Building Upon Positive Developments

Welcome back to the next blog post. It’s been a while since the last posting so I’m providing an update covering the past few weeks.

As stated in a previous post, I returned to Kansas City following the first round of treatment. It was great being back in the office at work and having the opportunity to interact with more people on a daily basis. I returned to St. Louis for the second round of treatment on April 20. The second round went well and my doctor was very encouraged that side effects and pain have been minimal. This past week I remained in St. Louis for another echocardiogram of my heart and follow up appointment with the cardiologist. The echocardiogram checked for fluid build-up. The results of the test were outstanding as my heart continues to be free of fluid. You might remember from an earlier post that the lack of fluid in heart and lungs is a positive development regarding the treatment of cancer. It could mean that treatment is working; however, I won’t have a more definitive answer about the treatment’s effectiveness until I undergo tests at the end of May. Cancer treatment can be unpredictable and I’m not assuming anything. Maureen and I are remaining cautiously optimistic.

Over the past few weeks my physical condition has continued to improve. In addition to the lack of pain, my energy level has increased and I have even started to work out in a limited capacity. Four to five times a week I do a brisk walk for 45-60 minutes. This past week I have incorporated a jog into that walk for about 10 minutes, and I finish with push-ups and ab exercises. The exercise has helped both mentally and physically. My goal is to become the best in-shape stage 4 lung cancer patient ever.

Reflecting over the past 2 months it’s astounding to see the progress I’ve made. It started with a trip to the Emergency Room and nearly experiencing Cardiac Tamponade from the fluid in my heart. I then was admitted into the Intensive Care Unit for 4 days and diagnosed with stage 4 lung cancer. I returned to the Emergency Room a second time to have fluid drained from my lungs. Treatment is now underway and I’m feeling great. I am providing this recap to highlight the contrast in my condition from the initial diagnosis to present day.  The prayers and support that Maureen and I have received have certainly played a huge role in this recovery. 

The next two weeks should be fairly routine. The third round of treatment is scheduled for Friday, May 12. Following the third round will be the most significant milestone to-date; in which I will be re-scanned to determine the treatment's (Keytruda) effectiveness. Stay tuned for more updates. I expect to have another post following the third round of treatment (May 12). 

A Return To Kansas City

It’s been an encouraging past few days. With the exception of fatigue, side effects continue to be minimal from last week’s treatment. On Thursday I had a chest x-ray and an appointment with my pulmonologist. The x-ray showed that my lungs had minimal fluid buildup since the left lung was drained three weeks ago. This is a great sign because now we can focus 100% on the cancer as long as the fluid remains under control. As long as I have cancer there is always the potential for fluid to accumulate in the heart and lungs; however, once the cancer begins to shrink, any fluid should dissipate.

Since I continue to feel good and don’t have any upcoming doctor appointments, I have returned to Kansas City. It’s certainly great to be back and I’m looking forward to working in the office for at least a few days this week.

My next round of Keytruda (immunotherapy treatment) is scheduled for Thursday, April 20 and will continue to be administered every three weeks. Following the third infusion I will undergo a battery of tests to determine if the drug is working. This will be a significant milestone. If it works, we will probably continue with the current plan and there will be time and flexibility in my favor. At this point I’m not thinking about the scenario in which it doesn’t work. I’m going to leave that to my medical team. Fortunately, along the way, there will be minor signs that can provide some guidance on the effectiveness of my treatment. As stated previously, if my lungs and heart continue to be free of fluid that could be a sign that treatment is working. Additionally, if I continue to feel good and have minimal pain, that will also be encouraging.

Now that my life and health has stabilized to some extent I don’t expect to have as much news every week. Therefore, I expect that the blog will be updated less frequently. For now I expect to have a new blog post uploaded at the end of April following the second round of treatment and an appointment with the cardiologist. If something significant occurs I will definitely post an update as soon as possible, but hopefully things will be stable for the next few weeks.

My best course of action is to remain positive, maintain a healthy lifestyle, get plenty of rest, and pray. Maureen and I continue to feel the impact of the support and prayers that everyone has provided. I have come a long way since I was taken to the emergency room in February. Part of it is due to my body’s willingness to fight and much of it is from the prayers and support.

The Fight Has Begun

Another eventful week is in the books. I am excited to announce that I received my first round of treatment Friday morning. This was a week earlier than expected, but my oncologist finalized the treatment plan during the week and wanted to go ahead and begin treatment immediately.

Unfortunately the final test results continued to show that my cancer did not possess any of the biomarkers that could be treated with targeted therapy. As a result, this limits the amount of treatment options available.

However, I am receiving a newly approved immunotherapy treatment called Keytruda. My test results showed that my cancer has high levels of Programmed Death – ligand 1 (PD-L1). PD-L1 suppresses the immune system and masks the cancer from detection, resulting in the cancer’s powerful ability to grow and spread. The immunotherapy is designed to expose the cancer cells and activate the immune system to fight and hopefully eliminate it. This marks a stark contrast to chemotherapy and many other forms of treatment, which typically involve chemicals and radiation to kill any fast growing cells. Fortunately, this means that immunotherapy side effects are less severe and will keep me eligible for new treatments or clinical trials that are developed in the future.

It took longer than anticipated to finalize the treatment plan, but the decision was made based on the culmination of a variety of tests including: CT scans, PET scans, brain MRI, lymph node biopsy, echocardiograms, blood tests, and fluid tested from my heart and lungs. Additionally, my oncologist sought feedback from a board of lung cancer specialists who unanimously agreed that immunotherapy was best for frontline treatment.

This treatment is not necessarily considered curative, but everyone responds differently to cancer treatment. There is minimal research on the effectiveness of this treatment for young non-smokers with advanced stage 4 cancer. It’s possible that this drug will not generate the required results or it could work magnificently. There have been many cases in which people have had prolonged positive responses to Keytruda. My oncologist is estimating that there is a 40% chance that the cancer will respond positively. I have faith that the prayers and support can bridge the gap of uncertainty and result in a success.

I’m excited for this treatment because it relies on my body to fight and not poisonous drugs to kill any rapidly growing cells. My body is ready to fight. Since my immune system is my main weapon, I have revamped my diet in an effort to rev up and supercharge my immune system. Some of these changes include: increasing my intake of dark green leaves (spinach, collard greens, and kale), other fruits and vegetables, herbal remedies, and vitamin supplements. Anything that I can do in addition to the treatment is going to help

Overall, the first infusion of the drug was a positive experience. Keytruda is given intravenously and takes about 30 minutes. This is significantly less compared to traditional chemotherapy which can take up to 8 hours for an infusion. At the time of publication of this blog post side effects have been minimal, resulting in only fatigue.

It was very sobering observing the other cancer patients receiving their treatment. It is amazing to see the strength of so many others that are battling cancer. Despite having stage 4 of the deadliest form of cancer, I certainly recognize that there are many in worse situations. I have plenty to be thankful for and I thank God for it.

Thank you once again for the prayers and support. I feel the impact of it every day. Despite my current situation, this has been one of the least stressful and most peaceful times in my life and I know that is not by coincidence. It is certain to get treacherous as I progress through treatment, but I have all the ammunition necessary to be successful.