A Man, A Plan, A Scan...China

Hi friends! Trusting that you had wonderful, bless-ed holidays and, like me, have sufficiently dug out of the new year haze to feel more hopeful than overwhelmed. James had an appointment with Dr. Einhorn this week which gave us greater understanding as to what just happened. And, we have something of a plan!  Exciting times ahead for sure.

James remains disease-free.
When we asked Dr. Einhorn how they made this determination, he graciously responded with a chuckle and a, "Well, that's a fair question." Apparently, once you've had cancer, in a sense you never really have a "clean" scan. Because of previous tumors, because of scarring, because of necrosis (one of my all-time favorite medical words!) there are lots of causes for "blips" on a PET which need to be monitored but do not warrant further treatment.

Instead, oncologists look for "progression" of the disease which looks like new tumors or growth of previous tumors. James has none of this.

James does not currently need further treatment.
If you recall, last summer James had two spots that showed up on his PET scan which then led to more chemotherapy. One, a lymph node, and the other, a spot on his hip (ilium). The lymph node in and of itself was not enough to warrant chemotherapy, as it was considered one of those typical "I had cancer in the last six months" blips. The bone, however, was understood to be metastatic lung cancer which needed immediate attention.

Yet Einhorn's team knows the following about squamous lung cancer - only in the rarest of cases does it metastasize to bone, and, as Dr. Einhorn remarked, "would that everyone's metastatic cancer responded so well to chemotherapy." That is to say, the tumor in James's hip really shouldn't have responded the way that it did. It is so unusual, in fact, that they remain unconvinced that it was ever actually a tumor. (On the other hand, James & I believe that it was, and that God miraculously intervened. Choose your worldview, and the interpretation of events will follow, I suppose.)

So, with the hip tumor "mysteriously" gone, James is considered disease free and thus no longer needs treatment.

Important Next Steps
1. On Monday, January 11 at 10:45, James will return to his thoracic surgeon to have his port removed. This is a huge milestone.  I am sure it will feel a lot like freedom. Pray that James comes out of anesthesia quickly (this is usually a struggle), pray for healing without complications, and pray that we'd have the opportunity to testify to the surgeon, Dr. Freeman. A Christian colleague of his described him as an honest, ethical man who is otherwise lost. May God's dealings with James speak to his heart.

2. James will be allergy tested on Tuesday...he is currently on an asthma inhaler & it has helped tremendously with his coughing. We believe that James has allergies, and think that having allergies on top of compromised lung function (due to scarring from cancer, chemotherapy, and radiation) may be contributing to his cough. It will be interesting to get a perspective from another discipline within the medical community...we've been encouraged that James was actually able to run a few hundred feet a couple times this week after being on the inhaler. (Something he's not been able to do in over a year!)  Continue to pray for complete restoration & healing.

3. Dr. Einhorn will continue to follow-up with James every two months this year. However, he understands our desire to return to China and has no problems with us returning as long as James continues to have clean scans. He would like to get James to the summer, so whether that means we return after May's follow up or wait until after July's follow up is yet to be determined. Einhorn seemed comfortable with both, though of course it all depends on how James is doing. Pray for wisdom, and pray that we would perceive and follow God's leading.

4. In the meantime, James gets to return home to celebrate Chinese New Year with his family. It will be a joyous celebration, no doubt. Pray that God would work mightily among his family and friends, that they would be humbled and give glory to God, and that the Spirit would use James's testimony to convict them of righteousness and judgment.

5. James will have a full-body PET in March to check once more on his hip "tumor." We may never really know what that was...but maybe the PET scan will give them some helpful information. James does have occasional pain there, and while he is awfully young to have arthritis, that is one possibility. Pray that God continues to heal this area...or that doctors can determine what it is to treat it accordingly.

6. For the long term, James will continue to be monitored by Dr. Einhorn. Every four months for years 2-3, every 6 months for years 4-5, and every year after 5 years. Dr. Einhorn has several "international" patients that he monitors, and is completely comfortable getting scans from James from overseas. Interestingly, Dr. Theera, the oncologist who first diagnosed James when we were in Bangkok, Thailand, was once a colleague of Dr. Einhorn's at MD Anderson. It is possible that James will return to Bangkok & Dr. Theera for at least some of his future scans.

As this is turning into a lengthy post, I won't say any more but to thank you all again for all the many, many prayers on our behalf and to say that God continues to be gracious. James is regaining strength, hair, and eyebrows...and we are thankful.