Dann's Cancer Chronicles

CT Scan Results Feb 5, 2012

2012-02-05T20:09:00.001-08:00

Friends and Family,

I had a CT scan of my lungs this past week. Genevieve and I had been getting increasingly tense and preoccupied for the week leading up to this scan. This was my first scan after being on only Avastin, so we didn't know if this Chemo Lite was doing anything. if it doesn't work, I lose a safety net. For as long as it works, Avastin keeps extending my life.

The results are in, and the Avastin is working. There was no growth in my lung cancer. The scans will be nine weeks apart, so every "no-growth" scan means my life is extended another 63 days. Every one of these days feels like a gift. Of course, the hope is that when I eventually start the targeted genetic therapy (Tarceva) it will eliminate the cancer completely.

People stay on this Chemo Lite for anywhere from two months to 20 months. I've been on it for nine weeks. No surprise here, but my goal is to set the record!

Thank you for your continued positive energy, prayers, and love. You are making a huge difference. It's been six months since I was diagnosed, and with the exception of minor symptoms, I feel as healthy as I did a year ago. My hair has even grown back. (Thank you, Miracle Grow!)

Just like last time, the grey hairs came back first, though for some reason more grays filled in than when I went through this five years ago. Genevieve has even trimmed my hair three times. Because the longer grays were covering the black hairs, each time my hair looked darker after it was trimmed. If this keeps working, I'm thinking of having Genevieve cut my hair indefinitely.

Love,

Dann

MRI + More January 21, 2012

2012-01-21T18:40:00.001-08:00

Friends and Family,

Bad news on the health front. I'm turning into my grandmother.

You know how we all have that secret fear that one day we will wake up, look in the mirror, and see one of our parents looking back? I've skipped a generation.

Conversations with Gramma would go like this: "How are you, Gramma?" Gramma would then recount her last visit with her doctor, word for word, including a description of when her doctor smiled, or chuckled, or looked concerned. If there was an ongoing health issue involved, the conversation would also include relevant portions of previous conversations. I found it best to ask Gramma this question when sitting next to a table with snacks, so I could keep up my nourishment throughout the story. For a woman with health issues, my Gramma had stamina.

So now it's me doing this. Someone asks, "How are you, Dann?" At this point I have an internal debate. Do I give this person my latest health report? Or do I give some socially acceptable response such as "I'm fine"? The wheels churn as I calculate whether there is anything new to share, if what I find important will seem important to this person, whether they are really just saying "hello", etc.

The tone of conversation has changed at home as well. Here's an example: Genevieve comes home, and I say, "Hi Sweetheart. Let's go upstairs to our bedroom. I'll slip off my shirt - and you can check to see how my incision is healing."

This incision conversation went on for four months because the chemo slowed the healing from my biopsy surgery in August. Now that it's healed I can do Manly Man things at the gym again like lift weights (grrrrr), shoot hoops, and, um, do yoga. But even the Chemo Lite causes some side effects, so Genevieve and I are still having daily conversations about my health.

I get why Gramma talked about her health so much. When your life depends on it, and it's fragile, it becomes the focus of conversation. It's just that I don't want to feel like I'm 93 yet, and I want room in my marriage for broader, richer conversations.

We talk about cold symptoms (ongoing for 3+ months), escalated blood pressure, and a headache. The headache wouldn't be an issue, except that it hasn't gone away for several weeks. Since the first place that lung cancer usually spreads is to the brain, my doctor got concerned. On Tuesday he ordered an MRI to find out if I have a brain tumor.

Ron, a friend of mine, died of lung cancer last year after it spread to his brain. Once it spread he had radiation treatment, and his functioning declined rapidly. The memory of Ron brought this even closer to home. Genevieve and I were both distracted, distant and on edge. If the doctor was going to worry about a brain tumor, we were going to be worried about a brain tumor. Neither of us could sleep well from Tuesday until Friday, when my doctor called.

The MRI showed no cancer in my brain. I feel about two tons lighter. I'm now taking blood pressure medication, which should take care of the headache. And I'm well enough to share my health news with all of you by email.

Gramma would be jealous.

Love,

Dann

Maintenance Phase January 16, 2012

2012-01-16T20:20:00.000-08:00

Friends and Family,

Just a brief update. I'm continuing with my "maintenance" phase of chemo. I consider this Chemo Lite. It prevents the cancer from growing, but the side effects are minimal.

I have Chemo Lite every three weeks, just like I did with the regular chemo. I've had three rounds of Chemo Lite now, including last Thursday. Each time, just before the nurse hooks me up to the IV, I ask to hold the chemo (Avastin) bag. In my mind (and heart!) I ask the drug to do its work by keeping the cancer at bay. I also thank it for extending my life. At that point I have a profound feeling of gratitude. It's because I fully appreciate that my life has been extended for another three weeks.

You know how people say that you should keep up your hope, because new cancer treatments are coming along all the time? I am living proof of this. Five years ago when I had lung cancer, I went through surgery to remove one lobe of my lung, and had chemo both before and after the surgery. I survived long enough for amazing new treatments to come along.

Five years ago there was no Avastin, so there was no maintenance phase. There was also no targeted genetic therapy, which I will start after the Avastin stops working. The targeted genetic therapy is my greatest hope for eliminating the cancer completely, or at least my greatest hope for extending my life by months or years. Even while it extends my life, newer treatments are being developed.

Genevieve's son Aidan is a doctor. He recently told me that if he was a newly-minted physician and was choosing a specialty, he wouldn't consider oncology. The reason: He thinks cancer would be cured before he was ready to retire.

What a beautiful thought.

Love,

Dann

Hope December 8, 2011

2011-12-09T19:40:00.000-08:00

Friends and Family,

The news is full of positives. Last Tuesday I had a CT scan, and the results showed NO GROWTH in the cancer!

Next, Genevieve and I met with my oncologist last Thursday. He completely stunned us. He said that he is hopeful that the genetic drug Tarceva will shrink the cancer away COMPLETELY. This is because I have many tiny spots rather than large tumors, so it's easier for the drug to get at the cancer.

With so much on the line, it's hard to let go and accept that much hope. The more I allow in, the more vulnerable I am if it doesn't work out. Sounds kind of like a relationship, doesn't it? Better to have loved and lost... I guess it's time to work on this one.

I started the "maintenance" phase on Thursday, where I have an infusion of Avastin every three weeks. It's a chemo-type drug but without the wicked side effects. I'll stay on Avastin for as long as it keeps the cancer from growing - anywhere from a couple of months to a couple of years. The longer the better! This is the last step before the genetic treatment phase.

With the "real" chemo now finished, my hair is growing again. Like the first crocuses of spring pushing out from under the rocks, the little nubbins are popping up everywhere. It's proof that there's life after chemo. Except... all the hairs are grey! It happened this way five years ago, too. The grays popped up first, and the black followed. I just figured that the grays were more experienced, so they led the way. This time I'm hoping that there are enough black hairs left so that I will know when they have made their appearance.

Wishing you joy though the holidays. There is so much to be grateful for.

Love,

Dann

Last Round of Chemo November 13, 2011

2011-11-13T12:17:00.001-08:00

Friends and Family,

Thursday was my last day of chemo, and it turned out to be a real treat. Genevieve and her twin sister Charlotte came with me for the first part of the day. Genevieve has been with me for every minute of every appointment, and Char was with me in chemo for the first time. Since I knew they had to leave to drive to a workshop at Mt. Shasta, I invited my friend Buck to sit with me for the rest of the day. This is a full day process - We start at 8:00, and finish at 4:30 - so having the support is a real gift. However, Buck went way beyond, and absolutely floored me. In support of me, he shaved his head bald!!! It is one of the few times in my life I have been left nearly speechless. We spent the rest of the day arguing about who looks better bald, and in mock indignation when people told us we looked like brothers.

I spend a lot of time wondering how well the next phases of treatment will go, and what will come next. I don't know how much time I have left to live. We all start thinking more about what our life meant, and what it still means, and what we have left to do as we get older. That process has been accelerated for me. I think about what I can do that will make the treatment more successful so that I can live longer. Then I remind myself that these positive steps will not only improve my chances of living longer, they will also make my life better. Isn't that what it's all about? Why wait until a moment like this to think about what will make your life better?

A few weeks ago Genevieve and I went out to dinner with some close friends, Chaz and Virginia. Chaz always asks the most thought provoking questions. He asked what I was learning this time that is different than what I learned when I had cancer five years ago. I told him that last time, the number one thing that I was focused on was removing the cancers from my life. This includes negative people, negative conversations with otherwise healthy people, some of the negative news, terrorism in television shows etc.

This time is different. Although there are others, I'm focusing on asking for what I want and need. Next comes the even harder part, accepting it when it is offered! Both are about love. Five years ago I wouldn't have asked my friend Buck to sit with me in chemo, and I would have missed out on something very special.

I'm also focusing on giving love to others. It has been trivialized in greeting cards and songs, but it seems more true the more time I spend thinking about it: We need love more than anything else in this world. I wouldn't be alive without love today. Would you?

On to the practical details. Here's what comes next for treatment. I'll recover from this round of chemo in three weeks, and then start a "maintenance" phase. I'll be on Avastin, which prevents blood vessels from expanding into the cancer, which keeps the cancer from growing. It won't shrink the cancer, so it just buys time. I'll be on this drug by itself for anywhere from 2 months to two years, depending on whether ongoing CT scans show any growth. Avastin is one of the three chemo meds I'm already taking, but it's the one with minimal side effects. My hair will grow back, I'll have all my energy, and I won't have nausea.

When the Avastin stops working, I'll switch to a pill called Tarceva, the genetic drug. It works for months, or years, or permanently. It will shrink the cancer, or keep it from growing, with minimal side effects.

Here's another great source of hope. Five years ago when I had cancer, there was no Avastin and there was no Tarceva. Cancer treatment is advancing at an amazing pace. While I'm buying more time, being treated with Avastin and Tarceva, new advances are on the way. I don't have to rely on the hope that new advances are coming out every few years. I'm BENEFITTING from those advances right now! What better source of hope could there be than this that more advances are on the way?

Love to you all.

Dann

CT Scan Results October 20, 2011

2011-10-30T17:22:00.000-07:00

Friends and Family,

Genevieve and I met with my oncologist before my chemo session today and got the results of my CT scan. The cancer didn't shrink, but it also didn't grow. However, the greatest hope has always been in the upcoming gene therapy. Any shrinkage from the chemo would have been a bonus.

Based on these results, I'll have just one more round of chemo in another three weeks. After that, I'll take a med called Avastin every three weeks. It keeps the cancer from growing all by itself. That usually works for another 2 to 20 months. Side effects are next to nothing compared with the full chemo.

When the cancer starts growing again, I'll start on the gene therapy medication called Tarceva. The timing is extremely fortunate for me, since this med just came on the market two months ago. It's a pill designed to stop the cancer from growing or shrink it. Better yet, 8-10% of the time, the cancer goes away completely. My oncologist thinks my odds are better than that, because the med works best on people who are in good shape and non-smokers. I have every intention of being in the 8-10% group.

Thank you again for all your expressions of caring. They are very much appreciated.

