10/20/07 90 More Reasons to Smile

Family and Friends,

Gen and I met with the oncologist on Friday, and once again got the best possible news we could hope for. We received the results from the CT scan I had done on Wednesday, which was coincidentally (or not) the one year anniversary of my lung surgery. There are absolutely no signs of cancer. My odds get better with every passing CT scan, so things keep looking better all the time.

I'll continue to get scans every 90 days for the next 15 months, which will be 2 years after I finished chemo. After that the scans will come every 6 months for three more years, then annually for life.

The scan schedule gives us a pretty good feel for the expected risk. It tells us we can take nothing for granted. Given that, the doctors are still very optimistic, based on my exercise and dietary habits, attitude, and great support. Gen and I get more and more optimistic as well, though we can't help but get apprehensive during the time leading up to each scan. Head and heart don't always line up easily.

Thank you to everyone who sent their thoughts, prayers, participation, and/or donations for the LiveStrong ride/walk last month. The event was a success. For Gen and me, it was emotionally loaded and rewarding. We will definitely do this again.

For now, we have 90 more days - and 90 more reasons - to smile.

Love,

Dann and Genevieve

9/25/07 A Request for Your Support

Family and Friends,

It has now been 13 months since I was first diagnosed with lung cancer, 11 & 1/2 months since one lobe of my lung was removed, and 9 months since I finished chemotherapy. As of my last CT scan two months ago, I am still cancer-free. How lucky can a person be?

I have said from the beginning that I am a very fortunate person to have found my cancer early enough to aggressively treat it. I have gained a much greater appreciation in the time since then how truly fortunate I am, to have each of you to help me make it through this amazing alternative path my life has taken. I am now asking you to join me in helping others to beat their cancer back with a tidal wave of support.

Join me in the September 29th LiveStrong Challenge fundraising event for cancer research and advocacy. There are three ways you can help:

* Join my team! Join Genevieve and me as part of our very own Team Attitude on the 5K walk on Sunday, September 29th at 9:00 AM beginning at Nike World Headquarters in Beaverton. It's a mere 5K - HA! I was walking more than that a few days after surgery! That's 3 miles, and yes - you can do it! Here's the link: http://portland07.livestrong.org/faf/home/default.asp?ievent=219861

* Donate the big bucks! Okay, the little ones are great too! If you can donate even $5, please do so. Unless you are cashing in empty pop bottles to get enough cash to ride the bus, you can probably scrape up $5. My fundraising goal for Team Attitude is $1,000, and my personal fundraising goal is $800. Your karma will thank you. I will also thank you. The link to donate is: https://www.kintera.org/faf/donorReg/donorPledge.asp?ievent=219861&supId=190804810.

* Send your positive energy, prayers, and good vibes! I KNOW you have that in you. Please share the wealth!

With gratitude and love to you all,

Dann

11/8/06 3rd and Final Phase of Treatment

Family and Friends,

Recovery from surgery has gone very well. Since a week after surgery I have been walking up and down the hills of NW Portland twice a day for a total of about 6 miles on most days. I started back to work roughly half-time last week and 3/4 time this week. I also regained the 8 pounds I lost after surgery, so I don't have to run around in the shower to get wet any more.

I met with the oncologist this Monday and got the go-ahead to start my last two rounds of chemotherapy. This time I met her alone because on my way to the appointment I got hit in an auto accident. Gen volunteered to stand in the rain (It rained 2 and a half inches that day) waiting for the tow truck while I took her car to the doctor's appointment. This, my friends, is true love in action.

The accident rattled me and added to an already generous amount of vulnerability I was feeling as a let-down after the surgery. However, since there was a 1-year old baby in the other car, I feel especially grateful that it was only metal that got hurt.

The oncologist was very encouraging. She believes we already have eliminated all of the cancer, but the research supports doing a total of four rounds of chemo to make sure no stray cells are left. After that I will have quarterly CT scans to be sure.

I began my third round of chemo today. Three weeks from now I will have the final round. We timed it so I will be able to best manage Thanksgiving and my sister Dona's visit from Belgium, and so that I WILL BE COMPLETELY DONE WITH ALL TREATMENT BY CHRISTMAS!

Love,

Dann and Genevieve

10/22/06 On the Mend

Family and Friends,

I am pleased to say that recovery is going better than I could have possibly hoped for. I arrived home yesterday after four days in the hospital. Yesterday Genevieve and I walked to the top of our street and back. Today we walked just under a mile round-trip up and down hills to the park near our home, and we're planning one more walk this afternoon. The wounds are healing nicely, and I'm now off all pain meds except ibuprofen.

