When a cancer patient is trying to cope with diagnosis, and decide on a treatment option, it can be overwhelming. Thankfully in our case we functioned as a team and I was able to ask questions, convey Lyn’s thoughts, and I took countless notes in an organized binder. I had printouts of medications and their side effects. I had research documents on terms that I had heard. Therefore, when we went to the appointments, the doctors understood we were engaged in the process, and we were there to learn the best options for my wife. We were extremely organized, which helped us arrive at an educated decision when posed with choices.
In a previous blog I explained that Lyn had her initial oncology appointment with a doctor outside of our medical plan because her chief oncologist was on vacation. They wanted Lyn to be seen quickly to get a baseline assessment and attain the necessary CT and MRI images to show what we were dealing with and discuss the treatment options.
As we were on our way to our first oncology appointment I asked Lyn if she was depressed or scared. Lyn could not speak because of her stroke, however, she nodded her head “no”. In one sense I was relieved, and the other sense I couldn’t believe it. In the beginning I was fearful, but Lyn, cool as ever, was not fearful. She boldly stepped into the deep waters holding God’s hand. Her faith was unshakable. Because of her courage it made me more courageous. It made us a strong team as we moved ahead in the journey.
We arrived at the Kaiser Hospital a bit early, and we sat in the car and prayed. What seemed like months to get to see her chief oncologist, was only two weeks. As we sat there, we prayed that God would once again give us strength, and that the doctor would give us hope to be able to treat this terrible type of cancer. We knew this was going to be a battle. We were well educated on melanoma since Lyn had melanoma as a 19-year-old.
As we entered the facility, the staff was very caring, calm and kind. Waiting in the exam room was a very difficult experience. It was too quiet, which made me want to talk more to mask my uneasiness and try to lighten the moment. Within a few minutes Lyn’s doctor came in and introduced himself. Two weeks earlier we were a bit upset when we found out it was going to be a bit of time to see this doctor. However, we were told by the initial oncologist, “Trust me, you want to wait—he is the best.”
The doctor discussed the findings and outlined what happened in the brain and the stroke. He explained that there were six cancer lesions (spots) that could be seen, and it was presumed that a seventh spot was in the middle of the bleed area. He also pointed to four cancer spots in the lung.
The doctor explained very clearly that with her type of cancer, that it was extremely difficult to attack. He stated that traditional chemotherapy does not work on melanoma. Additionally, he conveyed that low-dose radiation generally does not work well either.
One of the questions we wanted to know was the prognosis, and if she could get rid of this cancer. I asked the doctor directly, “Can Lyn get rid of this.” The doctor was careful in answering, but he said, “Yes, it’s possible, but it will be extremely difficult.” He explained that melanoma is difficult to treat, and when it’s in two parts of the body, the treatment is complicated. However, he did say that Lyn had age on her side, her immune system had been strong for the time leading up, and that there were good drug options now as opposed to just several years prior. We were pleased that there were options, and this gave us medical hope.
The doctor proposed that Lyn go in for a procedure called, “Stereotactic Radiosurgery (SRS).” This type of radiation is very high dose and radiates to about 1mm outside the cancer lesion. Over time the radiation destroys the spot. This was also the same type of surgery that former President Jimmy Carter had for his brain melanoma, and it was successful. We had more hope.
The second type of treatment is where we felt like we really needed to research, pray, discuss, and arrive at a decision. Lyn was given the option of two drugs. These were two drugs with completely different ways of treating the disease.
The first option was to go on immunotherapy. The doctor said that for unknown reasons, in some people their t-cells stop working effectively and these mutated cells are not killed off by the immune system. Eventually the cancer begins to mutate unchecked and multiplies rapidly. Melanoma is extremely aggressive and invasive once it gets loose in the body.
The immunotherapy drug ramps up the immune system to recognize the invading cancer mutations and kills them off. It is almost like placing the t-cells on steroids. This type of treatment is a slower treatment, but it can be very effective at treating the cancer at the systemic level.
The second option was two very special oral chemo pills. Some referred to these pills as the “miracle pills.” In some cases, they can reduce very large cancers into very small spots within a matter of weeks. This drug was described to us as almost like being a, “light-switch,” that tells the cancer, “you must turn off.” This drug would prevent a certain protein from being produced in Lyn’s body that the cancer needed to survive.
Lyn had to make the decision on either immunotherapy, or the oral chemo program, but not both at the same time. We were told to go home and to think and pray about it. There was so much to think about during this time, such as the pros and cons of each, the side effects, and how quickly would we know of the effectiveness.
We had two weeks to think about it. We discovered during this time, two people processing, and researching was a huge benefit. During this time, we did not talk a lot about the options. However, at about ten days, we talked and were in total agreement. Lyn decided on the immunotherapy and wanted to keep the oral chemo pill as a powerful option in the future. We thought that with the cancer spots being so small, the immunotherapy had a good chance of choking out the cancer at the systemic level, while the SRS treatment would eradicate the cancer in the brain.
As we finished the appointment, our doctor pulled his chair over and asked if he could pray for us. He held out his hands and we grabbed them. He prayed that Lyn would have the peace of God. When we left the appointment, we knew we were linked to the right doctor. God smiled upon us.
In early June 2017 my wife had her stereotactic radiosurgery on six spots in the brain. In mid-June, she had her first of many immunotherapy sessions. We made the best decision we could make at the time. Only time would tell how effective the treatment would be. However, we discovered the power of teamwork and that processing our decision together as partners gave us peace and a better confidence in our direction.