Treatment Update

Hello all. After a brief absence from updates, we finally have additional news to report. Yesterday, we met with two doctors at Rex to discuss dad's status and next steps. First up was a meeting with Dr. O, dad's oncologist. She wanted to check dad's vitals, discuss how he is feeling and talk about where we go from here. Dad's vitals were great, though his blood pressure was a little high. Dr. O said that this was likely due to the steroid he's taking and it should come down as he slowly comes down off of the steroid. That was also something we discussed with Dr. O. Dad's steroid medication has remained at a fairly high dosage from the trip home from Calif. It was a little higher to help him make the trip, but he doesn't really need it to be that high any more. So, Dr. O provided a schedule for slowly bringing him down off of the steroid (can't go cold turkey on that one) over the next few weeks. This should help dad with some of the jumpiness and sleeplessness that he's been experiencing. Dad also mentioned to Dr. O that he's been having difficulty with hearing during the past few days. He's been battling a head cold and Dr. O checked out his sinuses and believes that the hearing problem is due to that, and not anything related to the cyber knife treatment. So, she gave him a prescription for some ear drops that will help with the ear canal and also noted that reducing the steroid will likely help with the sinus problems as well.

Then, we talked about treatment options going forward. As we've mentioned before, the cyber knife treatment went quite well. Dr. O noted that, at this point, we have nothing to treat so it wouldn't be in dad's best interest to go ahead with whole brain radiation or chemotherapy at this time. There are two reasons she gave: 1) since there's nothing to treat, they wouldn't know if the whole-brain radiation is successful or not, and 2) once the brain has undergone whole-brain radiation, it has taken all of the radiation it can receive. This means that if another spot were to appear, they likely wouldn't have any further treatment options available. That's also pretty much the same situation with chemo. Once you've done it with one type of chemo, you can't use that same approach once again. So, she recommended that we take a wait, watch and see approach. The cancer may go dormant and not reappear ever, or it may come back again at some point in the future. If it comes back, depending on where it is, we can treat with cyber knife once again or ultimately work up to whole-brain radiation. This is a little different from what we understood earlier, but we have a much better understanding now and agree with her recommendation.

Lastly, Dr. O told us that melanoma is one of the hardest cancers to treat and it pretty much can't be completely eliminated. So, this means that it may always be hanging out there and we may need to do treatments in the future depending upon what happens. However, Dr. O said that dad is already "defying the odds" in that he's doing quite well physically and he responded great to the cyber knife treatment. So, we continue to maintain a positive stance.

We talked with Dr. O about what dad can and cannot do. Basically, she said the only thing he cannot do right now is drive. He can play golf, he can go to work, he can help out around the house (mom wanted to get that one cleared up!), he can workout at the wellness center, he can travel and he can even go skiing in January as part of the family trip we've been planning for a few months. So, the basic message-- go out and live! There's nothing stopping dad from doing anything that he wants to do. In many respects, that was something dad and all of us really needed to hear. As I told dad, he needs to get up tomorrow morning and go. If he has things he wants to accomplish, he should do them. There's nothing stopping him from doing anything at all.

We did meet with Dr. Wu, the radiation oncologist who does the whole-brain radiation procedure. He concurred with Dr. O. It's good to hear doctors agreeing on a course of action, especially when you know they are all consulting on your case.

So, for now, we're going to take the wait/watch/see approach. Dad will likely have another MRI done sometime in January to see what's going on with the spots they treated via the cyber knife procedure. He's also going to have a CT or PET scan done to see if there are any other spots anywhere on his body. Dr. O wants to follow-up once more on the mysterious spot that showed up on his sternum back in Sept. that was investigated during the surgery to remove the lymph nodes back then. This is more of a precautionary item right now.

As always, we thank you for your prayers and support. Dad is doing great and we are thankful for that. Please continue to post comments to this blog as you are able so dad can hear from each of you. It means a lot to help him keep his spirits up and know that so many people are in his corner. Also, give him a call, shoot him an e-mail, or stop by and visit. They are welcoming company and are always glad to hear from friends.