Love,

Dann

Training October 12, 2011

2011-10-12T21:02:00.001-07:00

Friends and Family,

First, about the hair. Gone. Pffft. It started falling out, so I asked Genevieve to shave my head completely. Since I was leaving a trail of hair that Hansel and Gretel could follow, she agreed. My apologies to the guys in the office who sit behind me, who probably wish they were wearing sunglasses to cope with the glare off my glow-in-the-dark, never-seen-daylight white head. We had some sun last weekend at Eagle Crest, so now baldness looks a little more like a fashion statement and a little less like a cancer patient. I'm a lot less self-conscious now that I'm not wearing a neon sign that says, "Ask me about cancer." I can choose who I tell! And the good part, as I told Genevieve, is that hair falling out is a sign that the chemo is doing its job.

Two friends called this weekend and said that they were concerned about "bothering" me, but decided to risk a call anyway. For me, there is nothing better than having friends reach out. All contact is welcome and appreciated! This is where the energy to fight comes from!

Both friends were surprised to find out I'm still working. Although my energy is down a little, it hasn't proven to be that hard. The chemo cycle is every three weeks. The chemo stays in my system and does its cancer-killing work, and its wear and tear on my body, in the first three or four days. I have enough steroids in my system during that time to prevent nausea and to keep up my energy, so there's only a couple days that I feel less than full speed. However, even with the benefit of all those steroids in my system, I've given up all hope of having a career in pro basketball. If only I was a foot taller. And 30 years younger. And had talent.

The two and a half weeks after that are the time needed for my body to recover. During that time, bone marrow production shuts down and takes awhile to restart. Bone marrow is where the blood cells are produced. Since the bone marrow stops working, about 12 days after chemo, my infection-fighting white blood cells reach their low point. I'm at my most vulnerable for picking up any bugs from people at that point, and have less ability to fight the bugs I get. This year, the timing means that Thanksgiving will be spent giving thanks for the good fortune I now have with new treatment options, but away from all the potential germs of our extended families. I'll miss being with the family. However, my nurse pointed out the positive: It increases my chances of having more Thanksgivings. Point taken!

I have a theory about surviving cancer. You have to be in good enough shape to go through treatments that add cumulative wear and tear on your body. It could be chemo, radiation or surgery. After the first course of treatment is complete, there will likely be the need for another of some kind, and maybe another after that. People sometimes aren't in good enough shape, so they don't get that next treatment. By the time they recover enough to handle treatment, the cancer has advanced too far to treat. The trick is to be in good enough shape to handle anything that they throw at your body.

That's why I'm still going to the gym four days a week, and climbing the seven flights of stairs up to my office twice a day, and getting extra sleep, and doing everything I can to keep my weight on. I'm in training to handle cancer treatment. Five years ago, the advice I got (and ignored!) was to "rest a lot". This time, my oncologist agrees with me completely. It's similar to how doctors used to tell people to rest after surgery, and now they get them up and moving as soon as possible.

The other part of this approach is that "training" to be in shape for treatment is one place where I can take charge. Beyond that, it's attitude. I look forward to each new chemo session, because I know that the chemo is attacking the cancer again. The impact on my body is a casualty of war needed to win the bigger battle. I also visualize the cancer shrinking like a prune, and withering under the heat of a blow torch. For me, these steps beat being passive. I'm sure other people have their own approaches, but this is what works for me.

Wishing the best for you and your loved ones.

Love,

Dann

Reaching Out, With Gratitude October 2, 2011

2011-10-02T18:03:00.001-07:00

Friends and Family,

You wouldn't know it by reading my emails, but writing about myself is way out of my comfort zone. However, I've done my life one way, and at least as far as my health is concerned, it didn't work. As Genevieve told me shortly after my cancer diagnosis, and many times since, "you need to change your vibration to get a different outcome."

So that is what I am doing. Reaching out and telling you about cancer, and about private moments with my wife, and about our fears and our victories. It's as uncomfortable, and at the same time it is as uplifting, as anything I've done in my life. And I do it because I know Genevieve is right. If I'm going to live, it will not be possible by myself. Your support is what is pulling me through this. The near-miracle of genetic therapy that is only possible for a small percentage of lung cancer patients passed me by. To then to be one of the rare people for whom there was a completely random reason to re-test, and then to be found eligible, is as close to a miracle as we could hope for! All of your positive energy and prayers must be part of this!

The positives like this and the healing happen in lots of ways, every day. I am daring to allow my heart to be more open, and you are offering support that I could not have accepted before. I'm finding it in little ways, like stopping to talk with the cashier at Home Depot about recycling. Before I left the store, he reaches out to shake my hand. I'm not used to this kind of response! People on the street are smiling at me more often, and I realize it is because I am smiling at them.

Your emails and cards and phone calls and food have all been a huge boost, and I know that wouldn't be possible if I had not let you know what I needed. Thank you so much for allowing me to put myself out to you in this way.

My stepmother Linda read the email where I said that it takes a whole village to shrink a tumor. I came over to visit one day, and she had me close my eyes while she slipped a wristband on my arm that said "It Takes A Village" on one side, and "Dann Wonser" on the other. She had two bags of these wristbands made up, and gave them out to family and friends. It was one of the sweetest, most thoughtful things anyone has ever done for me. She had me in tears.

So what I am learning, and which I hope you can learn for yourselves without waiting for a cancer in your lives, is that an open heart brings love in more ways than we can imagine. I hope you will reach out for your own benefit, as you have already been doing for mine. It keeps paying off in ways we can hardly imagine.

Love,

Dann

New Lease on Life September 29, 2011

2011-09-29T22:25:00.000-07:00

Friends and Family,

Genevieve and I went in for my chemo today, and got the best news we could possibly get. A month ago, Providence tested me for a genetic mutation that showed that I was not a candidate for genetic therapy. However, as part of OHSU's research protocol, they re-tested using a different lab. The OHSU test results show that I DO have the EGFR genetic mutation, so I AM ELIGIBLE FOR THE GENETIC THERAPY!!!! THE MUTANTS HAVE LANDED!!!!!!!!!!

WHAT THIS MEANS: At some point I will start the genetic therapy, Tarceva. This is the new "wonder drug" that was just approved for use a few weeks ago, and was featured on the news on many TV stations. Tarceva has been clinically proven to extend people's lives. Some shrink their cancer or prevent cancer growth for a few months, some benefit and stay on it for 4-5 years, and a few beat their cancer completely. When the day comes to start Tarceva, this last group is the group I will be fighting to join!I

But first, I will continue with chemo for a total of four to six rounds, three weeks apart. I had Round Two today. I'll be finished just after the New Year if I do six rounds. Then I get scanned regularly, and we wait until the cancer starts to grow again (unless, with your help, it is gone completely!). If/when it shows growth, I start Tarceva. As a double benefit, people with this genetic mutation usually have better success at shrinking their cancer through chemo. It's all good news today!!!!!!

I started worrying that this was too good to be true. I asked my doctor why I should believe that the second test is accurate and not the first. He said that the testing has a built-in bias in favor of spitting out false negative results. Also, sometimes the mutation shows up in one part of a tumor and not another, so it could have been missed the first time. Further, my oncologist thought from the beginning that the tumor visually appeared to be the EGFR mutation. These reasons are good enough for me and Genevieve to accept!

If I had not switched to OHSU and gotten in their research program, this false result never would have been found.There would be no reason to re-test other than for a research protocol. I am extremely fortunate that the mutation was discovered under these circumstances, and grateful to Macadam Forbes for providing health insurance that allowed me to switch my care to an OHSU doctor. I didn't have this insurance a year ago, so I would have stayed with a Providence doctor (through Genevieve's insurance) and never had the cancer re-tested.

I truly believe that all the positive energy, prayers, emails, phone calls, and all of your other acts of love are a significant part of why this was found. I am extremely grateful every day for having your support.

More about acts of love in the next email.

With love and gratitude,

Dann

Forecast: Falling Hair Sept 21, 2011

2011-09-21T21:37:00.000-07:00

Friends and Family,

People keep asking me if I'm back at work. Since chemo 13 days ago, I have missed a total of a half of a day. Things are going great. When I met with the doctor last week he asked how I was doing. I told him I was pleased that over the first weekend the nausea was mild, and other than a couple of naps ( and no taste buds) things were pretty normal. He frowned. "Those side effects shouldn't happen. We'll up your steroids next time." What???? It doesn't have to be that hard???? Are you sure I'm getting the nuclear option for chemo here????

My hair is supposed to start falling out 10-14 days after chemo starts, so I decided to take charge. Why wait for the inevitable? Five years ago when I went through this, I had embarrassing days at the gym. On one of those days, hair was falling out in clumps in the shower, clogging the drain. This is a shower with about 16 shower heads and no private stalls, so I swoop up the hair and bury it in the garbage before anyone sees. On another day, I was talking with a gym buddy while drying off my hair. When I looked down at the white towel, it was full of black hair. (Yes, it was all black then!) Also, for many days Genevieve and I woke up rolling in hair. It was not pleasant. I do not want to repeat any of this.

So my plan was to buy hair clippers and have Genevieve cut my hair. I drag her into the store to get the clippers, with her grumbling about not knowing how to do this. The next day, when it's time to cut, she's still grumbling about how she might mess it up, and dragging her feet. In this one battle, I prevail.

Following the directions on the clippers, I pull out one of the longer attachments for a "practice round". We get through that without injury, so I switch it to the shortest attachment. This is when it gets tense.

Genevieve is a reluctant cutter, and I'm an eager cuttee. I start barking out orders like, "Take one long sweep all across my head. Go coast to coast," and "hold it closer against my head." She snaps back with every order. There are now two Chihuahuas in the room.

After she finishes, I say, "Now let's go all the way." I remove the attachment and hand her the clippers. That is where she draws the line and blurts it out. "I'm not there yet. I understand that you are, but I'm not ready for everything to change." For her, going bald is physical proof that the cancer, and all the risks that come with it, are real. How did I miss that? She's worried about death, and I'm worried about clumps of hair.

So now I get it, and the haircut ends. We'll do this in stages. Today is Day 13 and I'm sporting a very, very short crew cut. I keep pulling my hair to see if anything is coming out. I thought I saw a long hair on my hand earlier, but when I put on my reading glasses the hair turned out to be a line in my hand. I guess I'm getting a little over-sensitive to the hair thing.

I have more to say, but I'll save it for another day.

Love to you all.

Dann

Chemo Update: It's About Love September 14, 2011

2011-09-14T19:49:00.000-07:00

Friends and Family,

I started chemo a week ago, and people have been asking how it's going. It's going great now, but we got off to a rocky start.

Last Thursday, the day chemo began, we started out meeting with the oncologist. He began the exam by telling us that my insurance company had approved use of two of the chemo meds, but denied the third. That's when my sweet, loving, gentle Genevieve showed a side of her that you would never know she posessed.

Have you ever walked by a car in a parking lot with a dog inside that has to defend his territory from lurking menaces such as you walking by? That little three-pound chihuahua attacks the glass again and again, teeth bared, just knowing that if he leaps at that glass one more time he is going to break through and tear off your face. As you circle behind that car and slide over to your car door, this little pup that is no bigger than a pastry snack looks more like 90 pounds of muscular pit bull. The glass starts looking a little more vulnerable. As the saying goes, it's not the size of the dog in the fight, it's the size of the fight in the dog. And YOU know he can't break the glass, but you keep eyeing all the car windows, sizing up the openings, just to make sure a maniac dog on steroids can't squeeze through.