Thank you all for your support throughout this unexpected turn of events in Genevieve's and my lives. I am absolutely certain that it has made, and continues to make, this whole process far less difficult than it would be alone.

Having Genevieve with me has been the greatest blessing of all. She has put on a courageous face even during the most difficult moments, and her love had given me the fuel to keep fighting with everything I have. Once in a lifetime, if you are extremely fortunate, this kind of love comes along.

Love to you all,

Dann and Genevieve

7/15/07 Living Life, 3 Months at a Time

Friends and Family,

Last Wednesday I had my quarterly CT scan to see if there has been a recurrence of my lung cancer. I received a call from the nurse in my primary care doctor's office two days later, on Friday. She told me that my CT scan showed a "hyper-dense nodule" on my thyroid gland, and that my doctor wanted me to have an ultrasound that afternoon to see if it was cancer. Reeling from this latest news, I gathered my wits enough to tell her that I had an appointment scheduled with my oncologist two hours later that afternoon, and that after discussing this with the oncologist, the two of them could coordinate what the next step should be. She agreed.

Genevieve and I have been more worried about how this CT scan would turn out than we were before the last two scans. Further, our fears were brought to a raw edge since we had just attended the funeral of my friend Dwayne Elam. Dwayne and I shared a special bond while we both dealt with our cancers over the past year. Dwayne was the husband of Gen's cousin, and our families are close.

At the reception following the funeral we spoke with a woman whose husband had died two years ago, while still in his late 40's, from the same type of cancer that I had last year. Combine this with Dwayne's passing, and we were on edge.

When we met for lunch just before the appointment with the oncologist, I shared the news with Gen. She immediately lost her appetite. We were doing everything we could to rationalize how this new development was insignificant, right up until we met with the oncologist. It wasn't working very well.

That changed very quickly when we met with the oncologist. He told us that the "so-called nodule" was so miniscule that it was probably a computer mis-read (oversampling of nearby tissue), the wrong shape (regular edges), and the wrong location on the gland, to be anything to worry about. Further, it was an extremely unlikely place for the cancer to reappear. He didn't think it would have even been mentioned in the radiologist's report if I didn't have a history of cancer. It wasn't worth investigating further.

We got even more good news when the doctor told us that the chances of recurrence are greatest right after chemotherapy ends (almost eight months ago!), and grow smaller with every passing scan. We had thought that the cancer was more likely to show up after a year or two, when it had time to grow large enough to be detected on the scan. Instead, my odds are getting better every three months!

There are very few moments in life, if any, where you see the entire course of your future shift in a matter of moments. This was one of them. Fear turned to guarded joy, and we were ready to move on and live the next three months of semi-normal life. Rapidly re-developing plans for dealing with chemotherapy, work, relationships, and potential shifts in financial stability were all discarded before we left the room.

But not forgotten. We have become very aware of how all of our plans can shift at some three-month interval in the future. It makes the time more precious.

These fantastic results have reinforced my belief in the steps that I have been taking to beat cancer. I won't pretend to have a cure for cancer, but I think these steps are helping me. I hope they are of some benefit for you as well, even if you don't have cancer. I may not have any more wisdom than the next person, but I can tell you that cancer has made me think really hard about my priorities. Here is my master plan, in no particular order:

1. Remove the "cancers" from your life. This includes negative people, negative conversation with otherwise healthy people, television shows that focus on negativity and terror (think local news and some dramas), etc.

2. Bring as much joy as you can into your life. For me this is sometimes playing golf or watching basketball, or taking the time to listen to someone, and sometimes just taking the time to discover what I really like.

3. Treasure the relationships that are important to you. Making time for the people that bring meaning to my life, treasuring the moments I do have with these people, and thinking about them even when I'm not with them.

4. Making healthier choices. I'm exercising six or seven days a week, eating a little healthier, and getting more sleep.

5. Doing things that bring meaning to your life. This one is still taking shape. Part of it is sharing ideas that I would otherwise be reluctant to share, as I am doing right now. It also means donating time or money to causes that are important. What it means for you may be very different.

6. Have an "attitude of gratitude". Whatever you think about, that is what grows in your soul. Feed it the good stuff, and it will return the favor.

7. Grow. 30 years ago I read about a group of nuns that were living well into their 90's. The common thread among them was that they continued to learn new things, read, and otherwise keep their minds active. How much room is there for cancer if your body is busy growing?

A friend of mine has a theory of gardening. There's no room for the weeds to grow if you plant the flowers really close together. Filling your mind, your heart, your body, and your environment with healthy, positive, growing things doesn't leave much room for cancer. Besides, it sounds like a pretty good life to me.

