Posts by: jamie

Ranch Get Away

The kids spent last week at Grammy and Paw Paw’s ranch, and Holly and I joined them over the weekend.  It’s always good to get out there to relax and enjoy what God made.

Here’s a few pictures from the weekend:

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Results of MRI-Guided Biopsy

Daniel and Candas Wedding (82 of 96)The doctor called tonight to give us the results of yesterday’s MRI-guided biopsy.   As a reminder, the radiologist took samples in front of and behind where they had previously found the cancer.

The good news is that the sample behind was not cancerous. This lessens the chances that cancer has spread to the lymph nodes.

The bad news is that the sample in front of was cancerous. It’s still DCIS (non-invasive), but it means that a mastectomy is the only reasonable option from here.

The next step is to start meeting with plastic surgeons, to find someone good to do the reconstruction (that will happen at the same time as the mastectomy).

Then after that she will probably have a sentinel-node biopsy.  How many biopsies can she have?  Evidently, she can have one more.   This one will be a little harder ( she’ll be under general anesthesia) and they will check to see if it has spread to the lymph nodes behind the breast.  There’s only about a 5% chance of this, but it seems better to rule it out as a possibility before the surgery.

On the home front, we are kidless.   Holly is very tired but getting lots of rest.  The kids are at Grammy and Paw-Paw’s ranch this week, and we will go join them this weekend.  It will be good to get away for a little bit.

That’s about all we know for now.  Thanks for all the continued prayers.

Summer Fun

In the midst of this calm, we had some fun in a Nanny-provided inflatable pool this weekend. Enjoy the pictures:

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More tests, new doctor

On Tuesday, we went to see another breast surgeon for what we thought would be a routine second opinion on Holly’s cancer diagnosis.  It was anything but routine.

From the start, something about this new doctor was different.  First, she put all our test results up and taught us what they meant.  It was during this process we collectively realized something was wrong.

You see, when we first got our MRI results we were told the suspicious area it was confined to just one small area, about 4.5cm long. That was not what we are all looking at on the screen at the MRI results.

It looked pretty obvious to the new surgeon and us that the suspicious area was essentially the length of the whole breast.  This is not good news.

The next step is to have a MRI-Guided Double Biopsy.  That’s a fancy way to say they will use the MRI to guide the needle to take more tissue samples above and below where the cancer was already found.

If the biopsy comes back positive like we are expecting, a mastectomy will be needed to remove all the cancer.

Unfortunately, right now it’s looking like we won’t be able to get this test done until July 29, almost 2 weeks away.  We would obviously want to get it over with quicker, but maybe this will be a nice calm in the midst of the cancer storm.

In the mean time, we have switched to this new doctor.  You see the old surgeon never even looked at the MRI results herself (or any other test results for that matter), she just trusted the radiologist’s report.  It would be kind of hard to trust her after that.

Thanks for all the support and prayers.  Please pray we would has wisdom in the midst of this trial – and with that wisdom the kind of faith that would keep us from being tossed like waves like James 1:2-6 says:

Count it all joy, my brothers,  when you meet trials of various kinds,  for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.

If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. But let him ask in faith, with no doubting, for the one who doubts is like a wave of the sea that is driven and tossed by the wind.

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Life happens

For our budgeting we use an on-line free program called Mint.  We lump all unexpected or hard to predict expenses into a category called “Life Happens.”  We got this email from Mint a few days ago that made us both laugh:

Screenshot - 7_17_2009 , 2_05_43 PM

Yes, we have way blown past our mental and emotional budget for “Life Happening.”  It’s a good thing God’s grace is endless.

Terrorist Cells

The picture of exactly what Holly’s cancer looks like is starting to develop more fully.  First, it turns out that fighting Ductal Carcinoma In Situ (DCIS) is trickier than we first thought. If you will allow me the liberty of an analogy here…

Fighting other types of cancer with a large easy to identify tumor is like fighting a traditional war.  The enemy is easy to find, it’s just a matter of picking the right weapon to kill them.

In contrast, fighting DCIS is like fighting terrorists.  The operate in small (ironically named) cells that are hard to identify, and therefore kill.