All this to describe Genevieve in the doctor's office. She made it clear that she was angry with the insurance company, not the doctor. Still, the doctor leaned back ever so slightly, then glanced over at the door. He looked as if he was wondering whether the car windows were rolled up far enough. I suggested to him that we start all three meds, and sort out the insurance later. He immediately agreed to the plan, still with one eye on Genevieve. That's my little lotus blossom in action!

The rest of the day was comparatively uneventful. We sat in a semi-private area on the seventh floor of OHSU's Knight Cancer Center on the South Waterfront. As they changed chemo drip bags off and on throughout the day, I meditated and Genevieve did her artwork. I also looked out the window and thought about the beautiful views, and the value of the condos in the surrounding buildings. What else would you expect a broker to think about?

At the end of the day my oncologist came back in and informed us that he had written a lengthy letter of justification for the third med to the insurance company, along with fourteen pages of documentation. I am very appreciative of the doctor's willingness to take such a strong stand. To me, this is an extraordinary step, and one that he won't get compensated for. However, I am even more grateful for Genevieve's pit bull advocacy. I don't think that third med would have happened if not for her.

Here's how the chemo has gone since Thursday:

Friday - Feeling fine all day, steroids keeping my energy up and the nausea at bay. Food tastes a little funny in the evening.
Saturday - Taste buds almost completely gone. Nausea, gagging on water, try to find anything I can get myself to eat so I don't lose weight. Take a short nap.
Sunday - Same, but longer nap.
Monday - I can eat again! Work half a day, go home and nap.
Tuesday - Nearly normal again.

Chemo sessions are three weeks apart. Next week I'll have low energy and a high risk of infection, then gradually return to normal before repeating the cycle. I'll have four rounds and then a CT scan. If the cancer is shrinking, I'll have two additional rounds. If not, I'll stay off chemo until they see CT scans that show the cancer growing again. Then they'll try a different chemo cocktail.

A friend of mine, Keith, called the other day and asked what Geneveive was doing to cope. I told him about the different gifts that she is creating for me: New artwork designed for healing, meditating, using crystals, and more. He summed it up in a stunningly straightforward way: "It's all love."

And he's right. It's all love. Pit Bull Advocacy, art work, the prayers and positive energy you are sending me, the cards, the emails, the questions, the soup. It's all love, and it makes as much difference, or more, than the chemo. Thank you all for your gifts of love. They are what will keep me alive.

Love,

Dann

Time for a Fight Sept 7, 2011

2011-09-07T21:56:00.000-07:00

Friends and Family,

Just a quick (for me) update. I had a minor medical procedure today. They put me under a local anesthetic and put a tube into a major vein by my heart. Then they inserted a permanent port just under the skin on my chest which they can use to deliver the chemo. They tell me that the chemo gets better diluted when it enters this much larger vein by the heart, so it won't cause the same kind of damage to my veins that using a regular IV would cause.

Before the procedure, a young man came in to tell me that he was a Fellow and would be part of the surgical team. OHSU is a teaching hospital, so I assumed he meant he would be doing the procedure himself. Except he looked like he just graduated from middle school! While he was going over the consent form, I was wondering if he had spent more time on a BMX bicycle than in an operating room. However, since I had been assured last week that this was a minor procedure, and I new there would be an actual doctor supervising every move, I wasn't worried.

In the operating room they put a "drape" over the part of my body surrounding the wound, so that everything that they aren't cutting remains sterile. I could feel the young trainee's surgical movements, as his arms were touching the drape. I kid you not, throughout the entire procedure I could feel him shaking! The surgeon was even giving him guidance on how to properly tie the sutures! I decided not to make him nervous by asking him if I was his first. However, I'm pretty certain we were both virgins.

With that taken care of, I'm all set to start chemo tomorrow (Thursday). I'm ready to kick some cancer A** and get healthy again!!!!!! That's where you come in. Your prayers, energy, thoughts (or more specifically, thoughts of emerald green light in my lungs if you like Genevieve's imagery), are all very much appreciated on Thursday. It takes a whole village to shrink a tumor.

With gratitude,

Dann

OK, So the Mutants Have Not Landed Sept 2, 2011

2011-09-02T15:19:00.000-07:00

Friends and Family,

I spoke with my oncologist, and we didn't get the news we hoped to hear today. My cancer does not have the right genetic mutation to make me eligible for the targeted therapy. Curse the lack of mutants!

Now we move on from the disappointment and pull the positive from where we can. They continue to work on new targeted genetic therapies, and OHSU is doing a full genetic profile of my cancer. If/when new genetic therapies come along, they will know immediately if I qualify. However, the best news today from my oncologist is that the CT scan that I had last week showed no growth of the cancer from the CT scan that I had a month before. With all of your prayers, positive energy, and loving support, is this a coincidence? I think not!!! Thank you all so much for your part in this. I don't know how anyone could get through this without the love and support of friends.

At this point, all I can do is control what I have control over, and let go of the rest. I have recovered from surgery enough to be back in the gym this week, I'm climbing seven flights of stairs twice a day, I'm meditating on healthy lungs and shrinking cancer, and trying to process the emotional load that comes with all of this. And the best part of all this: It has gotten much easier to stay in the present and get the most out of each moment. That has created some very special moments with Genevieve.

I got my hair cut two weeks ago. I thought I should get people used to the shape of my head before it goes naked. This has turned out to be a good idea at the gym and when meeting with my clients, since some people barely recognize me now.

I was more than a little hesitant when the young woman at Great Clips with tattoos all over her arms, dark purple hair with a shock of blond in the front, and hair died in purple leopard spots on the sides of her head, looked around the waiting room and said, "Who's next?" I blinked, breathed in deep, and said, "I am." On my way back to her chair I had to remind myself that she couldn't have done that to her own hair. And then I reminded myself that the rest of my hair was probably going to be gone before long anyway. It's too late to turn back, so let go, trust, and let it happen. (I'm getting practice with that thought.)

Turns out she was very nice, and gave me a great buzz cut. Who would have thought that appearance wouldn't matter in a person who is altering your appearance???

Next Wednesday Genevieve and I will go to the hospital for a day procedure, where they will install a medication port in my chest to make it easier to do chemotherapy. Then Thursday I will begin chemotherapy. I'll do one round every three weeks, for four to six rounds, depending on how the cancer responds. In the past when I had chemo I had one rough weekend crashed on the sofa every three weeks, but was otherwise OK and missed very little work. I'm hoping it will be similar this time.

Love to you all, and thank you again for sharing this journey with me.

Dann

Think Genetic Mutants Aug 30, 2011

2011-08-30T20:45:00.000-07:00

Friends and Family,

Let's start with this: Not everybody wants as much detail as I feel the need to share. If you would rather just get the highlights, respond to this email with "Give me a Lite!" or something similar. If you have heard enough, just tell me to take you off the list, and you can catch up on the blog (http://www.dannscancerchronicles.blogspot.com/) if you want an update. I will also not be in the least offended if you change your mind at any point in the future. Be warned: From this point forward I feel free to make these emails as long as I feel the need!

The waiting process to begin treatment got extended a week due to miscommunication between Providence and OHSU regarding what tests are being done, and when, to determine if my cancer has the genetic mutations that would respond to targeted therapy. We found out that my cancer doesn't have the first genetic mutation, so we are waiting for test results to see if I have the second mutation. There are only two mutations that have targeted therapies with proven results. We should hear the results by Thursday. If my cancer has this second mutation, then I will qualify for the targeted therapy, which is more than twice as likely to be effective, and has almost no side effects compared to chemo. GO MUTANTS!!!

Regardless of which path I end up taking, treatment will start next week. I'll send you an update as soon as I hear the news.

I want to share two stories from a woman who has been a great inspiration in my life. I used to work in a related field with a cancer counselor at Providence Medical Center named Katie Hartnett. After working with her for many years, I heard that she was diagnosed with cancer herself. I ran into her one day at Providence, and after a couple of minutes of polite chit-chat, she said, "I don't know if you've heard, but I've been diagnosed with cancer. It's a Stage IV cancer that is so spread throughout my body that they don't know where it even originated." I awkwardly told her that I had heard the news. She said, "Isn't it a blessing! I've had all these wonderful patients over the years to teach me how to deal with it!" When we finished talking, I walked away feeling a tremendous rush. I was inspired! It's odd, but I thought, "WOW! If I ever get cancer, THAT is the kind of attitude that I would want to have!"

About seven years later, in 2006, I was diagnosed with lung cancer. Katie was one of the first people that I contacted. She was still alive, and cancer free. With that kind of attitude, of course she was! She shared a couple of things that were very meaningful to me, and I want to share one of them with you. She told me that when people are diagnosed with cancer, she is much more concerned with how the family members are coping than with how the person with cancer is coping. I trusted that she knew what she was talking about, but I didn't really get it.

After surviving cancer for the past five years, I get it. All the support comes to me, but Genevieve's whole world is being rocked. Her lover and partner may not live, but she has no control of this. Her financial situation may change dramatically, but it would feel heartless to start making financial plans to be without me. People ask Genevieve, "How is Dann doing?", but very few ask her, "How are YOU doing?" Even if they ask the question, how does she answer? If she's doing OK she looks heartless, and if she's not, then she should "suck it up" because I'm fighting for my survival and need support. It's hard to show her fears to me, since she is sure that faith that I can make it is one of the most important things that she can offer me. Where does she find room to feel what she really feels, and still be supported? If you have had any similar experience and have thoughts about this, I would love to hear them.

OK, I'm off my soap box for the day. More to follow when we have some news.

Love to all.

Dann

Thursday was a Great Day August 20, 2011

2011-08-20T11:59:00.000-07:00

Friends and Family,

Thursday turned out to be full of good news. First, we got the best news we could possibly hope for at this stage: My MRI scan showed that the cancer has not spread to my brain. The only downside... I have no excuses for my mental lapses now.

Next, Genevieve researched oncologists who specialize in lungs, and three different sources came up with the same two names. We saw one of these doctors at OHSU Thursday, and we thought he was excellent. He was also more encouraging than we expected.

Dr. Lopez-Chavez told us that the survival statistics that I found on the internet are too general to apply to me. I'm in the lowest risk category for for this lung cancer for a lot of reasons. First is my youth. (A little slack here please - It's all relative.) Next, cancer behaves differently for non-smokers than for smokers, even when it is the exact same type of cancer. Third, I have a category of cancer called "non-small cell", which is less aggressive. Finally, my physical condition is excellent, with the exception of that pesky cancer problem. What makes treatment more successful is if you can treat it more aggressively, which you can do only do with people who are in good physical condition.

Dr. Lopez-Chavez also offered the possibility that I may qualify for one of two new therapies that are targeted to the genetics of that specific cancer. My biopsy will be tested. If I qualify, I will start on one of these treatments first. Odds of shrinking the cancer go from 30% for chemotherapy, to 60-70% for the targeted therapies, and there are no major side effects.