Love,

Dann

10/18/06 CANCER FREE

Dear All: Dann is "CANCER FREE". That is the bottom line.

So, this is the rest of the story. Dann went in Tuesday, a very good day to have surgery. His surgery lasted a shorter time than expected and it was very successful. Dr. Handy removed the upper lobe of the left lung easily and all went very well. He did find cancer in the lymph node that was closest to the tumor but they got it all out. It was the lymph node that shrunk with the chemotherapy. So, the good news is that the chemotherapy cocktail is effective for Dann's cancer and the next 2 rounds after surgery will be preventative to make sure any stray cells that even think about growing are zapped! This should be completed by Christmas. His 2007 New Year's resolution is to "grow and have hair".
I went in this morning (Wed) and Dann told me he had been exercising in bed . He wanted to start his rehab, however, this was 3AM. He did find he got tired easily and after the nurse told him it was not such a good idea, he has decided to modify his exercise plan. He transferred out to the unit this afternoon and after getting his pain under control is feeling very chipper and alert for a guy going through such a major surgery. I would not be surprised if he was out on the golf course in 2 weeks. That is what having a great attitude and a lot of support does.... you believe it and it is so. This has been a long haul and I am feeling very relieved he is in the final stretch. I want to thank each of you from the bottom of my heart for your support and the love that you have surround Dann and I with these last several months. He is the light of my life and a wonderful man... He has gone through this ordeal with grace and courage. I think the things that have helped are all the support, prayers, love, light, positive thoughts and energy from all of you. Dann will be coming home towards the end of this week. He is a model patient in terms of attitude but I think I will have to tone down his enthusiasm towards the exercising. All prayers are answered and so it is...

Love, Genevieve and Dann (in absentia)

10/16/06 No News is Good News: Surgery is ON!

Family and Friends,

We did NOT hear from the surgeon today. This means that the biopsies of the lymph nodes taken on Friday showed no signs of cancer. It sounds funny to get excited about, but...

YIPEEEEEEE! I get to have surgery this Tuesday!

I'll check in to Providence Portland Medical Center at 9:30. The surgeon will operate at about 12:30 or 1:00. I'll be in the Coronary Intensive Care Unit for about one and a half days (this is standard), then transfer to the respiratory unit. I was told to expect to be in the hospital 4-5 days, or maybe a little less.

That's all the news until Genevieve updates you after the surgery.

Love to you all,

Dann and Genevieve

10/17/06 Re: No News is Good News: Surgery is ON!

Hi, This is Linda. I just talked with Gen. Dann came through the surgery with flying colors. The surgeon found another cancerous node which he removed. This means that Dann will have two more rounds of chemo sometime after the surgery. He's in the cardiac intensive care unit over night. Gen will write when she gets a chance, so I thought I'd give you a quick update.

10/12/06 Next Step: FRIDAY!

Family and Friends,

After days of making increasingly assertive calls to both the oncologist and the surgeon to get them to talk to each other, we have results. TOMORROW (Friday) I will have a procedure to remove all the lymph nodes within reach of Dr. Handy's scope. They will biopsy the lymph nodes, and we will find out the results by Monday. If the lymph nodes are cancer free, my surgery will proceed on Tuesday as planned. If not, I will have 2 more rounds of chemo before the surgery, which would mean having surgery sometime around Christmas. Please send whatever prayers or positive energy you have my way for good results!

Dr. Handy will make a small incision in front of my trachea and remove the lymph nodes using the same minimally invasive technology that they will use for the main surgery. It should take about an hour, and is scheduled for 12:30 PM Friday. They will send me home a few hours later, after the general anesthetic wears off.

Love,

Dann and Genevieve

10/13/06 Good Day at the Hospital

Family and Friends,

Just a (relatively) brief note to let you know that today's procedure went very well. Dr. Handy didn't visually detect any signs of cancer in the lymph nodes and was pleased with how quickly I bounced back in the recovery room. He told us to expect to proceed with the surgery on Tuesday unless he calls Monday with biopsy results that are different than what he is expecting. We LIKE that optimism!

The procedure was quick, and I was out of the hospital 3 hours later. My throat is sore and I'm a little groggy from pain meds. However, we're happy to have a successful "dry run" at the lung surgery behind us, and to have the doctor's optimism to buoy our spirits.

Next step: This cancer is going OUTA HERE on Tuesday unless you hear otherwise Monday evening!