I would ask that you continue to pray specifically for dad in a few ways: 1) that the cancer will go dormant and that no new spots will reappear anywhere in his body. 2) that God will keep dad (and our entire family) strong and dependent upon Him during this time as we know He is the ultimate source of strength.

Thank you once again for your support. We are very grateful to have so many wonderful friends and family members that care for dad and for us. Take care!

Post-Treatment Update

Hello all. Dad completed the cyber knife treatment late this afternoon and he's doing well. The procedure started about 1:30 and finished up around 4:30. Dad was a little concerned traveling over to UNC-CH this morning as he had a headache and was concerned that it might affect the ability to do the treatment, but soon after arrival, the medical team assured him that taking some pain medication was OK and he felt much better after he did.

I spoke with dad after the treatment and he said he was very impressed at the medical team. They were right there with him the entire time and were quite responsive to his needs. He had to go to the bathroom a couple of times and they gladly stopped the process, he took a break and they went right back to it. Dad also said that the procedure was indeed painless as he never felt anything. In fact, all he could pick up on was the movement of the machine.

Dad told me that he feels even more confident now after having completed the cyber knife process that he is indeed on the right path for treatment. As someone mentioned to me today, staying positive with a good outlook is critical, and we couldn't agree more.

So, with the first step done, we move on to the steps ahead. Dad will go back over to UNC-CH on Dec. 17 for a follow-up consultation on this procedure and they will do another MRI in 3 or 4 months to see if the process was successful. Also, as I noted earlier, dad will meet with his medical team at Rex Hospital next week to evaluate the process for whole-brain radiation and the timetable for doing that.

For now, dad said he was planning to go home, get some dinner, put on some comfortable clothes and relax for the remainder of the evening. He's even talking about going to the Duke/State football game tomorrow afternoon if he feels up to it!

Thank you for your prayers today and I ask that you will continue to pray for him over the next few days that he will continue to feel good and strong. Also, please continue praying for ultimate healing in that the cancer will be completely eliminated from his body.

Today's Prayer Requests

Hello all. As I mentioned in yesterday's post, dad will begin his first treatment today at UNC-Chapel Hill. This is the gamma knife procedure and it is scheduled to begin around 12:30 today. It will take about 2 hours and the focus of this treatment is to kill off the affected tissue on his brain.

We have a couple of prayer requests for today:

1. Pray for wisdom for the doctors and medical staff so that they will know exactly how to conduct this procedure so that it will eliminate the affected tissue.

2. Pray for dad that he will remain strong before, during and after the procedure.

3. Pray for our family so that we can be a strong support system as he begins the treatment process.

4. Pray for ultimate healing for dad and that the cancerous cells will be completely eliminated from his body.

I spoke with dad at length last night and he's in a good frame of mind. He's ready to get started with the treatment process and is ready to do what is necessary to beat back this cancer. Thank you for all of your support and I will update this blog later in the day once the procedure is complete.

Treatment Update

Hello all. I want to provide you with a brief update on where things are with dad's treatment schedule. Mom, Dad and Cassie went over to meet with two doctors at UNC-Chapel Hill yesterday to discuss treatment options (I wasn't able to make the trip over). Dad began the day with another MRI (likely better at UNC-CH than the one done in LB) and upon closer inspection, they found what they believe to be a 4th lesion on the top of his brain. Then, they met with the first doctor of the day. He is a specialist that does the cyber knife treatment I mentioned on Monday. The doctor laid out the details on what the cyber knife treatment is, what it does and what the side effects are. Essentially, they go in for one treatment that takes about 2 hours and use a system of lasers to burn off the tissue of the affected areas. As of right now, the main side effects we are aware of-- and these are just possibilities-- are being very tired and the possible loss of some motor skills. The doctors indicated that these are potential side effects, but they can't say for certain whether or not they will actually happen. So, we'll pray that they do not. The cyber knife treatment is mainly designed to eliminate the spots that are currently there, but they do not treat any other cells that may be lurking under the surface.