In most cases, the targeted therapies and regular chemotherapy are expected to shrink the cancer, not eliminate it. The plan is to try one therapy for a full course, then stay off all therapy until the CT scans show cancer growing again. Then the process is repeated with the next therapy. Some people are fortunate enough to become cancer free. Otherwise, it simply buys more time. Meanwhile, new therapies keep coming out that are more and more successful, so the more time we can buy the better. Someone very close to us is a wonderful example of this, which gives us great hope. She had a breast cancer that had a 10% survival rate. After a new therapy was discovered, the survival rate is now 90%, including her. I just need to hang around long enough to have her success.

The plan is to start chemotherapy September 1st. If we hear that I qualify for the targeted gene therapy, we would try that first, and start around the same time. We'd like to start NOW, but I have to heal from surgery before I can do either.

I'm preparing in advance for the hair fallout. A very short haircut is on the way. I've been there before, and I want to be ahead of the curve this time - Get used to it so people will recognize me, and so I'm not shocked when I look in the mirror.

A heartfelt thank you to all of you who have reached out to us this week. I have been brought to tears more times this week by your reaching out to me than by the cancer itself. It is awkward and uncomfortable to talk about myself, something that you wouldn't guess by the length of my emails. However, I value sharing and connecting enough to get over this. Feel free to ask to be taken off this list, or to delete them from your inbox before reading if this is far more detail than you care to get. They're probably not going to get any shorter. It's the only way I know how to share, and it helps me keep up my own optimism.

Love to you all.

Dann

Test Results Aug 16, 2011

2011-08-20T11:49:00.001-07:00

Friends and Family,

We just got the test results, and they are not at all what we had hoped. My surgeon just called and informed me that I have another form of lung cancer.

This is a different lung cancer than I had removed 4 years and 10 months ago. My surgeon is at a complete loss to explain how a non-smoker can end up with two different types of lung cancer.

The cancer is spread out evenly in small dots throughout all four remaining lobes of my lungs. Because there are no healthy lobes, surgery is not an option. From what I understand from what the surgeon told me, and from doing some of my own research, treatment for Stage IV is used to extend life, but is not expected to be a cure.

We won't know any more until we meet with the oncologist, and we won't know when that will happen until he returns from vacation on Thursday and sees when he can fit us in. I am also going to be scheduled for a brain scan, since the brain is the first place that lung cancer will usually spread.

I know of two people that have completely beaten Stage IV cancer. I don't know if I will be the third, but I do know that I will give it everything I've got. I beat Stage III, which is about the best preparation anybody can get for beating Stage IV. I will continue going to the gym, climbing stairs, walking (sometimes with golf clubs in my hands), eating healthy, and anything else that I can think of to beat this. I will also do everything I can to enjoy life with Genevieve, since we don't know how long we will have together.

There are two things that I want to ask of you that I found very helpful the last time I went through this. The first is to send your prayers/positive energy my way. The second is to offer encouragement rather than sympathy. Sympathy = giving up: Encouragement = hope, and energy to fight.

More news will follow as soon as we know more.

Love to you all.

Dann

Tales from the Dark Side Aug 12, 2011

2011-08-12T15:52:00.001-07:00

Family and Friends,

The surgery went well, and I live to tell the tale. Things got entertaining at the onset when the nursing assistant came in to shave my chest around the surgery site. Her eyes got big, and she looked at that hair like she was going to be in for the fight of her life. She grabbed the electric razor with two hands and started stabbing at the hair, like she was trying to cut off the head of a snake. You could almost see her lips move, saying "get 'em! get 'em!" She stabbed and scraped and stabbed and scraped, until all the hair was dead, and one nipple was raw from a misdirected attack. She offered to "even things up", but I told her I could manage the other side by myself later. I'm not sure which of us was more relieved.

When I woke up in the Recovery Room I had something sticking out of my chest. They called it a "chest tube", but I know better. I've seen that stuff sold in 50-foot rolls in Home Depot, and they called it a garden hose. If God would have intended us to do this to ourselves, Adam would have had two less ribs to begin with.

If you've never had IV morphine, you should know this. It's a great pain killer, but it can also make you nauseous and turn as pale as a sheet of paper before you can count to five. After more than a little IV morphine, I began projectile vomiting into a bag. Genevieve said that the bag shot out the way those little party favors uncurl when you blow air into them. I think air is a better choice. Perhaps because I was loaded to the gills on morphine and it didn't bother me in the least, it was almost worth it to see the look on Genevieve's face.

It's now two days after the surgery, and I am back at home. The surgery was a success and the biopsies were taken from all three right lobes. Dr. Handy had a pathologist in the operating room reviewing the samples immediately, but they still have no idea what I have. He was hoping that the answer would be clear before we left the operating room. Since it is not, he expects that we won't know for another three weeks, which is how long it will take for samples to be tested and cultured. Until then, we will know nothing more than we know today.

We have no idea how this is going to turn out. All we can do in the meantime is to enjoy life to the fullest, and count our blessings. None of us know how long we have.

I count each of you among my blessings.

Love,

Dann

Dann Update Aug 11, 2011

2011-08-12T14:14:00.001-07:00

Hello all: I wanted to update folks . Dann will be out of the hospital tomorrow. All the tubes were pulled today . The chest tube was causing alot of pain so since that has been pulled, his pain is much more under control. Still no word on what is growing in his lungs. I am hoping the doctor will have some answers tomorrow before he leaves the hospital. I think it will take the weekend to get back on his feet but , come Monday... my guess is he will be taking the stairs once again at work and taking his rightful place as #1 in the flight club ( climbing the stairs).

Thank you for all the emails . Dann is so appreciative as am I.

Love and Light,

Genevieve

Dann Update Aug 10, 2011

2011-08-12T13:31:00.000-07:00

Hello all: I wanted to update you on Dann's surgery. The doctor took a out a slice of each lobe in the right lung. He was hoping to get a sense of what was in there so we would have some direction but it is still a mystery. He did not think it was a reoccurance of lung cancer as Dann does not fit the profile and the xray showed it as diffused rather than solid. The sample went off to the pathology lab and Dr. Handy is having many tests run to see if this is a virus, mold, tropical bug, or worse case scenario-cancer . We may have some answers at the end of next week. I greatly appreciate the calls and well wishes. I think both Dann and I have been anxious waiting and waiting is the hardest part.... Dann maybe coming home from the hospital as early as tomorrow evening or friday morning. He has to get the chest tube out and Dr. Handy wants to make sure he is stable. Dann thinks he can get up and jog tonight but they are trying to slow him down alittle.

Thank you again for all your kind thoughts and concerns. .

I will send another email when we have more news as to what the pesky little bug is ...

Genevieve

July 22, 2011 Update on My Lungs

2011-07-23T16:34:00.000-07:00

Family and Friends,

Just wanted to give you all a heads up on what’s happening with me. I have had a couple of CT scans in the past two months that have shown something growing evenly throughout my lungs, and the doctors don’t know what it is. They have considered a dozen possibilities, including anything from tuberculosis, to lupus, to bacteria, to cancer (least likely), and what they see doesn’t look quite like any of them. Because of this, they are going to do a biopsy by taking a section out of three lobes of my lungs that are each “about the size of a section of orange”. They will poke two or three holes between my ribs and go in with the assistance of a video camera, just like they did when I had one lobe of my lung removed four years and eight months ago (not that I'm counting the time or anything...). I’ll have surgery at Providence Portland on Wednesday, August 10th, will be there for 1-3 days, and will likely be back to work part-time the next week.

For perspective on whatever this is, my surgeon said that he had been very happy to see one of my real estate signs last year: "It's not often that you get to shake the hand of a Stage 3 lung cancer survivor." I'm very lucky to be alive. Chances of survival after five years are 40% for Stage 2 lung cancer, and I never wanted to find out just how much less the chances are with Stage 3.

I’m feeling very fortunate that whatever this is was even discovered before I had any real symptoms beyond minor tiredness and a dry cough. It was only picked up because I have been having routine follow-up scans to confirm that I am still cancer free. Had I not had lung cancer, this wouldn't have been picked up until my symptoms - whatever this is - were much worse, and possibly too late. You never know where the next blessing is going to come from.

Love,

Dann

New Website

2009-06-04T22:01:00.000-07:00

For posts related to Dann's Cancer Chronicles, please see the archives.

HOWEVER... There are countless ways of dealing with cancer for everyone involved. The real experts are those who are living with cancer in one way or another. Family and friends have ideas about what does and doesn't work, just as those who are dealing with cancer do.

I started a new website designed to get a lot of participation from others. Please check out http://www.cancerwithattitude.blogspot.com/. If you have thoughts of your own, please add them!

July 19, 2008 Got a New Scan, Dann

2009-03-07T14:12:00.001-08:00

Family and Friends,

The latest scan results are in, and I am still cancer free. It has taken a day to go from relief and a little numbness to excitement. How much better does it get than this? Life does not look like it will be hanging in the balance any time soon.

Getting cut off in traffic, strangers who don’t say thank you when you extend a courtesy, a return phone call at work that doesn’t come when promised… All the little annoyances of life again look so LITTLE. But time will dull the perspective, and these petty little things will again become irritating. And at that point I will know that there is so much to be thankful for, because if the biggest thing we have to worry about is five seconds of contact with a stranger, life is pretty darn good.

Love to all.

Dann and Genevieve

April 16, 2008 1.5

2009-03-07T14:11:00.002-08:00

Family and Friends,

Every three months brings another CT scan followed by another trip to the oncologist to get the results. The buildup to each meeting is not as overwhelming as it was the time before, though for big life-or-death thrills it's still hard to beat. Last time we enjoyed life like civilians for 10 weeks, then went into a state of near-panic for two weeks before getting the Word. This time we progressed to 11 good weeks, followed by a state of mere high anxiety while trying to ignore it for a little more than a week. A few random bedtimes of palpitations with our brains working overtime to find every rational reason why it would be impossible to have a recurrence of cancer seems like progress.

These intense live-or-die moments help me understand why people jump out of airplanes for fun, but I find zero appeal in doing it myself. Been there, done that. Still falling while waiting to see if the chute will open. But there will never be that sudden moment of relief where the wind fills the chute and gravity is placed on hold. Instead, there will(hopefully) just be periodic meetings with the doctor telling us, "Not this time."

Now for the facts! It has now been 1.5 years since my surgery, and it brings me great joy to tell you that the news is again the best it could be. No signs of cancer! Odds keep getting better! Every new report feels like another victory lap in the "I Beat Cancer" race, and I'm loving it. At times it's even exhilarating.

Except I didn't beat cancer. I have found that the further I get from cancer, the more I have been thinking of it as my own personal success. The reality is far different. When I was going through chemotherapy and asking you to "think prunes", when I was going through surgery, and when I was in the early stages of recovery, it felt like every breath I took was because of your support. I counted on your words, thoughts and prayers to see me through. I drew on every email, phone call, and visit to keep me going, much more than I think you can understand. I often re-lived those supportive interactions to find the strength to keep fighting. I know that WE are now beating cancer because you have been there for me. This is the absolute truth, and for this I will always be grateful to you.

We received other good news today from the oncologist. He said that after two years, the odds of a recurrence drop by 75%. We are now at 1.5 years and going strong. I am still counting on your words, thoughts, and prayers to help me through this.

Thank you for being there.