Love,

Dann and Genevieve

10/9/06 New Information/ Ambiguous Plans

Family and Friends,

Before sharing the latest update I need to share my own personal Top 10 Greatest Things About Going Hairless:

10. Gen doesn't pluck my eyebrows in my sleep any more.
9. My granddaughters don't ask why Grandpa Dann has hair in his nose any more.
8. Grooming time is cut waaaaay down.
7. No more wondering what it will look like one day...
6. Righteous salute of the brotherhood of bald men!
5. Easier to find in a crowd.
4. Great conversation starter.
3. Built-in, highly sensitive weather gauge.
2. Dandruff? What dandruff?
1. Endless tattoo possibilities.... See below for a sample!

Now for the latest news: We met with Dr. Ross, my oncologist, today. First, we found out that the location of the lymph node where the tumor had spread reclassifies my cancer as Stage III. She pointed out that the best part of this is that my tumor was so small, and it took 2 CT scans to even determine that it is Stage III, that we have caught the cancer at the earliest possible part of Stage III. In most cases it is easier to determine the stage because the cancer is more advanced.
Next, she said that the tumor shrunk by more than HALF, not the third that we had thought. (It pays to talk to an oncologist rather than a surgeon about these things!) She showed us the tumor on the CT scan after it shrunk, and YES, IT LOOKED LIKE A PRUNE!!!!! She laughed along with us when we told her all the people that were thinking prunes for me. Of course, she likes to think it was the chemo that did the trick. She is thrilled by how well the tumor responded to the chemo. This bodes extremely well for what impact chemo will have on stray cells.
Dr. Ross recommends that before the tumor is removed, I have a "sentinel lymph node biopsy". This would involve inserting a small tube through the front of my chest while I am under a general anesthetic, removing all the lymph nodes that can be reached this way, and doing a biopsy on them. It would take 1-2 days to get the biopsy results. If any of the lymph nodes show living cancer, surgery would be postponed until I have 2 more rounds of chemo. (I have had 2 so far.) If not, we proceed with the surgery. In any case, I would have 2 more rounds of chemo after the surgery. I handled the first 2 rounds relatively easily, so Gen and I are 100% behind anything that improves my odds.
All this means that we don't know if the biopsy will be this week or next. If it is next week, that may or may not delay my surgery for 2 weeks, since my surgeon will be on vacation. Once the oncologist and surgeon have a chance to talk we will know more, and will let you know.
Meanwhile, I consider myself to be in training for surgery. In addition to some form of exercise (weights, yoga, golf, walking) 7 days a week, I have added daily swimming. Being goal-oriented and focused on health rather than sickness, and having your support, are going to get me through this.
We will let you know as soon as the plan is a little clearer. For now, it seems like the more we learn, the less we know for certain. It's a bit like life.
Love,
Dann and Genevieve

10/5/06 Surgery Plans

Family and Friends,

Gen and I met with my surgeon, Dr. Handy, today. We now have a plan for surgery. Dr. Handy was so impressed with how quickly I recovered from the chemotherapy and how physically active that I have remained, that he moved the surgery to the earliest possible date. I will be having the surgery on October 17th, which is just 12 days away!!!!! It is also my son Matt's birthday, which we didn't want. However, the alternative was to put the surgery off for a full week, and getting the cancer out NOW has to be the priority.

Also, after more research and further discussion with Dr. Handy, I decided on the VATS (minimally invasive) surgery. The average length of stay at the hospital is 5 days, but Dr. Handy suspects I'll be out a little quicker. For one thing, I'm probably 25 years younger than that average patient. (That kind of makes the quick recovery from chemotherapy a little less impressive, doesn't it?) Most patients stay home from work for about 3 weeks after this surgery.

When we met with Dr. Handy we got the results from my repeat CT scan, which was done yesterday. The tumor shrank by about a THIRD. (I forgot to ask if the tumor appeared wrinkled like a prune from all that good energy you all have been sending my way.) On the not-so-bright side, one slightly enlarged lymph node shrunk after chemo, which they tell us means that cancer had spread to that lymph node. That makes my cancer Stage II. However, there is a definite silver lining. Because I did chemo before surgery, we now know that the chemo cocktail they gave me is effective on this specific cancer. If they had not done chemo prior to surgery, Dr. Ross (the oncologist) would have to guess and hope she had the right cocktail. Now we know that doing chemo after surgery will hit the target, and should catch any stray cells wandering around that didn't get picked up on any scans. We will meet with Dr. Ross next Monday to plan how soon/how much chemo I will have after surgery.

That's all the news that's fit to print for today. I'll send a brief update after meeting with Dr. Ross next Monday. After that, my next report will be AFTER the surgery.

Love,
Dann and Genevieve

9/26/06 The Current State of Affairs

Friends and Family,

I have now made it through 1 full round of chemotherapy, and we are making our way through the second and temporarily final lap. I had the second day of IV chemo last Thursday, but it's a three week recovery cycle, so I definitely don't consider chemo to be over yet. More on that in a minute.

