(Un)common Sense

The words were like music to my ears as the hospital pharmacist handed over a small brown paper bag in the waiting room of the Oncology Department at Auckland Hospital. A wave of relief swept over me as I took possession of the precious potential life-saving pills.

I finally had them.

I clutched them tightly as I walked to the car thinking about the transaction that had just taken place in the hospital. I could have been a drug addict participating in an illicit deal – a container of pills worth thousands of dollars concealed in a brown paper bag being handed over under hushed conversation in a quiet corridor. The only thing missing was the cash payment – but I imagine my years of paying taxes probably contributed enough to the health system to pay for the drugs.

The only catch – I had to come back to the hospital every 3 weeks to pick up a new batch of pills (as well as for a quick checkup on my progress) – a relatively small price to pay to have a piece of a brand new scientific breakthrough in the area of cancer treatment in my hot little hands.

When I left the Oncology department, I saw a lady standing outside clutching a brown paper bag identical to mine. I asked her if she had also received ‘the goods’. She had. Was this her first round? It was. We were instant drug-buddies.

She told me she had been battling melanoma for 4 years – longer than the ‘wonder drug’ had been in existence. She had gone through traditional DTIC-based chemotherapy and was fortunate enough to go into remission for 14 months.

But it had come back. And it did not respond to chemo this time. She was as happy as I was to be clutching the Brown Paper Bag of Hope. 

Sometimes people need hope they can hold onto. When the oncologist let slip with the ‘I’ word – Incurable – while talking about stage-4 metastatic melanoma during my visit, he was pronouncing a expectation of a negative outcome.

In the Bible, God says, “…the plans I have for you…are for good not for disaster, to give you a future and a hope.”*

In the eyes of the oncologist, I had been  ’doomed’ by my disease. I assured him I wasn’t going anywhere and my expectation was for a full recovery.

‘Til next time,
David

*Jeremiah 29:11 (NLT)

Well I could have called this blog post “The Good, The Bad and The Ugly” but there really wasn’t anything particularly ugly about today so I’ve gone with a relatively boring title.

Today’s visit to the Auckland Hospital Oncology department was a new chapter in my journey through cancer. They gave me the bad news first, followed by the good (not that I had a choice). The June CT scan had shown the cancer was still there. And it was bigger. And there was more of it. And it had resurfaced in my neck around the area where I was operated on in December.

Where’s the good news I hear you ask. Well, that test that I had to determine if I was genetically eligible for a new type of drug (B-Raf inhibitor) came back positive. This is great news as the success rates of the B-Raf inhibitors are a lot higher than traditional chemotherapy drugs – recent trials of the drug Dabrafenib have shown a 47% partial success rate and a 3% complete success rate, far higher than the 6% success rate with the 40-year old chemotherapy drug dacarbazine (DTIC) commonly used for treating patients with metastatic melanoma.

The next step in my case is for the hospital to apply to the Dabrafenib drug manufacturer GlaxoSmithKline for me to go onto their drug trial on ‘compassionate grounds’ as the drug is not funded by the NZ government at this stage. This process may up to 4-6 weeks although it could be quicker.

If there’s one thing doctors don’t generally like, it’s uncertainty. When the young doctor told me they really had no idea how effective the new drug might be in my situation, her body language conveyed a feeling of empathy for our situation. That’s why she seemed a little surprised when my wife Tracy told her how great the uncertainty was because it meant there was every opportunity for something good to happen.

Of course, what Tracy was alluding to was God’s ability to heal me from cancer completely. That ‘not knowing the outcome’ factor that could have brought fear and worry to our hearts instead brought excitement and expectancy about what God can and will do for us. 

Whatever the uncertain situations we face in life, we have to choose to focus on the positive outcomes and speak them out as though they were a done deal. Otherwise if we speak the negative outcomes over our situation we take ourselves out of the realm of the miraculous and become subject to the power of the ‘natural odds’.

So the future looks bright for me. How does yours look?

‘Til next time
David

I was thinking as I was driving home from the hospital this afternoon that there was something much worse than having cancer – worrying about having cancer.

What’s the worst cancer can do but take your life. Worry kills you every day you’re alive – if you let it.

A while back a guy called Jesus gave this great quote, “Don’t worry about your life, what you will eat or drink or wear…who can add a single moment to their life by worrying?”* The fact is, God cares about us deeply** – we just need to give him our burdens and not hold on to worry about the unknown.

The medical oncologist I visited today gave me basically the same story as last week’s consult with the surgical oncologist but with more detail about drugs and how they worked. He also said the B-RAF inhibiting ‘wonder drug’ had mixed results and didn’t have a long-term effect in most patients. He also said that the list of chemotherapy drugs used to treat malignant melanoma was a lot shorter than those used for treating other cancers and that the main drug used was effective in only 10-15% of cases.

Heavy stuff.

I asked him why he got into oncology – surely there was another field of medicine with a higher probability of patient cure? He said he just wanted to keep it real.

I think deep down he wants to smash cancer into little tiny pieces as much as I do.

So while he waits for scientists to come up with new wonder-drugs, he will persevere with treating people at the coal-face with drugs that have limited ability to cure cancer. The science (and mathematics) of cancer treatment is average at best. He has the unenviable task of being upfront about the odds while trying to still get people to hold out hope that they will be one of the lucky ones.

Melanoma, I’ve been told, can be quite unpredictable – it can grow quickly and regress just as fast. Another CT scan has been booked in June so they can see how much the cancer has spread (or not) since the last scan in March. This will also give them time to get the results of the B-RAF testing so they know if they can give me the B-RAF inhibiting drug.

In the meantime I’m going to continue on with my life and not let worry’s what-if’s rob me.

David

* Matthew 6:25-34
** 1 Peter 5:7 

Had a phone call on Friday afternoon from Auckland Hospital asking me if I could come to the Oncology Department on Monday afternoon (28th).

Obviously I said yes, but I was amazed at how quickly I was able to be seen – I was originally told at the Wednesday consult that it could be a month before I got to see an Oncologist due to their high waiting list. 

So more good news for me (yay!). Will keep you posted on the outcome of the meeting.

David

P.S. Thanks to everyone out there who is praying for me – your support is greatly appreciated