Love,

Dann

January 22, 2008 Time is on Our Side

2009-03-07T14:11:00.001-08:00

Family and Friends,

It has now been 18 months since I was diagnosed with lung cancer, 15 months since my surgery to remove one lobe of my lung, and 13 months since I finished chemotherapy. For the past two and a half months Genevieve and I have been extremely confident that the next CT scan would be negative. In fact, in a weird way I was LOOKING FORWARD to this scan, as proof that we are that much further away from cancer. Of course, that changed over the last two weeks, as the tension mounted for both of us. Our brains are calculating the odds and telling us to be confident, while our hearts are beating out of our chests, waiting for the "verdict". I wanted to SCREAM while we were waiting for the oncologist to come into the room. WHAT DOES IT MEAN that he needs a few more minutes to review the scan? Was there some doubt about the results? Maybe he's on the phone talking with the radiologist... Maybe he's consulting with somebody else...

While you are waiting for the news, it is easy to start interpreting every potential clue. You start watching to see if the staff is making eye contact, or being toooooo nice. In fact, in the weeks leading up to the meeting, every potential hiccup becomes a potential harbinger of doom. I had a cold/flu bug for the past two and a half weeks, and for three days in a row I had terrible headaches. Wait a minute... Didn't they say that the first place lung cancer usually migrates is to the BRAIN? Maybe it's a sign of brain cancer. Why should I have a cold for two and a half weeks? Do I have a weak immune system, which means I could get the cancer back if I even BLINK wrong? Okay, I heard other people had the same bug, and they were even sicker than me, so maybe not.

The common element to these irrational, emotionally charged fears is vulnerability. Even though the oncologist told us that the risk of cancer drops dramatically every three months for the first two years, then drops off more slowly after that, every visit FEELS like a 50/50, yes/no, live/die possibility. Not intellectually realistic, but emotionally it is the absolute truth.

We met with the oncologist today. There are no signs of cancer on my latest CT scan. We live to worry another day.

And so it goes.

Love,

Dann

10/20/07 90 More Reasons to Smile

2009-03-07T14:10:00.000-08:00

Family and Friends,

Gen and I met with the oncologist on Friday, and once again got the best possible news we could hope for. We received the results from the CT scan I had done on Wednesday, which was coincidentally (or not) the one year anniversary of my lung surgery. There are absolutely no signs of cancer. My odds get better with every passing CT scan, so things keep looking better all the time.

I'll continue to get scans every 90 days for the next 15 months, which will be 2 years after I finished chemo. After that the scans will come every 6 months for three more years, then annually for life.

The scan schedule gives us a pretty good feel for the expected risk. It tells us we can take nothing for granted. Given that, the doctors are still very optimistic, based on my exercise and dietary habits, attitude, and great support. Gen and I get more and more optimistic as well, though we can't help but get apprehensive during the time leading up to each scan. Head and heart don't always line up easily.

Thank you to everyone who sent their thoughts, prayers, participation, and/or donations for the LiveStrong ride/walk last month. The event was a success. For Gen and me, it was emotionally loaded and rewarding. We will definitely do this again.

For now, we have 90 more days - and 90 more reasons - to smile.

Love,

Dann and Genevieve

9/25/07 A Request for Your Support

2009-03-07T14:09:00.000-08:00

Family and Friends,

It has now been 13 months since I was first diagnosed with lung cancer, 11 & 1/2 months since one lobe of my lung was removed, and 9 months since I finished chemotherapy. As of my last CT scan two months ago, I am still cancer-free. How lucky can a person be?

I have said from the beginning that I am a very fortunate person to have found my cancer early enough to aggressively treat it. I have gained a much greater appreciation in the time since then how truly fortunate I am, to have each of you to help me make it through this amazing alternative path my life has taken. I am now asking you to join me in helping others to beat their cancer back with a tidal wave of support.

Join me in the September 29th LiveStrong Challenge fundraising event for cancer research and advocacy. There are three ways you can help:

* Join my team! Join Genevieve and me as part of our very own Team Attitude on the 5K walk on Sunday, September 29th at 9:00 AM beginning at Nike World Headquarters in Beaverton. It's a mere 5K - HA! I was walking more than that a few days after surgery! That's 3 miles, and yes - you can do it! Here's the link: http://portland07.livestrong.org/faf/home/default.asp?ievent=219861

* Donate the big bucks! Okay, the little ones are great too! If you can donate even $5, please do so. Unless you are cashing in empty pop bottles to get enough cash to ride the bus, you can probably scrape up $5. My fundraising goal for Team Attitude is $1,000, and my personal fundraising goal is $800. Your karma will thank you. I will also thank you. The link to donate is: https://www.kintera.org/faf/donorReg/donorPledge.asp?ievent=219861&supId=190804810.

* Send your positive energy, prayers, and good vibes! I KNOW you have that in you. Please share the wealth!

With gratitude and love to you all,

Dann

7/15/07 Living Life, 3 Months at a Time

2009-03-07T14:08:00.004-08:00

Friends and Family,

Last Wednesday I had my quarterly CT scan to see if there has been a recurrence of my lung cancer. I received a call from the nurse in my primary care doctor's office two days later, on Friday. She told me that my CT scan showed a "hyper-dense nodule" on my thyroid gland, and that my doctor wanted me to have an ultrasound that afternoon to see if it was cancer. Reeling from this latest news, I gathered my wits enough to tell her that I had an appointment scheduled with my oncologist two hours later that afternoon, and that after discussing this with the oncologist, the two of them could coordinate what the next step should be. She agreed.

Genevieve and I have been more worried about how this CT scan would turn out than we were before the last two scans. Further, our fears were brought to a raw edge since we had just attended the funeral of my friend Dwayne Elam. Dwayne and I shared a special bond while we both dealt with our cancers over the past year. Dwayne was the husband of Gen's cousin, and our families are close.

At the reception following the funeral we spoke with a woman whose husband had died two years ago, while still in his late 40's, from the same type of cancer that I had last year. Combine this with Dwayne's passing, and we were on edge.

When we met for lunch just before the appointment with the oncologist, I shared the news with Gen. She immediately lost her appetite. We were doing everything we could to rationalize how this new development was insignificant, right up until we met with the oncologist. It wasn't working very well.

That changed very quickly when we met with the oncologist. He told us that the "so-called nodule" was so miniscule that it was probably a computer mis-read (oversampling of nearby tissue), the wrong shape (regular edges), and the wrong location on the gland, to be anything to worry about. Further, it was an extremely unlikely place for the cancer to reappear. He didn't think it would have even been mentioned in the radiologist's report if I didn't have a history of cancer. It wasn't worth investigating further.

We got even more good news when the doctor told us that the chances of recurrence are greatest right after chemotherapy ends (almost eight months ago!), and grow smaller with every passing scan. We had thought that the cancer was more likely to show up after a year or two, when it had time to grow large enough to be detected on the scan. Instead, my odds are getting better every three months!

There are very few moments in life, if any, where you see the entire course of your future shift in a matter of moments. This was one of them. Fear turned to guarded joy, and we were ready to move on and live the next three months of semi-normal life. Rapidly re-developing plans for dealing with chemotherapy, work, relationships, and potential shifts in financial stability were all discarded before we left the room.

But not forgotten. We have become very aware of how all of our plans can shift at some three-month interval in the future. It makes the time more precious.

These fantastic results have reinforced my belief in the steps that I have been taking to beat cancer. I won't pretend to have a cure for cancer, but I think these steps are helping me. I hope they are of some benefit for you as well, even if you don't have cancer. I may not have any more wisdom than the next person, but I can tell you that cancer has made me think really hard about my priorities. Here is my master plan, in no particular order:

1. Remove the "cancers" from your life. This includes negative people, negative conversation with otherwise healthy people, television shows that focus on negativity and terror (think local news and some dramas), etc.

2. Bring as much joy as you can into your life. For me this is sometimes playing golf or watching basketball, or taking the time to listen to someone, and sometimes just taking the time to discover what I really like.

3. Treasure the relationships that are important to you. Making time for the people that bring meaning to my life, treasuring the moments I do have with these people, and thinking about them even when I'm not with them.

4. Making healthier choices. I'm exercising six or seven days a week, eating a little healthier, and getting more sleep.

5. Doing things that bring meaning to your life. This one is still taking shape. Part of it is sharing ideas that I would otherwise be reluctant to share, as I am doing right now. It also means donating time or money to causes that are important. What it means for you may be very different.

6. Have an "attitude of gratitude". Whatever you think about, that is what grows in your soul. Feed it the good stuff, and it will return the favor.

7. Grow. 30 years ago I read about a group of nuns that were living well into their 90's. The common thread among them was that they continued to learn new things, read, and otherwise keep their minds active. How much room is there for cancer if your body is busy growing?

A friend of mine has a theory of gardening. There's no room for the weeds to grow if you plant the flowers really close together. Filling your mind, your heart, your body, and your environment with healthy, positive, growing things doesn't leave much room for cancer. Besides, it sounds like a pretty good life to me.

Love,

Dann

11/8/06 3rd and Final Phase of Treatment

2009-03-07T14:08:00.003-08:00

Family and Friends,

Recovery from surgery has gone very well. Since a week after surgery I have been walking up and down the hills of NW Portland twice a day for a total of about 6 miles on most days. I started back to work roughly half-time last week and 3/4 time this week. I also regained the 8 pounds I lost after surgery, so I don't have to run around in the shower to get wet any more.

I met with the oncologist this Monday and got the go-ahead to start my last two rounds of chemotherapy. This time I met her alone because on my way to the appointment I got hit in an auto accident. Gen volunteered to stand in the rain (It rained 2 and a half inches that day) waiting for the tow truck while I took her car to the doctor's appointment. This, my friends, is true love in action.

The accident rattled me and added to an already generous amount of vulnerability I was feeling as a let-down after the surgery. However, since there was a 1-year old baby in the other car, I feel especially grateful that it was only metal that got hurt.

The oncologist was very encouraging. She believes we already have eliminated all of the cancer, but the research supports doing a total of four rounds of chemo to make sure no stray cells are left. After that I will have quarterly CT scans to be sure.

I began my third round of chemo today. Three weeks from now I will have the final round. We timed it so I will be able to best manage Thanksgiving and my sister Dona's visit from Belgium, and so that I WILL BE COMPLETELY DONE WITH ALL TREATMENT BY CHRISTMAS!

Love,

Dann and Genevieve

10/22/06 On the Mend

2009-03-07T14:08:00.001-08:00

Family and Friends,

I am pleased to say that recovery is going better than I could have possibly hoped for. I arrived home yesterday after four days in the hospital. Yesterday Genevieve and I walked to the top of our street and back. Today we walked just under a mile round-trip up and down hills to the park near our home, and we're planning one more walk this afternoon. The wounds are healing nicely, and I'm now off all pain meds except ibuprofen.

Thank you all for your support throughout this unexpected turn of events in Genevieve's and my lives. I am absolutely certain that it has made, and continues to make, this whole process far less difficult than it would be alone.

Having Genevieve with me has been the greatest blessing of all. She has put on a courageous face even during the most difficult moments, and her love had given me the fuel to keep fighting with everything I have. Once in a lifetime, if you are extremely fortunate, this kind of love comes along.

