Our Journey Moves Onward

Hello, Friends,

I feel like I need to start this blog just reminding you that we serve such a mighty and living God. He cares so much about each of you, and me, and Matt and I were reminded of that when we visited UCSF for a post-op appointment with my surgeon and oncologist.

Last Thursday, Matt and I traveled back to San Francisco, where I started with a blood test to check that my phospates and electrolytes were balanced after the surgery (we asked for the results at the appointment, then got side-tracked, so we're assuming they were within the normal range!)

Next we met with 'Max', or Dr. Meng, who was very pleased with the results of the surgery. He was able to get a good margin around the adrenal gland and the attached tumor (6.4 cm in all), and according to the surgical report (which is fascinating to read) had to take a very small portion of the liver as well. The tumor was extensively necrotic, which means that it was largely dead. That was the meds at work! He also took nineteen lymph nodes, one of which shows metastatic renal clear cell carcinoma, or kidney cancer. He asked if I felt at least 80% recovered from the surgery, and I said a hearty yes! This recovery has been so much easier, and I have to remind myself to take it easy. He also released me to go back to work at whatever date I want, so I will return on April 9th.

After that meeting, we waited for what seemed like forever, but gave us a chance to people watch, and then met with Dr. Ryan, my oncologist. (I just realized we got to skip the step where we meet with a 'fellow' first!) Dr. Ryan was also very pleased with the outcome of the surgery. He shared that I am in a unique position in that there are not a lot of cases out there where a person with kidney cancer can successfully have most of the cancer removed. Therefore, there are not a lot of cases for him to study in order to make recommendations of what is next. So he presented my case to a lot of his colleagues, and asked their opinions. Overall, the opinion is that I should go back on the chemotherapy for an extended amount of time...a year total. Matt's first question was 'a year from now or from when she first started?', and the answer (whew!) was a year from when I first started, so I am already a third of the way through! In the middle of this conversation, he asked me how I had done on the meds, and I shared that overall it was bearable, but that the hardest parts were my feet, the sore at the back of my throat, and the bottom of my first incision, which gets scabby and very sore. I shared with him that having been off of the meds for several weeks made me realize that I had forgotten just how good I could feel. He hesitated for a bit, then said that no, he would remain firm. (His hesitation was about having me stay off the meds for awhile, just to see what might happen.)

So, this Thursday I will resume the chemotherapy, 28 days on then 14 days off. The first week I am off, I will have a blood test, as the good doctor wants to follow how the meds affect my thryoid, and to keep track of my creatinin. I also have to check my blood pressure during the meds. Then the second week I am off the meds, I will travel back to see Dr. Ryan for a check-up. After every other round of meds, I will have CAT scans done to see how things are. The goal is that I keep this up until there is nothing else showing, including in my lungs, small as those nodules are, which will possibly be until November, or whenever it seems safe to be done.

I will have to be very careful this summer as the meds affect my skin when it is overheated, and of course that means that the sun could be very irritating. So Matt and I visited the gift shop at Mount Zion (USCF) and found a great, red hat for me to wear to the kids' ballgames, etc. I also have found a good, strong sunscreen.

One thing that Dr. Ryan shared that really put all of this in perspective for Matt and I, as I accepted what he said about going back on the meds but wasn't very excited, is that he wishes he could have such good news to give to more of his patients. Very few who have the same cancer I have can successfully have the main sources of their cancer removed. I have had almost all of mine. Of course we can never know what might still be lurking in my body, but what is showing itself is small. There is a 5% full recovery rate for the kind of cancer I have, which is not a very good percentage. However, someone has to be in that 5% for there to even be that percentage. I believe that I will be one of those someones. It is that belief, along with the hope I have in Jesus, and all of your prayers, that gets me through each day. As hard as it is sometimes, I will not give up. I believe that God is not done building my character, growing me up in Him, and allowing me the privilege of sharing what He has done in my life, so that others will want to know this God I speak of. Keep praying for me, my friends.

Lovingly, Danene
March 28, 2009