Then, they met with a neurologist to discuss in more detail what the game plan should be to treat all of this. The neurologist let them know that melanoma is one of the hardest cancers to kill because it reacts differently in different bodies. But, with that said, the doctor laid out a plan that is designed to aggressively go after it and eliminate it from dad's body. So, here's the plan:

1. Dad will undergo the cyber knife treatment on Friday afternoon (tomorrow) at UNC-Chapel Hill. It will take about 2 hours and he has to remain perfectly still during the treatment. They created a head mold yesterday to use on Friday to help him remain still. During this treatment, the lasers will be used at different angles to burn off the affected tissue. Dad should be able to go home soon after the procedure is finished and he'll need lots of rest. As far as we know, there will only be one cyber knife treatment session. The downside: it will take about 4 months to get the results of this procedure as they will need time to allow the tissue to either be absorbed by the body or hang around waiting to be removed. During that time, they will be looking to see if any new cancerous cells have appeared. If none, then it looks good. If there are more, we go back to the drawing board.

2. Early next week, dad will go back over to Rex to meet with Dr. O and Dr. Wu. They will do a consultation to begin dad on whole-brain radiation. I know I wrote on Monday that it looked like we wouldn't have to do that, but the medical team at UNC-CH recommended it as a way to get any of the cancerous cells that are under the surface. It kind of makes sense-- you need to go after the root of the problem or you will always be dealing with whatever pops up. Still, it's kind of tough to hear. Nonetheless, the sessions will be done at Rex, they should take about 3 weeks (Monday - Friday) and last about 10 - 15 minutes per session. The side effects here include hair loss, weakness and potential loss of appetite.

The medical team we are working with is still very positive and focused on eliminating the cancer from dad's body. And that's exactly what we are praying for. Dad continues to stay positive about the situation as well, and that is critical as the next few weeks will be challenging.

I want to relate one final thought. I was listening to a Bible study on the drive in this morning and Dr. David Jeremiah was discussing the concept of thanksgiving, why we should thank God (in good times and in bad) and how hard it seems to do that. As he was discussing this, I thought about something that dad said to me yesterday. He was talking with the doctors and said, "you know, I eat reasonably well, I work out, I take care of myself and I'm just a little puzzled and frustrated as to how my body can develop this." And the doctors in turn replied, "you know we look at it a little differently. We see patients that come in having smoked a pack of cigarettes each day, they are significantly overweight and have other medical issues to deal with in addition to something such as melanoma. So we are thankful that in your case, all we have to deal with is the melanoma." And with that, dad was able to change his viewpoint and stay a little more positive about this situation.

I tell you that story to say this-- stay positive and look at the different possible perspectives of the situations you are facing in life. We are choosing to give thanks to God for a few different things: 1) that other than the melanoma, dad is in pretty good health. 2) that we live in an area with top-level medical professionals that are the best at what they do. Not everyone has access to that kind of care. 3) that we have a great network of support from family and friends like you.

Please continue to pray specifically for healing for dad and for this melanoma to be eradicated from his body. Pray for the medical team and that God will grant them the wisdom to know exactly what to do to treat dad. Pray for strength for our family as we help dad during the next few weeks.

As always, thank you for your prayers, kind words and loving support. And, be sure to keep up the comments as they mean a lot to dad.

Many thanks.