Love to you all,

Dann and Genevieve

10/18/06 CANCER FREE

2009-03-07T14:07:00.001-08:00

Dear All: Dann is "CANCER FREE". That is the bottom line.

So, this is the rest of the story. Dann went in Tuesday, a very good day to have surgery. His surgery lasted a shorter time than expected and it was very successful. Dr. Handy removed the upper lobe of the left lung easily and all went very well. He did find cancer in the lymph node that was closest to the tumor but they got it all out. It was the lymph node that shrunk with the chemotherapy. So, the good news is that the chemotherapy cocktail is effective for Dann's cancer and the next 2 rounds after surgery will be preventative to make sure any stray cells that even think about growing are zapped! This should be completed by Christmas. His 2007 New Year's resolution is to "grow and have hair".
I went in this morning (Wed) and Dann told me he had been exercising in bed . He wanted to start his rehab, however, this was 3AM. He did find he got tired easily and after the nurse told him it was not such a good idea, he has decided to modify his exercise plan. He transferred out to the unit this afternoon and after getting his pain under control is feeling very chipper and alert for a guy going through such a major surgery. I would not be surprised if he was out on the golf course in 2 weeks. That is what having a great attitude and a lot of support does.... you believe it and it is so. This has been a long haul and I am feeling very relieved he is in the final stretch. I want to thank each of you from the bottom of my heart for your support and the love that you have surround Dann and I with these last several months. He is the light of my life and a wonderful man... He has gone through this ordeal with grace and courage. I think the things that have helped are all the support, prayers, love, light, positive thoughts and energy from all of you. Dann will be coming home towards the end of this week. He is a model patient in terms of attitude but I think I will have to tone down his enthusiasm towards the exercising. All prayers are answered and so it is...

Love, Genevieve and Dann (in absentia)

10/17/06 Re: No News is Good News: Surgery is ON!

2009-03-07T14:06:00.002-08:00

Hi, This is Linda. I just talked with Gen. Dann came through the surgery with flying colors. The surgeon found another cancerous node which he removed. This means that Dann will have two more rounds of chemo sometime after the surgery. He's in the cardiac intensive care unit over night. Gen will write when she gets a chance, so I thought I'd give you a quick update.

10/16/06 No News is Good News: Surgery is ON!

2009-03-07T14:06:00.001-08:00

Family and Friends,

We did NOT hear from the surgeon today. This means that the biopsies of the lymph nodes taken on Friday showed no signs of cancer. It sounds funny to get excited about, but...

YIPEEEEEEE! I get to have surgery this Tuesday!

I'll check in to Providence Portland Medical Center at 9:30. The surgeon will operate at about 12:30 or 1:00. I'll be in the Coronary Intensive Care Unit for about one and a half days (this is standard), then transfer to the respiratory unit. I was told to expect to be in the hospital 4-5 days, or maybe a little less.

That's all the news until Genevieve updates you after the surgery.

Love to you all,

Dann and Genevieve

10/13/06 Good Day at the Hospital

2009-03-07T14:05:00.002-08:00

Family and Friends,

Just a (relatively) brief note to let you know that today's procedure went very well. Dr. Handy didn't visually detect any signs of cancer in the lymph nodes and was pleased with how quickly I bounced back in the recovery room. He told us to expect to proceed with the surgery on Tuesday unless he calls Monday with biopsy results that are different than what he is expecting. We LIKE that optimism!

The procedure was quick, and I was out of the hospital 3 hours later. My throat is sore and I'm a little groggy from pain meds. However, we're happy to have a successful "dry run" at the lung surgery behind us, and to have the doctor's optimism to buoy our spirits.

Next step: This cancer is going OUTA HERE on Tuesday unless you hear otherwise Monday evening!

Love,

Dann and Genevieve

10/12/06 Next Step: FRIDAY!

2009-03-07T14:05:00.001-08:00

Family and Friends,

After days of making increasingly assertive calls to both the oncologist and the surgeon to get them to talk to each other, we have results. TOMORROW (Friday) I will have a procedure to remove all the lymph nodes within reach of Dr. Handy's scope. They will biopsy the lymph nodes, and we will find out the results by Monday. If the lymph nodes are cancer free, my surgery will proceed on Tuesday as planned. If not, I will have 2 more rounds of chemo before the surgery, which would mean having surgery sometime around Christmas. Please send whatever prayers or positive energy you have my way for good results!

Dr. Handy will make a small incision in front of my trachea and remove the lymph nodes using the same minimally invasive technology that they will use for the main surgery. It should take about an hour, and is scheduled for 12:30 PM Friday. They will send me home a few hours later, after the general anesthetic wears off.

Love,

Dann and Genevieve

10/9/06 New Information/ Ambiguous Plans

2009-03-07T14:04:00.002-08:00

Family and Friends,

Before sharing the latest update I need to share my own personal Top 10 Greatest Things About Going Hairless:

10. Gen doesn't pluck my eyebrows in my sleep any more.
9. My granddaughters don't ask why Grandpa Dann has hair in his nose any more.
8. Grooming time is cut waaaaay down.
7. No more wondering what it will look like one day...
6. Righteous salute of the brotherhood of bald men!
5. Easier to find in a crowd.
4. Great conversation starter.
3. Built-in, highly sensitive weather gauge.
2. Dandruff? What dandruff?
1. Endless tattoo possibilities.... See below for a sample!

Now for the latest news: We met with Dr. Ross, my oncologist, today. First, we found out that the location of the lymph node where the tumor had spread reclassifies my cancer as Stage III. She pointed out that the best part of this is that my tumor was so small, and it took 2 CT scans to even determine that it is Stage III, that we have caught the cancer at the earliest possible part of Stage III. In most cases it is easier to determine the stage because the cancer is more advanced.
Next, she said that the tumor shrunk by more than HALF, not the third that we had thought. (It pays to talk to an oncologist rather than a surgeon about these things!) She showed us the tumor on the CT scan after it shrunk, and YES, IT LOOKED LIKE A PRUNE!!!!! She laughed along with us when we told her all the people that were thinking prunes for me. Of course, she likes to think it was the chemo that did the trick. She is thrilled by how well the tumor responded to the chemo. This bodes extremely well for what impact chemo will have on stray cells.
Dr. Ross recommends that before the tumor is removed, I have a "sentinel lymph node biopsy". This would involve inserting a small tube through the front of my chest while I am under a general anesthetic, removing all the lymph nodes that can be reached this way, and doing a biopsy on them. It would take 1-2 days to get the biopsy results. If any of the lymph nodes show living cancer, surgery would be postponed until I have 2 more rounds of chemo. (I have had 2 so far.) If not, we proceed with the surgery. In any case, I would have 2 more rounds of chemo after the surgery. I handled the first 2 rounds relatively easily, so Gen and I are 100% behind anything that improves my odds.
All this means that we don't know if the biopsy will be this week or next. If it is next week, that may or may not delay my surgery for 2 weeks, since my surgeon will be on vacation. Once the oncologist and surgeon have a chance to talk we will know more, and will let you know.
Meanwhile, I consider myself to be in training for surgery. In addition to some form of exercise (weights, yoga, golf, walking) 7 days a week, I have added daily swimming. Being goal-oriented and focused on health rather than sickness, and having your support, are going to get me through this.
We will let you know as soon as the plan is a little clearer. For now, it seems like the more we learn, the less we know for certain. It's a bit like life.
Love,
Dann and Genevieve

10/5/06 Surgery Plans

2009-03-07T14:04:00.001-08:00

Family and Friends,

Gen and I met with my surgeon, Dr. Handy, today. We now have a plan for surgery. Dr. Handy was so impressed with how quickly I recovered from the chemotherapy and how physically active that I have remained, that he moved the surgery to the earliest possible date. I will be having the surgery on October 17th, which is just 12 days away!!!!! It is also my son Matt's birthday, which we didn't want. However, the alternative was to put the surgery off for a full week, and getting the cancer out NOW has to be the priority.

Also, after more research and further discussion with Dr. Handy, I decided on the VATS (minimally invasive) surgery. The average length of stay at the hospital is 5 days, but Dr. Handy suspects I'll be out a little quicker. For one thing, I'm probably 25 years younger than that average patient. (That kind of makes the quick recovery from chemotherapy a little less impressive, doesn't it?) Most patients stay home from work for about 3 weeks after this surgery.

When we met with Dr. Handy we got the results from my repeat CT scan, which was done yesterday. The tumor shrank by about a THIRD. (I forgot to ask if the tumor appeared wrinkled like a prune from all that good energy you all have been sending my way.) On the not-so-bright side, one slightly enlarged lymph node shrunk after chemo, which they tell us means that cancer had spread to that lymph node. That makes my cancer Stage II. However, there is a definite silver lining. Because I did chemo before surgery, we now know that the chemo cocktail they gave me is effective on this specific cancer. If they had not done chemo prior to surgery, Dr. Ross (the oncologist) would have to guess and hope she had the right cocktail. Now we know that doing chemo after surgery will hit the target, and should catch any stray cells wandering around that didn't get picked up on any scans. We will meet with Dr. Ross next Monday to plan how soon/how much chemo I will have after surgery.

That's all the news that's fit to print for today. I'll send a brief update after meeting with Dr. Ross next Monday. After that, my next report will be AFTER the surgery.

Love,
Dann and Genevieve

9/26/06 The Current State of Affairs

2009-03-07T14:03:00.001-08:00

Friends and Family,

I have now made it through 1 full round of chemotherapy, and we are making our way through the second and temporarily final lap. I had the second day of IV chemo last Thursday, but it's a three week recovery cycle, so I definitely don't consider chemo to be over yet. More on that in a minute.

On Thursday, October 5th Genevieve and I will meet with the surgeon (Dr. Handy) to plan a surgery date and to finalize a plan for which form of surgery I will have. There are advantages to the less invasive VATS surgery (shorter recovery time being #1), but there may be less likelihood of chronic pain after surgery with the more traditional surgery due to the location of the nerves that are cut. Gen is strongly leaning toward the VATS, and I'm becoming more convinced, but in my usual analytical way I'll do more research before coming to what is probably the same conclusion. I think it's the illusion of control that makes it worth the extra effort.

The surgery will likely take place 2-6 weeks after we meet with the surgeon, so between late October and late-November is Dr. Handy's target. Gen and I are targeting the earlier end of this, and I am doing everything I can to prepare for an earlier date. For example, I'm still lifting weights 3x/wk, doing yoga 2x/wk, golfing 1x/wk, and walking the other day. I take a few days off immediately after a chemo infusion but otherwise consider my body to be in training for surgery and for post-surgery quick recovery. With Gen's encouragement I have also added acupuncture with a naturopath as well as massage therapy, both of which are part of Providence's Integrated Medicine program.

We will meet with the oncologist a few days after meeting with Dr. Handy. She has already recommended that I do a couple more rounds of chemotherapy after the surgery because the biopsy showed that the tumor was growing at a faster rate than anticipated. This will be one more way of ensuring that no stray cancer cells are left to wander around my body looking for a home. It increases my survival odds once again and is very reassuring, at least when I'm not thinking about the chemo side effects.

