Lung Biopsy and Plotting a Course of Action

Dear Friends,
Yesterday (May 25) I had a lung biopsy procedure; which was an interesting experience. This is where a small probe is placed into my lung in order to sample one of the growing nodules present there. The doctor performing the procedure selected the largest nodule, which was in the left side, and was able to take the sample using a CT scan machine. The most direct route was through my back, so I had to lay on my stomach in the CT scan machine for about 2 hours; with partial sedation and alot of pain killer. It still hurt quite a bit, and was a strange experience feeling a probe going into my chest and lung (that is why it was "interesting"; which is the kindest word I could come up with). One positive aspect of this experience was again observing the incredible kindness and compassion of the hospital staff. One of the two doctors who perform these biopsy procedures had called me the night before, and went through the whole process just to set my mind at ease. The next morning when I got to the hospital, I found out that a different doctor would be doing the job; but still the doctor who had called me the night before made sure to find my prep room and assure me that the doctor on duty would do equally well and they had both studied my case. The nurses and other staff who handled me were equally kind; in fact the nurse who put in my drip needle did the best job ever (believe me, I have had alot of IV drips the past 9 months). The doctors who perform these chest related biopsy procedures said mine was a tough case in the lung area, because my nodules were so "small". What a thought, that something growing in your lungs can still be described as "small".... a good thought for the day. Another complication of these lung biopsy procedures is risk of the lung collapsing, due to removal of negative pressure naturally occuring in the lung. The location of my insertion was having a high risk for lung collapse, which would have required having a tube inserted into the chest cavity and then an overnight stay in the hospital. Fotunately, this did not happen and I was allowed to go home after a 4 hour observation period and 2 chest X-rays. In the > 24hrs since, I have not had any further problems and the pain is almost completely gone. Now the hope is that there was enough tissue from the biopsy to get a definitive pathology type leading to a course of treatment.

I also had a visit with my oncologist the day before the biopsy. Myself, Usha and my father attended this visit so that we could all listen to what was said and cross check notes afterward. We were really amazed at how much background research my oncologist had done in the one week since we last met. He had talked to others specializing in this type of situation, and consolidated the information into treatment options; assuming the biopsy reconfirms the original tumor type discovered last August. The institutes with most experience in this area (rhabdo type sarcoma in adults) are Sloan-Kettering in NYC (where we had our surgery and initial chemo schedule) and MD Anderson in Houston. Unfortunately, there is not alot of experience in this type of sarcoma in adults; and the next logical step uses different chemicals but is nothing really new. It is still mostly practiced in children. There are slight variations or additives that my oncologist will try, depending on effectiveness; but since my original course did not seem to eliminate all cancer cells; it is possible that this will also have limited success. The goal is to at least get the growth to stop and then take steps to have the nodules reabsorbed into the system; and go from there.

We also got another good lead through contacts which Usha has developed while serving on the Borad of Trustees with Donald Danforth Plant Science Center. One of the trustees is the CEO of Merck Inc.; which is actively involved in cancer drug research. Through this contact, we received information on early stage trials of an antibody based drug from 3 different companies which appears to show efficacy in sarcoma cases. One of the companies still had 2 openings in these trials, and would institute Phase II trials in the next few months at various hospitals. Information was also given for a coordinator of experimental trials in sarcoma cases, and this coordinator offered to talk with me or my doctor to explore options. We need to make a decision soon on how to participate in such experimental drug trials; but this new option may be required to find at least a temporary solution.

On the spiritual and emotional fronts, this is still a work in progress; which is true of everyone (we are all God's work in progress). There are really times of little joys (such as interacting with the hospital staff during my biopsy) and many times of dark thoughts. These negative thoughts can take over one's mind and affect physical health also. They do not help in building faith-based peace of mind and perspective; so must be done away with as much as possible. Sometimes it seems that this takes more strength than one person can handle. But it helps to have family and friends. One of my brothers has visited this weekend. He always seems to have good words for me, and during our walk together this morning he was really able to put life and after-life into perspective in such a way that my mind has been more peaceful today. Good family is another reason to praise God.

Thank you for all your cards, letters, emails, phone calls, and especially prayers. We need continued prayer for physical and emotional healing; as well as discernment on how to proceed. This week will really be important in coming to conclusions on how to proceed with treatments that will have the best chance of effectiveness. Here is a list of prayer requests:

-- That we have a definitive outcome of the biopsy, which leads to clear treatment options.
-- That we are able to make best decisions on participation in experimental drug trials; in which timing is critical.
-- Continued faith building through prayer and study, which will lead to peace for myself and family; but also will allow me to go beyond my situation and share with others so that they can benefit from whatever I have to offer.

I have heard many people share that cancer can be a life changing experience for the better, but requires perspective to grasp that opportunity. God surely puts us through these experiences to improve ourselves in the time we have to live. There are no guarantees for outcomes in this life, but God provides us with opportunities to learn and grow in Spirit. This growth can be seen by the positive effects we have on lives of other people. I hope this blog helps keep everyone up to date on my journey; and brings some inspiration also.

BRENT