On Thursday, October 5th Genevieve and I will meet with the surgeon (Dr. Handy) to plan a surgery date and to finalize a plan for which form of surgery I will have. There are advantages to the less invasive VATS surgery (shorter recovery time being #1), but there may be less likelihood of chronic pain after surgery with the more traditional surgery due to the location of the nerves that are cut. Gen is strongly leaning toward the VATS, and I'm becoming more convinced, but in my usual analytical way I'll do more research before coming to what is probably the same conclusion. I think it's the illusion of control that makes it worth the extra effort.

The surgery will likely take place 2-6 weeks after we meet with the surgeon, so between late October and late-November is Dr. Handy's target. Gen and I are targeting the earlier end of this, and I am doing everything I can to prepare for an earlier date. For example, I'm still lifting weights 3x/wk, doing yoga 2x/wk, golfing 1x/wk, and walking the other day. I take a few days off immediately after a chemo infusion but otherwise consider my body to be in training for surgery and for post-surgery quick recovery. With Gen's encouragement I have also added acupuncture with a naturopath as well as massage therapy, both of which are part of Providence's Integrated Medicine program.

We will meet with the oncologist a few days after meeting with Dr. Handy. She has already recommended that I do a couple more rounds of chemotherapy after the surgery because the biopsy showed that the tumor was growing at a faster rate than anticipated. This will be one more way of ensuring that no stray cancer cells are left to wander around my body looking for a home. It increases my survival odds once again and is very reassuring, at least when I'm not thinking about the chemo side effects.

Many of you have asked how chemo is going. The "big picture" answer is fantastic, because it is happening, and that cuts my chances of a recurrence in HALF. The "day to day" answer goes like this:

Day 1: Chemo infusion with steroids x 5 hours. Ho hum, read a few carefully selected magazines, work on laptop, chat with
new chemo buddies.
Day 2: Back to work. (It's Friday.) Energy good almost all day,
food tastes a little funny.
Day 3: Golf (Par 3 course): First 9 - Great, Back 9 - Semi-
horrible (same pattern both chemo cycles!). Tired.... bed
early... The steroids have worn off.
Day 4: Food tastes like a rusty spoon left in the yard all
winter, then used to scrape the gunk in the bottom of a
planter. Nausea gratefully dispelled by meds and sleeping
most of the day.
Day 5: Back to work and gym, hanging on at work for 3 hours,
then sleeping most of the next 18 hours. Less nausea, but
the rusty spoon lives.
Day 6: Giddy optimism returns, selective foods taste great. Use
spatula to get the last of the Fettuccini Alfredo sauce
out of the bowl. Lick the bowl. And the spatula.
Days 7-14: Decreasing fatigue, increasingly normal taste buds.
Day 14: Hair starts falling out!!!!!!!!! False sense of
security dashed!!!!! Embarrassment at the gym!!!!!
Day 15-20: Piles of hair floating down the drain at the gym. White (naturally) towels are then filled with black
hair and discretely chucked in the bin. Vacuum the
pillows and sofa every night to avoid dreams of
sleeping with Big Foot.
Day 21: New cycle. Repeat from Day 1 UNTIL....
Day 25: ABANDON THIN HAIR CHARADE!!!!!!! SHAVE HEAD!!!!!!!!!!!
Day 26: Get "Bald Power Solidarity" right arm salute from 3 bald guys and two thinning hair guys at work. 3 women at work
(and two men) tell me I have a shapely head. I'm trying
not to let it go... to.... my.... (for those of you who
know me too well, forgive me going for the way-too- obvious punch line.)

Actually, being bald is more fun, at least as a novelty, than I had imagined. Placing my hand on my head is like being stuck to Velcro, so I can entertain myself. It is also a much stronger look than a wispy massive comb-over, so I'm wearing it with pride. A great benefit is that it makes it easier for me to choose whom I tell that I'm having chemo, which helps prevent the dreaded pathetic "I'm so sorry" looks. (I LOVE the people who can see how lucky I am to catch it early, rather than focusing on a victim's outlook.) I can also lie and tell people my Olympic team is all doing this to show team unity.

I'm on Day 6 (licking spatula) today. As you can tell by the length of this email, my stamina is returning. I won't test yours any further today by writing more. Although I haven't responded to each email you have sent due to fatigue, emotional overload or both, every word means so much to both Genevieve and me. Thank you, and Love to you all.

Love,

Dann and Genevieve

8/31/06 Gentlemen, Start Your Engines

Family and Friends,

At last, treatment has begun!

