Wednesday, March 9, 2016

I Hate Your Rotten Guts

Okay, so last time I said that the latest report from the oncologist made us feel like we were on a roller coaster. Actually, I think it feels more like this.
while screaming "I HATE YOUR ROTTEN GUTS!!" to cancer, pain, suffering, and death. 
We spent most of our day at the hospital yesterday, perhaps the last time we will need to do that for awhile. We had asked for prayer that the results would be conclusive, and I think God graciously answered those prayers. Here's a summary. 

What We Found Out
*James had two severely restricted airways. The pulmonologist said it is "classic" radiation damage. The airways were "pinholes" too small for the bronchoscope to enter. In one, the pulmonologist was able to inflate a balloon and open it up. Time will tell if it will stay open. In the other (which leads to the right middle lobe), he was able to insert and inflate a balloon, but as soon as the balloon was removed the airway went back to its original size. The pulmonologist also stated that the airway leading to the right middle lobe is so constricted that it will possibly close off completely, resulting in James losing his right middle lobe. Thankfully, if and when that happens, that is the smallest lobe of your lungs, live.  

*The pulmonologist saw no visible tumors. (Yeah! Good news!)

*Pathology was at the bedside and as the pulmonologist was removing tissue samples for biopsy, they found cancer cells. (See above picture for how we feel about that.)

*The conclusion is that James has a recurrence of lung cancer, which is completely likely and, in many ways, expected. There is a reason they track you every 2 months after they think you are in the clear: this crap is aggressive and is likely to recur. They assume that James's hip is metastasized lung cancer. 

Where We Go From Here
*Tissue samples will be sent for genetic testing for one more (rare) mutation. If James does have this mutation, he will start a daily oral chemo pill. The results of this test will take about 2 weeks. 

*Assuming he does not have this mutation, James will start the immunotherapy drug pembrolizumab on March 23rd. This is not chemotherapy, but a relatively new drug that was recently approved for use with lung cancer patients. It is given intravenously once every 3 weeks. Most patients tolerate it very well (ie, much better than chemo) with very few side effects. For those of you who are really interested in research, James does have the PD-L1 biomarker.

How Are You Guys Doing? (No, Really...)
We know that if you're reading this, its because you love & care for us deeply, so we know that this news will be met with sadness, grief, and maybe even anger. I think this is valid, and I think you should let God know. 

To be quite honest, after the doctor's appointment last week James and I both ended up wrestling with God with where this journey seemed to be heading. By the weekend, though, we had both willingly submitted to His plan and were able to pray, "Not my will, but Yours be done." We are very much perplexed, but we do not despair. He has graciously given us His peace.

I think one of the greatest joys of my life came yesterday when I was reflecting on this "sudden" turn of events. I realized that when the doctor called me over to that little glass room in the basement for a consult, I didn't feel that my world was imploding. The word "cancer" came off his lips, and I could accept it. The first time James was diagnosed, we felt lost. We were shocked, stunned, and grieved to the core. Cancer came into our lives and had us in a choke hold. Or maybe it was trying to drown us. This is not to say that God didn't meet us in those times. He did, and He showed Himself present and merciful in some really spectacular ways. 

But this time was so very different. Our future remains incredibly unclear, with all sorts of unknowns. My parting words to the doctor yesterday first expressed my gratitude, and then I said, "So James lives to die another day. That's true for each of us." I don't think I expected the sobering effect that would have on him. Yet if there's only one "gift" of cancer, it is that it makes you incredibly aware of your own mortality. James is going to die. I am going to die. You are going to die. It might not be today, but it is going to be one day. And when all this temporal rubbish passes away and we live in the true reality of the "eternal glory in Christ Jesus" I know we won't be sorry. Not for one millisecond. 

So yesterday it was with joy that I realized - I have changed. God has changed me. I can look cancer in the face and say that I am not afraid. I can look at all the loose ends that are my life, and be at peace with where God has me. I can see all the unanswered questions, and see that I have an opportunity to happily trust Him. I can joyfully accept this path, and I can willingly submit to all He has for us. We do not feel our lives are screeching to a halt, imploding, or spinning out of control. James actually said he was "encouraged" that things weren't as bad as he thought they'd be. We have hope. Hope that is real and sure. This is not the end. And even when death comes...and it will...that is not the end. 

So when I realized that once upon a time...not so very long ago...I struggled to do any of these things, I rejoiced with deep gratitude in my soul. God has changed us, is changing us, and will continue to change us. For His greater glory. Amen and Amen. 

But Please Pray
Okay, so we are feeling emotionally and spiritually bolted together today, but that doesn't mean we don't covet your prayers. We need them now as much as ever. Our faith, peace, and joy are inextricably tied to your prayers for us. 

*Thank God that James's cancer seems to be progressing slowly/slower than normal. One thing that Dr. Einhorn had told us pre-PET scan was that if James's hip was cancerous, there would be multiple bone tumors at this point. But there aren't. Just the one. And no visible tumors in the lungs. Praise God.

*Ask for God's continued "intervention" in our lives. I keep thinking how none of this has gone the way doctors expect/have expected. Pray that that continues, for God to continue to miraculously override the typical path, and that God will use all this "confounding of the wise" to bring glory to Himself. 

*Ask for God's deliverance. I have no idea what that would even look like at this point...what does healing look like when you're set on a path of drug therapy that does not stop until your cancer stops responding? Do you get to a point where you've been doing so well for so long that they decide to see what happens with no treatment? I have no idea. But let's not lose heart, resigning ourselves to the typical outcome (ie, death). I want James to live. Jesus came to give us abundant life. So let's pray for that. 

*Pray for God's clear guidance over the next days, weeks, and months. Where should we live? (Continue with my parents? A house? An apartment? A large-ish box?) What should we do? (Work? Ministry? Sit around for extended periods of time?) What should we drive? (Please something different!) What should we do with our "life" in China? (Sell it? Store it? Keep it? Move it?) How do we manage a restaurant and ministry now that it seems clear we are not returning any time soon? (Uhh....)

*Pray for our girls - who do not yet know their Daddy is not yet well. I hear lots of people talking about praying James is around for them, and healthy for them, for memories of him, and all that. Those are good, fine prayers, and you can continue to pray them. But pray most of all that through all of this, no mater what happens, that this would drive them to God where they can find the love of a perfect Father. May they come to love and trust Him, even through this. No. Matter. What.

Thank you. You're awesome.
And unless you're cancer, I don't hate your rotten guts.


  1. We continue to pray even when we don't know how to express our hearts most deepest desires. We are encouraged greatly by your faith, love and trust in our great God. Numb comes to mind when I wonder how I would feel if faced with the ugly C word. We love your family and treasure your friendship. And even though the doctors have given time frames we continue to pray for James to experience a miracle of healing. Through it all we trust with hope. 💕🙏

  2. I don't even know what to say. Praying, knowing the Holy Spirit can utter what my heart cannot convey. Encouraged by your faith. Lord, be near to our friends.

  3. Sending so much love, Kristen. I rejoice that the wonderful hands of Jesus are holding you close during these days. (And PS: I'm with you in hating cancer's rotten guts.)

  4. Sweet friends...we just love you. Ron, Teresa and Zoe.