Hi all - thanks for checking in with us again! I'm sorry that between the technology issues and the pace of life we've kept up over here, our postings have been few and far between. Nevertheless, James made it back to the States on Monday, and yesterday (or today, depending on where you are in the world) (Wednesday) James had his PET scan and a review with the doctor. Dr. Einhorn was away at a medical conference, so James was seen by his colleague. (Just to forewarn you of the coming pronoun change.)
I'll first share her observations & then the conclusion.
She noted that James is doing really well and looks really good. He's put on some weight (not surprisingly!) which is noted a good thing in cancer world. I was able to mention that his energy levels are way up even from two months ago, and that his cough is generally improved as well. She felt that overall he is doing great and looking quite healthy. She was really pleased with his overall condition.
Per the scan, all the tumors in his chest are stable. There is one spot that was a little brighter than before, but not enough to worry about yet. His hip, however, continues to light up strongly with no improvement. In fact, it is a bit worse than before - though whether this denotes tumor growth or inflammation (15 hour plane flight, anyone?) is impossible to discern.
She observed that James is definitely favoring his hip, making sure that he doesn't do too much to cause additional pain. She was not comfortable with him continuing like this. She also doesn't like the possibility of tumor growth.
So, the plan for now is to continue on with the immunotherapy. She felt that James needs more time, and that given that his overall health is improving & that the tumors are stable is proof enough that it may be working. Yesterday was his 5th dose, so he's only been on this for 3 months. I get the sense that they were expecting a fairly immediate result, but as James's cancer never acts the way they think it should, I am not surprised. And I am also thankful that we're not pulling the plug on immunotherapy yet.
Additionally, given James's age, energy level, and the reality of present cancer she has recommended that James start radiating his hip. She doesn't want any tumor growth and they know (as much as they "know" anything related to James's cancer - ha!) that radiation will help with pain. Different than before - where radiation was daily for over a month - this will be a once a month treatment between immunotherapy treatments. For all I know, this may kill off the tumor there...though they haven't said that. (Personally, while I believe it's a tumor there, I am not fully convinced that it's lung cancer in the bone...since it doesn't act the way it's supposed to and they've never biopsied it.) Who knows but that radiation may be a means of His grace to bring healing. We can at least pray toward that end.
So we move forward. As I said, we are both thankful that James gets more time with the immunotherapy. James was feeling less then thrilled about radiation, but I believe that since it's not daily nor concurrent with chemotherapy, his experience with it this time will likely be radically different than before. We are both genuinely thankful that James had such an incredible month here in China, impacting so many people in such a short time. We give thanks that James's health is improving, and that the cancer is stable. As I told the doctor yesterday,* I think that is counted as a win in the world of cancer.
We both feel strongly to continue to move forward, one day at a time, trusting in God's loving care. We are called to believe and to trust in who He is, and that His plans for us are genuinely good, even when things don't go exactly the way we want them to. (See Tim Challies, "God Doesn't Owe Us a Happy Ending.") So for today, we have grace to believe that God is faithful, and He will sustain us to the end (1 Corinthians 1:8,9).
Thanks, as always, for your prayers! (And for reading what seems to be a very dry blog post!)
~james & kristen
*Yes, I talked to the doctor via James's WeChat app - there I was, stumbling out of bed at 12:30a.m. like a drunk housewife, trying to put coherent thoughts together while simultaneously trying not to wake everyone in my house. I am sure I made quite a first impression!