I started chemo today and was pleasantly surprised by the lack of immediate side effects. It must be the steroids talking. They give the steroids to reduce or eliminate the nausea, which works for 2-3 days, and also helps with energy.

The next hurdle comes when white blood cell, red blood cell, and platelet counts all progressively decrease, reaching their low point in 7-10 days. My ability to fight infection and my energy levels will be impacted by this. The doctors and nurses recommend continuing with normal activities, don’t overdue it, and listen to my body. I will also need to be very sure to avoid sick people, even with sniffles, during the more vulnerable blood count times.

Today after chemo we met for the first time with the surgeon, Dr. John Handy, who does both the more traditional surgery and the minimally invasive surgery to remove the tumor. There is still not enough clinical data for a complete statistical comparison, but it looks like the tradeoff for having potentially a shorter/better recovery period using the minimally invasive procedure is the increased risk of chronic pain (less than 1% for the other procedure vs. “a little higher” for the minimally invasive procedure). There is also about a 10% chance that they will need to abandon this approach mid-surgery and separate my ribs to enter under my arm, which has a slower recovery rate and more chronic pain (13.5%) than entering from the front. We don’t know yet which procedure we want, but we do know we both feel very comfortable choosing Dr. Handy as the surgeon. He has an outstanding reputation, and we liked him a great deal.

Here’s the evolving timeline, as we know it today: Another day of chemo on September 21st. About 2 weeks later I have a follow-up CT scan to see if chemo shrunk the tumor, then see Dr. Handy to make sure he is comfortable that I am ready for surgery. Surgery would be mid-October to early November. However, we’re finding that just about any timeline we get is a moving target.

A friend and cousin by marriage, Dwayne Elan, has been going through treatment for lung cancer for the past 2 years. His cancer has metastasized, and he is fighting the good fight with a great attitude and a loving support system. Please send a prayer, positive energy, or even thoughts of shrinking his cancer like a prune if you can. He likes the prune image a lot.

Dwayne shared his observations about cancer with me. One of his comments was, “when one person in the family gets cancer, the whole family gets cancer.” In other words, everyone is affected. I thank each of you for how you have offered to be a part of the healing process for me in your own way, knowing that allowing yourselves to be touched by my experience exposes raw nerves for you as well. I am particularly grateful to Gen for this, as she has been side by side, and sometimes leading me, toward healing choices. I am also most concerned about the impact that this could have on her over the long haul. She shares in all of the struggles, yet most of the support comes to me. Of course, she denies any of this, and I will be lucky to get this email out without the paragraph being deleted.

I don’t expect to have any news to share from now until about the second week in October, when we get results of the repeat scan and a more firm plan for a surgery date. Until then, your love, energy, prayers, and support for both Gen and me, as well as thoughts of prunes, are very much appreciated.

Love,

Dann

8/28/06 At Last, a Solid Plan

Friends and Family,

Gen and I met with the oncologist, Dr. Helen Ross, for the first time today. The first news that we received was the results of the repeat CT scan, which was done to see if the tumor had grown, and the MRI scan, which was done to see if there were any tumors in the brain. Good news on all fronts – The size of the tumor in my lung was about the same, there was no tumor found in my brain, and they found a brain. Whewwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww.

We got a much clearer picture of the diagnosis, treatment options beyond surgery, and statistics now that we are talking with the oncologist rather than a pulmonologist and a surgeon. The tumor has been identified as an adnocarcinoma, which is a fairly slow growing variety. However, there is a 50/50 chance based on the CT scan that there is a second tumor within the same lobe of my lung. It would come out just the same since that lobe will be removed, but the suspicion that it could have spread to a second site qualifies me for chemotherapy. Even though chemo reduces the odds of getting cancer again, it has only been approved for cases where it is suspected that the cancer has spread.

The surgeon will remove all the lymph nodes he can get during surgery, each of which will be tested for cancer that was too small to be picked up on the CT or PET scans. If they find any traces it means that I will have chemo after I have recovered from surgery to get the rest.

The “Saturday stroll in the park” version of chemo that the surgeon described to us is not quite the same chemo that Dr. Ross is recommending. Because I am so (ahem) young and healthy, Dr. Ross suggests taking a more aggressive cocktail of Docetaxel and Cisplatin. The upside is that we are attacking the little monsters with Shock and Awe. The downside is the national budget of white blood cells, red blood cells and platelets goes into deficit about 7-10 days later, leaving me more vulnerable to attack from other foreign bodies, but this passes shortly before election day. I’m also likely to lose hair, but Dr. Ross informed me that I had (ahem) plenty of thick hair to spare, so it may get thin rather than vanish altogether. It grows back, but 21 days later it’s time for Shock and Awe Round 2. About 21 days after Round 2 it’s time for surgery, and after that… possibly more rounds of chemo. If I go completely bald by Halloween I’m going to glue horns on my skull like Jai Dev did last year.