What does that mean for how we go forward?  It means that even if the alternative medicine methods we are trying work, there’s no way to definitively know it.  The test simply aren’t that sensitive.  The mammogram can detect calcium deposits which sometimes, but not always, hang out with cancer.  The MRI can detect increased blood flow to an area, but by no means detect it at cellular level.

Besides knowing the nature better of what we are fighting, we also learned more details out of the pathology report.  It turns out that the DCIS Holly has is “High Nuclear Grade.”

Here’s how one website explains what that may mean:

There are three grades of DCIS: low, intermediate, and high. The grade relates to how the cells look under the microscope, and gives an idea of how quickly the cells may develop into an invasive cancer (or how likely it is that the DCIS will come back after surgery). Low-grade DCIS has the lowest risk of developing into an invasive cancer, and high-grade carries the greatest risk.

Here’s another one says (it also gives a much more technical explanation of how they determine the grades):

Cancers with a high grade, necrosis, cancers close to the surrounding margin of breast tissue of a lumpectomy sample, or large areas of DCIS are more likely to recur after breast cancer treatment than other breast cancers.

So, obviously neither of these pieces of information are good news.  Stack on the fact that just getting breast cancer so young increase the chances of recurrence substantially.  So, Holly still has the best kind of breast cancer to have — it’s just the worst kind of the best kind.

We’ve been discouraged about this this weekend.  While we have been praying and wondering what this means about how we move forward we have found great comfort in Psalm 147:3-5:

He heals the brokenhearted
and binds up their wounds.
He determines the number of the stars;
he gives to all of them their names.
Great is our Lord, and abundant in power;
his understanding is beyond measure.

Thanks for sticking through a long post.  Continued prayers for wisdom are appreciated.

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Death is Not Dying

death is not dyingI just discovered this video today and it was right at a moment I needed it. I needed to be reassured that despite cancer being outside of my plans for my 33 year old wife, God is firmly in control.

It’s the wonderful testimony of a Rachel Barkley — a 38-year-old mom of 2 — gave in March after finding out she had terminal cancer. Rachel died Monday.

From deathisnotdying.com:

But for Rachel the essence of life is found in her relationship with God through Jesus. And that’s why Rachel is convinced that death is not dying.

On March 4, 2009, what started out as a small talk to a women’s group at her church grew into an event attended by 600 women from around Vancouver, giving Rachel an opportunity to share about her hope in the midst of terminal cancer.

Rachel’s honest and thought-provoking talk touched women of all ages and left a hunger for discovering more about Rachel’s journey and the faith that has so deeply affected her life.

It’s long — almost an hour. But it’s the best hour I’ve spent this week. I encourage you to take the time to watch it if at all possible: Death is not Dying by Rachel Barkley on Vimeo (wouldn’t let me embed it).

exploring alternatives

Now that we’re a few weeks into the cancer diagnosis, we are trying to find slow down from the initial sprint to more of a marathon pace.   We had spent weeks bracing ourselves for the worst of news, and when the news came back (relatively) good, we are stepping back to figure out what’s next.

First, in case you didn’t here it anywhere else, the BRCA genetic test came back negative.  This is huge!  It means she has an average chance of the breast cancer recurring (about 1%/year), not a virutal certainity.   That said, there’s still the cancer that’s there that we have to deal with.

The surgeon is ready to cut it out now, then send Holly on to radiation.  While there’s a good chance that’s still in our immediate future, we wanted to take a breath and look at all options.  After talking with our pediatrician who had had some success treating her breast cancer with alternative methods, we decided to give it a try.

So, last week Holly started a series of treatments at Chalmers Wellness.  It involves some detoxification and mineral supplements designed to make the body less hospitable to cancer.   The idea is to let her body kill it off so that maybe we don’t have to cut it out.

We are going to give this a six week try, then have the MRI done again to see if there are any changes. 

Even if it doesn’t eliminate the cancer, this regimen and her workout schedule will allow her body the best chance to bounce back from surgery and radiation.  So, frankly, it just seems prudent to do everything we can before decide to have pieces of her body cut out.

