2020. An Update

Here are four words that suck:

The cancer is back.

And yet, those are words we heard not long ago. March 25th actually. Thankfully, Joella's been doing regular scans and tests since her last round of treatment ended, so the doctors seemed to have caught it early, for whatever that is worth. (A lot, actually. It's worth a lot.)

The cancer has metastasized (a fancy word for meaning it's now in new places) into her liver and into a lymph node in her neck (and because of how lymph nodes work, probably others, too, which are as of yet undetectable). They did a biopsy on her liver to confirm suspicions (and two weeks later, she is still tender from that one). And then came the call. And the sucky four words.

Weirdly, it wasn't a gut punch to us like the last time. Well, the last time was more like a Mack truck rolling over us. Backing up. Hitting us again. Backing up. And...? One more time. Oddly, neither of us were surprised. Bummed out. Saddened. A bit heartbroken. But we've gone down this road before. And when the reality was confirmed, it was nostalgic in a way...but with all of the bad parts of nostalgia. It was like, alright...valley isn't over yet.

And so we are doing this again. One day at a time. God controls our lives...we both firmly believe that. And he can do with us as he chooses. That's not to say we like this particular choice, but we are walking this road. Through faith.

I have to admit, I've never understood the questions I get when people try to ask me to connect my faith with Joella's cancer. As if one is dependent upon the other, or the result of another, or some equilibrium must be established--as in more faith only results from less or no cancer, or as if more cancer means less faith.

That just doesn't compute for me. That's not how it works.

I'm not called to be faithful as long as the circumstances are good. Or as long as life is going "right," whatever that means. I'm called to be faithful. Period. Doesn't matter what happens. Rain. Snow. Sleet. Sunshine. Heavy wind. Clear skies. (And yes, I know that's a normal April day in Texas. Pretty much in that order. Oh...forgot hail.) So that's what I'm doing. That's what we are doing. We are doing faith no matter what comes at us. Right now, it's mucosal melanoma. And today, we are good. We know there will be hard days ahead. We hope there won't be, but we know that those are likely. And still...one day at a time.

So what's ahead for us?

There are basically four options for mucosal melanoma treatment:

1. surgery

2. chemotherapy, or it's nasty little evil cousin: biochemotherapy

3. immunotherapy

4. medical trials, which right now mostly consist of gene therapy

Last time, we did surgery. Joella lost part of her tongue in that one. We also did biochemotherapy, which is basically traditional chemotherapy on steroids with some jet fuel thrown in for good measure. Joella did that one. This time we are doing immunotherapy, which was actually in medical trials for mucosal melanoma the last time we attended this rodeo.

Essentially, immunotherapy is a treatment that helps your body more aggressively detect and eliminate cancer cells, because those little punks put off some enzyme or something that masks their true identity. "Oh no, we are supposed to be here," and white blood cells just walk on by, as if the cancer cells are doing some Jedi mind trick. "You are glad we are here." But not any more, fake-Jedi-punky cells!! The immunotherapy suppresses those markers so Joella's own immune system attacks them.

The down side? Sometimes it makes the white blood cells attack healthy tissue, too. So the doctors have to closely monitor her treatment, which is 30-minute infusion every three weeks. Her next one is April 17. I'm sure there will be several scans along the way. Blood work is a requirement before treatment. And if anything looks "off," they press pause on the treatment or stop it altogether. But because Joella didn't really have any side effects from the first treatment, the doctors are hopeful she will be just fine throughout treatment.

An upside? There are none of the chemotherapy side effects. It should pretty much be life as normal while the cells inside are waging war. That's our prayer. And in fact, it's basically been that so far. Life is 100% normal for her even though she's hosting an internal battle. And as crazy as it sounds, we remind ourselves she is in treatment...because to look at her or to ask her how she feels is no indication. At least today. And we hope that continues. According to the doctors, it should generally continue.

So to recap, because I'm not telling this linearly--it's more of a stream-of-emotional-logic-emotion-logical-ness kind of thing--Joella had her normally scheduled PET scan in mid-March. They saw something not great. Joella had a liver biopsy on Monday, March 23. We got the call confirming results on Wednesday, March 25. Joella had bloodwork run on Thursday, March 26. Then her first treatment (drug she is taking is Keytruda) on Friday, March 27. And then we had a moment to breathe and catch up. That week was a whirlwind.

And now here we are...living in a new reality where Joella's cancer has returned, where coronavirus has effectively shut down the planet, where I'm having to occasionally get up early to go on hunting and gathering missions when we run out of toilet paper (because we aren't hoarding), where millions of people are suffering and have lost jobs or loved ones, where we have all lost our sense of physical community, where doctors and nurses and grocery store workers and pharmacists and hourly workers at restaurants have all joined police officers and firefighters in the "my work literally puts my life on the line" category, where others around us are suffering from other personal hardship, or mourning the passing of a loved one, or wondering how they can afford to buy food, or awaiting the birth of a child into this uncertain world...and our family's cancer fight kind of pales in comparison to the turmoil around us. We recognize we are just people going through a struggle. Our struggle might look a little different, but our struggle isn't necessarily more important or urgent than another. All are important. Thankfully, we serve a God who loves all people. We are celebrating that this next Sunday, on Easter, the day he walked out of the grave. So he can not only heal, he conquers death...whenever that comes to all of us. For our family, we are praying that death will not come quite yet. That the medicine works for Joella. That she will live a long life and continue to bless others and make this world better.

And hopefully, after a while in treatment (we have been given no timeframe), they'll do another PET scan and conclude the cancer has diminished. Or is gone altogether. We are praying for that.

So if you are a praying person, join us in those prayers. Yes, we are praying for healing. But we are also thankful for technology and for the tenacity of doctors who put Joella into treatment two days after diagnosing the cancer was back. And that with all of the COVID-19 chaos around us...they still cared for Joella and made a fast-track for her treatment, for which we are thankful.

Thank you for walking this journey with us. More updates will follow. I wish I didn't have to write in this blog any more. But for today, this is our reality, and we covet your prayers. If we need anything, we will let you know. But for now, we are as good as we can be, and I can simply look forward to the day I can write a blog post that begins with four better words:

The cancer is gone.