I’m likely to be energetic for a day or two after chemo due to the use of steroids, and then become very fatigued for an unknown number of days after that. Pacing will be the issue for me. Nausea is supposed to be fairly minimal. There’s a laundry list of other side effects, none of which is intolerable given the benefit that chemo brings.

Follow-up after surgery includes CT scans, lab tests and full physicals every three months for the first two years after surgery, then every 6 months for years 3-5, then annually. The surprising news from Dr. Ross is that about 1 out of 3 people who go into complete remission for 5 years end up with some form of lung cancer again at some stage of their life, and not necessarily the same type. With this type of close long-term care, it improves the chances of catching it early enough to prevent the spread again. Beyond that, we will deal with tomorrow when tomorrow comes.

After we go to chemo on Thursday we will meet with the surgeon who does the minimally invasive procedure. We will then find out if this procedure is a fit for me, and probably pick a tentative surgery date about 6 weeks out. We will have more news to share after that.

Thank you for tolerating my Encyclopedia of Cancer Treatment approach to keeping you informed. Some people want to know just the highlights, and others want all the details. Partly I write these so that Gen and I will have a way of remembering the entire process. There is so much to learn along the way, and so much to be grateful for. We were reminded of that by Dr. Ross, who said they NEVER catch lung cancer this early unless it is by accident, the way mine was found. How lucky can you get!!!!

Love,
Gen and Dann

8/22/06 Plans

Family and Friends,

We have our first appointment with the oncologist, Dr. Helen Ross, next Monday. We have been told by a couple of sources that she is a nationally recognized lung cancer expert, and that both her colleagues and her patients like her a lot. We have two goals for that appointment. First, we want to find out if she recommends the chemotherapy that we heard about from the surgeon. If so, chemotherapy would presumably begin within a few days of that time. Our second goal is to see if there is anything else that she recommends. If chemotherapy is recommended, it would happen before surgery. Because of this, it will probably be mid-September before I have surgery.

We have an appointment next Thursday with a second surgeon, Dr. John Handy, to consider a minimally invasive surgical procedure for removing the tumor. The first surgeon we spoke with does not do this procedure. Dr. Handy is also recognized as being outstanding in his field, not to mention having a great name for a surgeon. At this point Gen and I are both thinking that the minimally invasive option sounds much better, unless we hear something to the contrary from either Dr. Handy or Dr. Ross.

Although we have not yet met with Dr. Ross, she reviewed my chart and ordered two more tests. This Thursday I will have a repeat CT scan of my chest, and will also have an MRI of my brain. Apparently the MRI is much more sensitive to picking up cancer in the brain than the PET scan that I had two weeks ago, and Dr. Ross ordered the repeat CT scan to see if my tumor had grown in three weeks. This is very reassuring in one way, as it tells us how thorough Dr. Ross is, before we have even seen her. However, it is also a bit disconcerting after we thought all the questions about the potential spread of cancer had been answered.

Our friend Rebbecca offered this reassurance: As the former head nurse of an oncology unit, she said that it is common for oncologists and surgeons to repeat tests and find even more things to test. This is to make sure that they don’t miss anything the first time around. It reminds me of the old carpenter’s saying, “Measure twice, cut once.” Perhaps this saying is a little TOO fitting….

Thank you for your continued support, prayers, positive energy and prune thoughts throughout this challenging time for us. We remain optimistic through the process. I continue to feel healthier now than I did even a few years ago because I am in better shape. The only thing that hurts is a few sore ribs from a little incident on a ski boat a couple of weeks ago. I am convinced that I could have gone a few more years without ever knowing that I had lung cancer, but I had the extraordinary good fortune of having a sore back and a conscientious chiropractor. There is so much to be thankful for.

Love,

Dann and Gen

8/16/06 Improving Odds and a Course Correction

Family and Friends,

Gen and I met with Dr. Douville (surgeon) today and were given a lot more to think about. We learned of a new option that looks like it could improve my long-term chances of remaining cancer free, and also changes the anticipated timing for my surgery. That option is to have two courses of chemotherapy before the surgery. With surgery alone, there is a 20% to 25% chance of getting cancer again. Those chances are CUT IN HALF by doing this preventative chemotherapy. WE LIKE THOSE ODDS!

