It's meta

"Omnia in bonum" - "We know that in everything God works for good with those who love him." (Rom 8:28)

Hi everyone,

With this post we are making it more broadly known among our community of friends that I have metastatic melanoma.  For a brief period of time we kept the news to a smaller group while we awaited definitive results and some idea of what the path ahead looked like.  You are clear to get your family and friends praying for me, Kendra, and the kids.

I had a PET CT scan this week, and the results weren't a worst case and they weren't a best case.

The bad news:  What my oncologist said is that I have "a fair amount" of small melanoma tumors lining parts of my lungs and in the lymph nodes in my chest.  They called me before the full radiologist's interpretation was done to let me know they had seen some nodules in my lung as well as in lymph nodes.  The "fair amount" assessment came a day later, after the radiologist had a look.  In reality, there doesn't seem to be much difference that the radiologist came across other areas - and that's coming from the oncologist, not a naive self-assessment.  Either I've got the malignancies in there or I don't.  Counting tumors doesn't help us.  If they can see one tumor on the image, there could be 50,000 that are too small to see.  The important thing, at least medically speaking, is the good news.

The good news: This remains pretty much the same as the first post.  The therapies out there are really fantastic, and they are kicking melanoma in the teeth.  My doctor at UCLA is recommending an FDA-approved immunotherapy that has great results for a lot of patients, plus a clinical trial of a drug that they're studying.  This route would very likely have no significant side effects and has proven to be very effective at helping many people's immune systems to attack melanoma aggressively.  They're also conducting genetic testing on my tumor to see if there are some other options that are available to me.  I gather that these others are superbly effective for brief periods of time and that they also have more serious side effects, along the lines of the nausea, fever, fatigue, headache that I experienced with my old pal interferon.  I'm also going to go in for a second opinion with a melanoma specialist at USC in the coming week.  We have a good friend who is an oncologist there and who is helping and advising me.  He believes the USC melanoma specialist is likely to advise a somewhat different course.  The appointment with him is Tuesday, so we will probably be making treatment decisions on Tuesday evening, maybe Wednesday morning.

Another thing my oncologist offered is that I've probably had these malignancies in there since 2007.  So it's nothing new that I'm a stage 4/metastatic/end stage cancer patient.  I have been all along, and while I think treatment is going to go great for me - the 1-2 punch of interferon and my immune system beat down this disease pretty effectively already, so why not again with an even better drug - I just want to take a moment to savor the fact that I have had an incredible last 10 years, and I still feel great.  In that time Kendra and I have been instruments in bringing 6 more souls into the world, and I have been loved by them, by Kendra, and by the first 3.  I delivered my daughter, coached a lot of tee ball, climbed Mt. Whitney, got to see my son - who was confirmed Saturday - receive his First Communion from the Pope, read thousands of bedtime stories, wiped hundreds of runny noses, received dozens of homemade Father's Day cards, helped with untold hours of algebra homework.  And all that came after a diagnosis of stage 3b metastatic melanoma (which was actually stage 4).  What stage 4 cancer patient gets that?  Thanks be to God that I have had these long ten years.  I begrudge Him nothing.  I shake my fist at Him zero times.  He has granted me the best 10 years I could have imagined.  And...

That 10 years has given melanoma researchers enough time to develop a whole new set of weapons that very likely mean at least another 10 years, if not 40.  Where will they have progressed to 10 years from now?  Maybe a no-kidding cure.  I feel great about the prognosis.

And if the drugs don't work or this thing takes a sharp left when we didn't expect it, thanks be to God for that, too.  "May the most just and most lovable Will of God be done, be fulfilled, be praised and eternally exalted above all things. Amen. Amen." (St. Josemaria Escriva)

With fortitude and prayers for you,

Jim