Many of you have asked how chemo is going. The "big picture" answer is fantastic, because it is happening, and that cuts my chances of a recurrence in HALF. The "day to day" answer goes like this:

Day 1: Chemo infusion with steroids x 5 hours. Ho hum, read a few carefully selected magazines, work on laptop, chat with
new chemo buddies.
Day 2: Back to work. (It's Friday.) Energy good almost all day,
food tastes a little funny.
Day 3: Golf (Par 3 course): First 9 - Great, Back 9 - Semi-
horrible (same pattern both chemo cycles!). Tired.... bed
early... The steroids have worn off.
Day 4: Food tastes like a rusty spoon left in the yard all
winter, then used to scrape the gunk in the bottom of a
planter. Nausea gratefully dispelled by meds and sleeping
most of the day.
Day 5: Back to work and gym, hanging on at work for 3 hours,
then sleeping most of the next 18 hours. Less nausea, but
the rusty spoon lives.
Day 6: Giddy optimism returns, selective foods taste great. Use
spatula to get the last of the Fettuccini Alfredo sauce
out of the bowl. Lick the bowl. And the spatula.
Days 7-14: Decreasing fatigue, increasingly normal taste buds.
Day 14: Hair starts falling out!!!!!!!!! False sense of
security dashed!!!!! Embarrassment at the gym!!!!!
Day 15-20: Piles of hair floating down the drain at the gym. White (naturally) towels are then filled with black
hair and discretely chucked in the bin. Vacuum the
pillows and sofa every night to avoid dreams of
sleeping with Big Foot.
Day 21: New cycle. Repeat from Day 1 UNTIL....
Day 25: ABANDON THIN HAIR CHARADE!!!!!!! SHAVE HEAD!!!!!!!!!!!
Day 26: Get "Bald Power Solidarity" right arm salute from 3 bald guys and two thinning hair guys at work. 3 women at work
(and two men) tell me I have a shapely head. I'm trying
not to let it go... to.... my.... (for those of you who
know me too well, forgive me going for the way-too- obvious punch line.)

Actually, being bald is more fun, at least as a novelty, than I had imagined. Placing my hand on my head is like being stuck to Velcro, so I can entertain myself. It is also a much stronger look than a wispy massive comb-over, so I'm wearing it with pride. A great benefit is that it makes it easier for me to choose whom I tell that I'm having chemo, which helps prevent the dreaded pathetic "I'm so sorry" looks. (I LOVE the people who can see how lucky I am to catch it early, rather than focusing on a victim's outlook.) I can also lie and tell people my Olympic team is all doing this to show team unity.

I'm on Day 6 (licking spatula) today. As you can tell by the length of this email, my stamina is returning. I won't test yours any further today by writing more. Although I haven't responded to each email you have sent due to fatigue, emotional overload or both, every word means so much to both Genevieve and me. Thank you, and Love to you all.

Love,

Dann and Genevieve

8/31/06 Gentlemen, Start Your Engines

2009-03-07T14:02:00.002-08:00

Family and Friends,

At last, treatment has begun!

I started chemo today and was pleasantly surprised by the lack of immediate side effects. It must be the steroids talking. They give the steroids to reduce or eliminate the nausea, which works for 2-3 days, and also helps with energy.

The next hurdle comes when white blood cell, red blood cell, and platelet counts all progressively decrease, reaching their low point in 7-10 days. My ability to fight infection and my energy levels will be impacted by this. The doctors and nurses recommend continuing with normal activities, don’t overdue it, and listen to my body. I will also need to be very sure to avoid sick people, even with sniffles, during the more vulnerable blood count times.

Today after chemo we met for the first time with the surgeon, Dr. John Handy, who does both the more traditional surgery and the minimally invasive surgery to remove the tumor. There is still not enough clinical data for a complete statistical comparison, but it looks like the tradeoff for having potentially a shorter/better recovery period using the minimally invasive procedure is the increased risk of chronic pain (less than 1% for the other procedure vs. “a little higher” for the minimally invasive procedure). There is also about a 10% chance that they will need to abandon this approach mid-surgery and separate my ribs to enter under my arm, which has a slower recovery rate and more chronic pain (13.5%) than entering from the front. We don’t know yet which procedure we want, but we do know we both feel very comfortable choosing Dr. Handy as the surgeon. He has an outstanding reputation, and we liked him a great deal.

Here’s the evolving timeline, as we know it today: Another day of chemo on September 21st. About 2 weeks later I have a follow-up CT scan to see if chemo shrunk the tumor, then see Dr. Handy to make sure he is comfortable that I am ready for surgery. Surgery would be mid-October to early November. However, we’re finding that just about any timeline we get is a moving target.

A friend and cousin by marriage, Dwayne Elan, has been going through treatment for lung cancer for the past 2 years. His cancer has metastasized, and he is fighting the good fight with a great attitude and a loving support system. Please send a prayer, positive energy, or even thoughts of shrinking his cancer like a prune if you can. He likes the prune image a lot.

Dwayne shared his observations about cancer with me. One of his comments was, “when one person in the family gets cancer, the whole family gets cancer.” In other words, everyone is affected. I thank each of you for how you have offered to be a part of the healing process for me in your own way, knowing that allowing yourselves to be touched by my experience exposes raw nerves for you as well. I am particularly grateful to Gen for this, as she has been side by side, and sometimes leading me, toward healing choices. I am also most concerned about the impact that this could have on her over the long haul. She shares in all of the struggles, yet most of the support comes to me. Of course, she denies any of this, and I will be lucky to get this email out without the paragraph being deleted.

I don’t expect to have any news to share from now until about the second week in October, when we get results of the repeat scan and a more firm plan for a surgery date. Until then, your love, energy, prayers, and support for both Gen and me, as well as thoughts of prunes, are very much appreciated.

Love,

Dann

8/28/06 At Last, a Solid Plan

2009-03-07T14:02:00.001-08:00

Friends and Family,

Gen and I met with the oncologist, Dr. Helen Ross, for the first time today. The first news that we received was the results of the repeat CT scan, which was done to see if the tumor had grown, and the MRI scan, which was done to see if there were any tumors in the brain. Good news on all fronts – The size of the tumor in my lung was about the same, there was no tumor found in my brain, and they found a brain. Whewwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww.

We got a much clearer picture of the diagnosis, treatment options beyond surgery, and statistics now that we are talking with the oncologist rather than a pulmonologist and a surgeon. The tumor has been identified as an adnocarcinoma, which is a fairly slow growing variety. However, there is a 50/50 chance based on the CT scan that there is a second tumor within the same lobe of my lung. It would come out just the same since that lobe will be removed, but the suspicion that it could have spread to a second site qualifies me for chemotherapy. Even though chemo reduces the odds of getting cancer again, it has only been approved for cases where it is suspected that the cancer has spread.

The surgeon will remove all the lymph nodes he can get during surgery, each of which will be tested for cancer that was too small to be picked up on the CT or PET scans. If they find any traces it means that I will have chemo after I have recovered from surgery to get the rest.

The “Saturday stroll in the park” version of chemo that the surgeon described to us is not quite the same chemo that Dr. Ross is recommending. Because I am so (ahem) young and healthy, Dr. Ross suggests taking a more aggressive cocktail of Docetaxel and Cisplatin. The upside is that we are attacking the little monsters with Shock and Awe. The downside is the national budget of white blood cells, red blood cells and platelets goes into deficit about 7-10 days later, leaving me more vulnerable to attack from other foreign bodies, but this passes shortly before election day. I’m also likely to lose hair, but Dr. Ross informed me that I had (ahem) plenty of thick hair to spare, so it may get thin rather than vanish altogether. It grows back, but 21 days later it’s time for Shock and Awe Round 2. About 21 days after Round 2 it’s time for surgery, and after that… possibly more rounds of chemo. If I go completely bald by Halloween I’m going to glue horns on my skull like Jai Dev did last year.

I’m likely to be energetic for a day or two after chemo due to the use of steroids, and then become very fatigued for an unknown number of days after that. Pacing will be the issue for me. Nausea is supposed to be fairly minimal. There’s a laundry list of other side effects, none of which is intolerable given the benefit that chemo brings.

Follow-up after surgery includes CT scans, lab tests and full physicals every three months for the first two years after surgery, then every 6 months for years 3-5, then annually. The surprising news from Dr. Ross is that about 1 out of 3 people who go into complete remission for 5 years end up with some form of lung cancer again at some stage of their life, and not necessarily the same type. With this type of close long-term care, it improves the chances of catching it early enough to prevent the spread again. Beyond that, we will deal with tomorrow when tomorrow comes.

After we go to chemo on Thursday we will meet with the surgeon who does the minimally invasive procedure. We will then find out if this procedure is a fit for me, and probably pick a tentative surgery date about 6 weeks out. We will have more news to share after that.

Thank you for tolerating my Encyclopedia of Cancer Treatment approach to keeping you informed. Some people want to know just the highlights, and others want all the details. Partly I write these so that Gen and I will have a way of remembering the entire process. There is so much to learn along the way, and so much to be grateful for. We were reminded of that by Dr. Ross, who said they NEVER catch lung cancer this early unless it is by accident, the way mine was found. How lucky can you get!!!!

Love,
Gen and Dann

8/22/06 Plans

2009-03-07T14:01:00.001-08:00

Family and Friends,

We have our first appointment with the oncologist, Dr. Helen Ross, next Monday. We have been told by a couple of sources that she is a nationally recognized lung cancer expert, and that both her colleagues and her patients like her a lot. We have two goals for that appointment. First, we want to find out if she recommends the chemotherapy that we heard about from the surgeon. If so, chemotherapy would presumably begin within a few days of that time. Our second goal is to see if there is anything else that she recommends. If chemotherapy is recommended, it would happen before surgery. Because of this, it will probably be mid-September before I have surgery.

We have an appointment next Thursday with a second surgeon, Dr. John Handy, to consider a minimally invasive surgical procedure for removing the tumor. The first surgeon we spoke with does not do this procedure. Dr. Handy is also recognized as being outstanding in his field, not to mention having a great name for a surgeon. At this point Gen and I are both thinking that the minimally invasive option sounds much better, unless we hear something to the contrary from either Dr. Handy or Dr. Ross.

Although we have not yet met with Dr. Ross, she reviewed my chart and ordered two more tests. This Thursday I will have a repeat CT scan of my chest, and will also have an MRI of my brain. Apparently the MRI is much more sensitive to picking up cancer in the brain than the PET scan that I had two weeks ago, and Dr. Ross ordered the repeat CT scan to see if my tumor had grown in three weeks. This is very reassuring in one way, as it tells us how thorough Dr. Ross is, before we have even seen her. However, it is also a bit disconcerting after we thought all the questions about the potential spread of cancer had been answered.

Our friend Rebbecca offered this reassurance: As the former head nurse of an oncology unit, she said that it is common for oncologists and surgeons to repeat tests and find even more things to test. This is to make sure that they don’t miss anything the first time around. It reminds me of the old carpenter’s saying, “Measure twice, cut once.” Perhaps this saying is a little TOO fitting….

Thank you for your continued support, prayers, positive energy and prune thoughts throughout this challenging time for us. We remain optimistic through the process. I continue to feel healthier now than I did even a few years ago because I am in better shape. The only thing that hurts is a few sore ribs from a little incident on a ski boat a couple of weeks ago. I am convinced that I could have gone a few more years without ever knowing that I had lung cancer, but I had the extraordinary good fortune of having a sore back and a conscientious chiropractor. There is so much to be thankful for.