Monday Update

Hello all. We traveled over to Rex Hospital this morning to meet with a couple of doctors at the Rex Cancer Center. I previously thought that we were there to actually begin treatments, but instead, today was to be a consultation and a "dry-run" for the whole-brain radiation treatment, if that's the approach they felt we should take. First up was a meeting with Dr. Wu. He is the doctor that administers the whole-brain radiation treatments. After reviewing his MRI from St. Mary's in LB, he said that it appears that there are 3 lesions that he can find. Additionally, he said that he believes dad would be a good candidate for a specific type of radiation that pinpoints on the lesions (called gamma knife), instead of doing the whole-brain radiation treatment. This is very good news because it means there will be less of an impact on dad with the treatments as whole-brain radiation is rather intensive. Instead, this pinpoint approach only treats the affected area and the impact is much smaller. It also has the benefit of being more precise. So, Dr. Wu got on the phone and consulted with Dr. Morris at UNC-CH to see if he agreed that dad would be a good candidate and Dr. Morris agreed that dad should come over for a consultation and it looked likely that the pinpoint treatment would be the way to go. So, we're currently trying to schedule an appointment to get over to UNC-CH for that consultation. If we end up going this route, Dr. Wu said we're looking at 3 treatments for the affected areas and that should be it (unless they find something else in there). Also, we believe that UNC-CH will want to do their own MRI, which is fine with us as we feel very good about their knowledge and abilities and want them to have the most accurate test information available. As a result of this meeting, there was no need to do the dry-run of the whole-brain radiation. Additionally, they've put the chemo treatments on hold as well as there may not be a need for them pending the decision about the gamma knife approach.

Following that meeting, we met with Dr. O, dad's oncologist. She, too, was quite positive about the gamma knife approach and spoke highly of Dr. Morris and his ability to provide diagnosis/treatment. She wants dad to monitor his blood-sugar levels and his blood pressure, but for now, she says that if he's feeling up to it, he can return to work and do things just as he was doing prior to the seizure. And since he's on anti-seizure medication, he's at a much lower risk of any further seizures at this point in time.

Dad will continue to be on a lot of different medications (some of which they will wean him off of over the next few weeks), but for now, the prognosis looks to be quite good. We continue to take the stance that we'll respond to this aggressive appearance of the lesions with aggressive treatment options.

Please continue to pray for healing for dad, specifically that dad will be a candidate for the gamma knife approach and that it will eliminate the lesions from his brain. Additionally, please pray for wisdom for the doctors so that they will know how to treat dad during this time.

I know I can't say it enough, but thank you for your continued support during this time. We stand in awe of what God has done in taking care of dad during this time and in how He has united so many people through this incident to see how He works.

As I mentioned in an earlier post, you are welcome to call dad or shoot him an e-mail. His e-mail address is nparks68@nc.rr.com. Thank you for your love and support!

Next Up -- Treatment

Hello all. After a day's absence, I'm back to writing on this blog. As I mentioned on Friday, I plan to keep this blog going as we shift from being focused on getting home to the next phase: treatment. Dad is scheduled to begin treatment tomorrow morning (Monday) at Rex Hospital in Raleigh. He will undergo both radiation and chemotherapy. The chemo will be done by pill and the radiation will be done at the Rex Cancer Center. We get started first thing at 9 a.m. followed by a meeting with Dr. O. to discuss the situation. Naturally, I'll post an update as soon as it is available.

Dad has done quite well since arriving back home. He's had a number of visitors since Friday and we've enjoyed every smile, every hug, every laugh and every tear. It's kind of been like a mini-reunion since arriving back home and that's been good for all of us.

Melinda and I have talked a lot since arriving back home and there's one thing that is a constant topic of discussion between us-- the amazing way in which God has revealed himself in this entire situation. This one incident brought together so many people in a short period of time. Additionally, we have heard from many of you that you were either praying personally for dad or your Sunday school/small group/church/school etc. were praying for dad-- that is an awesome thing to see happening. Please don't stop. We have much further to go and we can use every prayer you can offer up as we know God can do amazing things.

Thanks for all you've done in the last 7 days. I will keep you updated in the days and weeks ahead. Also, please know that you are welcome to call dad as he'd like to hear from each of you. It does wonders for his spirits. Please be in prayer for us at 9 a.m. tomorrow morning and specifically pray that God will allow these treatments to work and eradicate this disease from dad's body.

Have a wonderful start to your week!