Each course consists of having an IV of chemotherapy for one day. We then wait about a week for my white blood cells to regenerate, and then have a second course. (Fortunately it’s only a two course meal.) After my white blood cells have regenerated again, I have the surgery to remove the tumor. Only 2-3% of people get very sick using this form of chemo, and usually don’t lose their hair. However, I’m blaming any future hair loss on chemo.

Dr. Helen Ross is the oncologist that we will be seeing. She came with very high recommendations from both Gen, who works in Rehab at Providence, and our friend Rebbecca, who used to be the cancer unit head nurse at Providence St. Vincent. Dr. Douville says that Dr. Ross is a nationally recognized specialist in lung cancer, that her patients love her, and that he very highly recommends her. We are trying to schedule an appointment with her to get her opinion and to begin chemo if it sounds as positive after talking with her. She’s out of town this week, so Dr. Douville recommended that we take whatever appointment with Dr. Ross that the scheduler has available, then get Dr. Ross to squeeze us in sooner when she comes back next week.

The surgery itself involves removing the upper lobe of my left lung, along with the lymph nodes. The surgeon told us that the surgery usually lasts about two hours, and I will probably be in the recovery room for about an hour, and will likely spend the first night in the Coronary Care ICU. I should expect to be in the hospital 4-5 days, then go home and need assistance for a day or two. I should be able to get up and down stairs as soon as I am home. I will likely be at home through about the third week, return to limited activity within 6 weeks, and have almost 100% of lung functioning and be pain-free in 8-12 weeks. There is about a 10% chance that my vocal chords could get nicked while removing the lymph nodes, which would leave me sounding constantly hoarse, but there are solutions that lead to a very good chance of full recovery from that side effect. There should be no other long-term complications to my health. “The only change you would see in your functioning over the long run is that if you were a marathon runner, you would probably run a little slower.” I think I’m safe there.

Skip the next paragraph if you don’t want to know the gory details of the surgery options.

There are two ways that the surgeon recommends to perform the surgery. The method this surgeon uses for the surgery is to cut the breast bone and spread the ribs. This has a shorter and less painful recovery period than the more traditional method of entering from the side and spreading the ribs, which he does not recommend. The other option that he recommends is to make a small hole to insert a camera, and two more small holes to perform the surgery. Recovery time appears to be quicker with this method and there are no known increases in risk. He does not perform this surgery, but his partners do, and all have outstanding reputations. The only down side he sees is that there is a much shorter history of research on the effectiveness of this method (seven years). We will give these options further thought.

Now for the statistics. There is about a 2% mortality rate after this surgery. An extremely small (“infinitesimal”) percentage of that is from patients who die during surgery. The rest are patents who die of complications after surgery due to pneumonia, infection, heart attack, etc. That being said, Dr. Douville says that my chances are MUCH better than that because I’m in the top 5% of the patients he sees as far as condition prior to surgery: I’m young (no wise cracks – It’s all relative), healthy, exercise regularly, have an excellent diet, a great support system, and have a great attitude. I would add to that list all of the people that are praying for me, sending positive energy, or thinking dried prunes. Once again, we appreciate the love, support, and prayers that you are sending, and we strongly believe it makes a very big difference.

Overall we are very optimistic but drained after the appointment today. We were gearing up for the possibility of surgery as early as this Friday, and we’re having a post-meeting crash right now. However, I’m enlivened by one other upside to this new turn of events… There’s time for GOLF THIS WEEKEND!

Love,

Dann and Gen

8/9/06 Great News!

Family and Friends,

We received fantastic news this morning. The PET scan revealed that THE CANCER HAS NOT SPREAD!

The next step is to meet with the surgeon, hopefully within the next couple of days. Our understanding is that the standard procedure at this point would be to remove the tumor, and then keep a careful watch to make sure there are no surprises. We have no details of how the surgery would be done until we meet with the surgeon, but the surgery is likely to be done next week. We will share what we learn from the surgeon as soon as we can.

Love,

Dann and Genevieve

8/9/06 Surgeon Appointment

Family and Friends,

We are now scheduled to meet with the surgeon next Wednesday, July 16th (Michele's birthday). We'll let you know the recommendations after that appointment. Meanwhile, we're still dancing after the good news!

8/7/06 Good News Du Jour

Family and Friends,

Although I received the pathology reports on Friday, the info was relayed by a physician filling in for my own pulmonologist, Dr. Lafor. Today Dr. Lafor called and gave me more information to give a better context to the results. Dr. Lafor informed me that over 95% of the time, with this type of cancer caught this early, that the cancer will not have spread. We like those odds!

I will have the PET scan Tuesday morning to find out for certain whether it has spread, and if so, to where. We should get the results from this test Wednesday or Thursday, and we will share the news with you ASAP!

Love,

Dann and Genevieve