Love,

Dann and Gen

8/16/06 Improving Odds and a Course Correction

2009-03-07T14:00:00.000-08:00

Family and Friends,

Gen and I met with Dr. Douville (surgeon) today and were given a lot more to think about. We learned of a new option that looks like it could improve my long-term chances of remaining cancer free, and also changes the anticipated timing for my surgery. That option is to have two courses of chemotherapy before the surgery. With surgery alone, there is a 20% to 25% chance of getting cancer again. Those chances are CUT IN HALF by doing this preventative chemotherapy. WE LIKE THOSE ODDS!

Each course consists of having an IV of chemotherapy for one day. We then wait about a week for my white blood cells to regenerate, and then have a second course. (Fortunately it’s only a two course meal.) After my white blood cells have regenerated again, I have the surgery to remove the tumor. Only 2-3% of people get very sick using this form of chemo, and usually don’t lose their hair. However, I’m blaming any future hair loss on chemo.

Dr. Helen Ross is the oncologist that we will be seeing. She came with very high recommendations from both Gen, who works in Rehab at Providence, and our friend Rebbecca, who used to be the cancer unit head nurse at Providence St. Vincent. Dr. Douville says that Dr. Ross is a nationally recognized specialist in lung cancer, that her patients love her, and that he very highly recommends her. We are trying to schedule an appointment with her to get her opinion and to begin chemo if it sounds as positive after talking with her. She’s out of town this week, so Dr. Douville recommended that we take whatever appointment with Dr. Ross that the scheduler has available, then get Dr. Ross to squeeze us in sooner when she comes back next week.

The surgery itself involves removing the upper lobe of my left lung, along with the lymph nodes. The surgeon told us that the surgery usually lasts about two hours, and I will probably be in the recovery room for about an hour, and will likely spend the first night in the Coronary Care ICU. I should expect to be in the hospital 4-5 days, then go home and need assistance for a day or two. I should be able to get up and down stairs as soon as I am home. I will likely be at home through about the third week, return to limited activity within 6 weeks, and have almost 100% of lung functioning and be pain-free in 8-12 weeks. There is about a 10% chance that my vocal chords could get nicked while removing the lymph nodes, which would leave me sounding constantly hoarse, but there are solutions that lead to a very good chance of full recovery from that side effect. There should be no other long-term complications to my health. “The only change you would see in your functioning over the long run is that if you were a marathon runner, you would probably run a little slower.” I think I’m safe there.

Skip the next paragraph if you don’t want to know the gory details of the surgery options.

There are two ways that the surgeon recommends to perform the surgery. The method this surgeon uses for the surgery is to cut the breast bone and spread the ribs. This has a shorter and less painful recovery period than the more traditional method of entering from the side and spreading the ribs, which he does not recommend. The other option that he recommends is to make a small hole to insert a camera, and two more small holes to perform the surgery. Recovery time appears to be quicker with this method and there are no known increases in risk. He does not perform this surgery, but his partners do, and all have outstanding reputations. The only down side he sees is that there is a much shorter history of research on the effectiveness of this method (seven years). We will give these options further thought.

Now for the statistics. There is about a 2% mortality rate after this surgery. An extremely small (“infinitesimal”) percentage of that is from patients who die during surgery. The rest are patents who die of complications after surgery due to pneumonia, infection, heart attack, etc. That being said, Dr. Douville says that my chances are MUCH better than that because I’m in the top 5% of the patients he sees as far as condition prior to surgery: I’m young (no wise cracks – It’s all relative), healthy, exercise regularly, have an excellent diet, a great support system, and have a great attitude. I would add to that list all of the people that are praying for me, sending positive energy, or thinking dried prunes. Once again, we appreciate the love, support, and prayers that you are sending, and we strongly believe it makes a very big difference.

Overall we are very optimistic but drained after the appointment today. We were gearing up for the possibility of surgery as early as this Friday, and we’re having a post-meeting crash right now. However, I’m enlivened by one other upside to this new turn of events… There’s time for GOLF THIS WEEKEND!

Love,

Dann and Gen

8/9/06 Surgeon Appointment

2009-03-07T13:59:00.002-08:00

Family and Friends,

We are now scheduled to meet with the surgeon next Wednesday, July 16th (Michele's birthday). We'll let you know the recommendations after that appointment. Meanwhile, we're still dancing after the good news!

8/9/06 Great News!

2009-03-07T13:59:00.001-08:00

Family and Friends,

We received fantastic news this morning. The PET scan revealed that THE CANCER HAS NOT SPREAD!

The next step is to meet with the surgeon, hopefully within the next couple of days. Our understanding is that the standard procedure at this point would be to remove the tumor, and then keep a careful watch to make sure there are no surprises. We have no details of how the surgery would be done until we meet with the surgeon, but the surgery is likely to be done next week. We will share what we learn from the surgeon as soon as we can.

Love,

Dann and Genevieve

8/7/06 Good News Du Jour

2009-03-07T13:58:00.000-08:00

Family and Friends,

Although I received the pathology reports on Friday, the info was relayed by a physician filling in for my own pulmonologist, Dr. Lafor. Today Dr. Lafor called and gave me more information to give a better context to the results. Dr. Lafor informed me that over 95% of the time, with this type of cancer caught this early, that the cancer will not have spread. We like those odds!

I will have the PET scan Tuesday morning to find out for certain whether it has spread, and if so, to where. We should get the results from this test Wednesday or Thursday, and we will share the news with you ASAP!

Love,

Dann and Genevieve

8/4/06 Dann’s Health: Phase 2

2009-03-07T13:57:00.000-08:00

Dear Family,

We received results of my pathology report today. Though we didn’t get the near-perfect answer that we wanted, the results were still positive. We found out that I have malignant non-small cell cancer. What this means is that it is NOT the aggressive type of cancer, and I have a great chance of a positive long-term outcome.

On Monday I will have a Pulmonary Function Test to see how well each of the lobes of my lungs are working and to establish baseline functioning. On Tuesday I will have a PET scan. The PET scan will tell if the cancer has spread. I don’t know how quickly we will get those results, but I assume it would be within a day or two at the maximum. Next we will meet with an oncologist and most likely also a pulmonary surgeon, but I will get that sequence confirmed on Monday. After consultations with the oncologist and pulmonary surgeon, Genevieve and I will work with the doctors on the best plan of attack.

We are extremely fortunate that our good friend Rebbecca is the former Oncology Unit Head Nurse at Providence St Vincent, and is a resource both for treatment information and treatment providers. As a big bonus, she is now high enough up in the Providence health care system to carry a lot of clout if/when we need the system or providers to be more responsive. Gen is also knowledgeable about who the top physicians are in different specialties, so I can really trust that I will see the right people and that the right things are going to happen. Of course, Gen is so much more than the term “support system” conveys. She helps so much with my strength, attitude, and focus, and I am so blessed to have her in my life.

I have already told this to some of you, but I want each of you to know this. I am in an extremely good position to be one of the success statistics. You are part of the reason. I have everything going for me. Here is what I know that works, and that I have working for me:

• A strong will to live
• A positive attitude
• A healthy lifestyle
• An outstanding support system, including each of you. It makes a tremendous difference in outcomes, and I appreciate you very much.
• Many people of all faiths are praying for me.
• Visualization: I have been visualizing shrinking the tumor up like a dried prune, and tying this in with meditation.

Your prayers are very much appreciated. And if you don’t pray, think dried prunes.

Love,

Dann and Genevieve

7/16/06 Dann's Health

2009-03-07T13:52:00.000-08:00

Dear Family,

Some of you have already heard that last Monday I went in for an x-ray due to recurrent back pain, and found that I have a spot on my lung. The x-ray was ordered by a chiropractor, who was concerned that the back pain wasn’t going away after continued treatment. I’m very fortunate that this was picked up on an X-ray, or I may not have become aware of any problems in my lung until much further down the road.

That X-ray bought me a quick ticket to the hospital for a CT scan last Wednesday. Genevieve and I met with pulmonologist Dr. Michael Lafor today to review the results and implications of the CT scan, and to plan the next step.

Dr. Lafor said that the mass is about 2 cm X 3 cm, or slightly smaller than a golf ball, and is located in the upper portion of my left lung. He cannot imagine what else it would be other than cancer due to the characteristics that he can determine from the CT scan. However, this may not be all bad. Based on the CT scan, he thinks that it is most likely to be either an adnocarcinoma or a carcinoid carcinoma, in that order. He believes it is unlikely to be small-cell carcinoma, which is another category of cancer, and it’s not worth going down that road of discussion unless we hear otherwise.

If it is a carcinoid carcinoma it is very likely to be benign, but should be removed anyway, as they can become malignant if left for a very long period of time. If it is an adnocarcinoma, the five year survival rate is about 70% for Stage 1 cancer and 40% for Stage 2 cancer. “Staging” is basically categorizing how fast it grows and how fast it spreads. Based on size and shape, and the fact that the CT scan did not reveal signs of any other masses in other parts of my abdomen (heart, liver etc.), he would expect it to be Stage 1 or 2 if it is an adnocarcinoma.

As with most good doctors I have ever met, Dr. Lafor qualified everything I have described above, beginning with, “The first rule of cancer is that there are no rules.” Therefore, we can’t count on any of the above until we get hard data. That brings us to the next step.

On Wednesday afternoon I will have an outpatient bronchoscope, where a narrow flexible cable with a camera and a pincher on the end will be guided into my lung. A sample of the mass will be taken for a biopsy. By Friday we should have results of the biopsy, but it could be Monday. Also, he said that about 20% of the time they can’t get a good sample, and will have to either try a needle biopsy through a puncture in my back, or surgery. This is another road we won’t go down until we know if it is necessary.

Two more steps will take place throughout this ongoing process. First, I will have a pulmonary function test on Monday, which will be needed as a baseline in the event that I have the mass removed from my lung. Next, a PET scan is being ordered. That will take another 7-10 days because it requires pre-authorization from the insurance company and a note from God. (Son Mike, put in a good word for me.) The PET scan involves sending a few radioactive sugar molecules into my system. They “light up” in areas where there is metabolic activity, such as the lymph nodes, which is an indicator of cancer. That will tell if the cancer has spread.

All of this sounds much further down the road than we may actually need to be. We may have just tuned in to the worst case scenario and gone too far and too fast. Hopefully we’ll have a more realistic picture Friday or Monday.

One of the first things I started wondering was how I got this mass to begin with. The doctor dismissed out of hand the possibility that this is related to my having smoked for a few years ending in 1981. He said that he considers me the equivalent of a non-smoker because the length of time and amount that I smoked were insignificant. Further, only small-cell lung cancers are related to smoking. His only explanation is genetics and bad luck.

As soon as we have an update we will email you. I find it hard to share this info without getting too choked up if I try to tell the story verbally. I’m happy to hear from you, but it’s easier to share the hard stuff this way, particularly when it means telling many different people.

There are a few people we wanted to email, but all the contact info is on Gen’s computer. Of course, it is now at the computer hospital, so we’re both getting our diagnostics run. Bad timing for the computer. Bad timing for me too – I think about January 2051 would be a better time.

Love to all, and we welcome all prayers.

Love,

Dann and Genevieve