On the home front, one or both of our mothers has been in town helping us deal with everyday life as we figure out what’s next.  They just left after being here more than two weeks and it was great help, not just in the everyday, but in helping get us more organized.  Who could do life without Mommas?

Thanks to all for the continued prayers for healing and wisdom.  These are very uncharted waters for us, and we need lots of both every step of the way.

MRI Results

We got the results of the MRI today. It’s as good of news as we can hope for…

The cancer seems to be confined to the area where they originally biopsied. These results probably rule out option 2 below, and now we wait for the genetic test, which we may know results from by Friday.

There’s so little in this process that’s certain. Waiting on test results seems to stretch our faith more that even finding them out. The biggest fear seems to be uncertainty.

This whole process is tearing down our pride that thought we knew what tomorrow would look like. James 4:13-16 puts it this way:

Come now, you who say, “Today or tomorrow we will go into such and such a town and spend a year there and trade and make a profit”— yet you do not know what tomorrow will bring. What is your life? For you are a mist that appears for a little time and then vanishes. Instead you ought to say, “If the Lord wills, we will live and do this or that.” As it is, you boast in your arrogance. All such boasting is evil. So whoever knows the right thing to do and fails to do it, for him it is sin.

So today, we don’t boast in what tomorrow will hold. We do fight to do what it is “the right thing to do.” Today, that is celebrate Abbey’s 4th birthday.

Love you all and thanks for your prayers.

Looking Forward

This afternoon we had our first visit with the breast surgeon since the cancer diagnosis last week.  We came away with a lot more information – it’s a lot to process. 

We already knew that the next steps are to get the breast MRI (again) next week.  She also had them draw blood for the BRCA genetic screening.  This tests for a specific gene mutation that makes it much more likely that the cancer will recur in the future.

We will have results from both test by the end of next week. Those results will drive one of three basic paths we will take from here:

  1. Lumpectomy + Radiation: If the genetic test comes back negative, and the MRI does not find any other suspicious spots, then the prudent course of action seems to be a lumpectomy. 

    This surgery removes the cancerous tissue and the surrounding tissue.  The cells on the edge are tested, and if there’s more then that have to do another surgery to remove more.

    It would be followed by a 6 week course of localized radiation.  She would visit 5 days a week for a 10 minute treatment.

  2. Single Mastectomy: If the genetic test comes back negative, but the MRI shows other suspect areas, those would have to be biopsied.  If they are cancerous also, there’s a high chance the whole breast would have to be removed.  Specifically, the doctor is worried about the rest of the duct that was producing the blood that started this whole charade. 

    The surgery would also involve a Plastic Surgeon immediately reconstructing the affected breast. 

  3. Double Mastectomy: This is obviously the most radical option.  If the MRI showed it in both breasts (unlikely), or the genetic test came back positive, we would have seriously consider a double mastectomy.

    While this is common surgery now, it has serious implications that weigh heavy on us.  We may be meeting with a Plastic Surgeon soon to talk about what this would look like.

Q&A:

Some things you may be thinking…

  • If it’s not invasive why do anything? 
    Because it can grow, and has a 50% chance of turning invasive.
  • Are you considering holistic/natural/alternative alternatives?
    Yes!  We are looking for a natropath/nutritionist in DFW to work with to compliment the traditional therapies.  If you know if someone email us.
  • How long will the surgeries take to recover from?
    The lumpectomy is outpatient surgery that takes 2-5 days fully bounce back from.  The mastectomy takes 1-2 weeks to fully recover from.
  • What are the side affects of radiation?
    Not much since it’s it’s local.
  • What about chemotherapy?
    There’s only one drug, Tamoxifen, that can help with this type of Stage 0 cancer.  Based on the tests so far, it doesn’t seem to be a fit, so we probably won’t need any.
  • Will Holly loose her hair?
    Hair loss is usually cause by some of the chemotherapy drugs.  Since that seems very unlikely at this point, she should not loose any of her luscious locks.
  • What’s the timeframe on all this?
    The surgeon said she would like to see the surgery happen in the next 30 days.

Thanks for all the sweet notes and prayers.  We feel every one, and there are times that’s all that seems to sustain. 

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