So I’ve been exercising as much as I can, going for short walks, and doing limited workouts in my chair.

    Chemo
    I had my first chemo session on Thursday, October 3, on schedule.  The infusion took about 2 hours, and everything went fine.  I’ll have 4 sessions total, each 3 weeks apart, the last one taking place on December 5th.

    My first infusion. Yes, I’m saying “Let’s do lunch!”

    Tumors Shrinking!
    Thursday was a very busy day. After my chemo session, I actually had a late radiation session and a meeting with my radiation oncologist.  He told me that my tumors, both of them, were shrinking faster than anticipated.  Yes, both of them!  Even before chemo, he noticed that my primary tumor in my lung was shrinking as well.  It was shrinking about 3 times as fast as normal.  My doctor said “I can’t really explain such a change.” He seemed quite pleasantly surprised, and baffled at the some time.

    Abscopal Effect?
    If anything, he said he might attribute this to a phenomenon called the Abscopal Effect.  Basically, debris that is formed as the rib tumor starts to fall apart due to the first set of radiation treatments end up becoming material that the immune system uses to mount a defense against the second tumor.  The radiation starts killing the rib tumor, creating a vaccine that tells the immune system how to attack the primary tumor! Just to emphasize, even to my radiation oncologist, the Abscopal Effect is still theoretical, and is a very rare phenomenon to see.

    I recently graduated from a walker to a hiking stick.

    Today, Monday October 7, before my radiation treatment, they actually did a new mapping scan in order to re-calibrate because of the extra tumor shrinkage. 

    In short, your prayers are working!  Thank you so much for your prayers and keep it up!  I actually need extra prayer because chemo is making it hard to keep food down. Hopefully this will just be happening the first week.

    Don’t fear, but be smart!
    Erik

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