Dear Friends and Family,
It has been a while since I last updated you on Stuart’s health and progress. Up until a few weeks ago there was very little to report as the trial drug was working very well and all his scans were clear. Stuart was feeling great and life had become "quasi-normal” again.
Three weeks ago (February 10), Stuart’s brain MRI was clear but his chest CT scan showed some cloudiness in the right lung, a possible sign that his cancer was beginning to rear its ugly head again. Since he had just gotten over a cold, the doctors weren’t sure whether they were seeing cancer or signs of a lingering virus. As Stu had absolutely no clinical symptoms and was feeling great, we agreed to wait until the next scheduled CT scan (March 23) and compare the two. If in fact it was viral, it should be diminished, if not gone, in the next scan.
As previously planned, on February 20, Stu and I left on vacation for Nevis with our close friends Mike and Dian, We had a great time with the Nevisian people, learning their history, eating their food, and exploring their island. The beaches were beautiful, the weather was great, and the wild animals including donkeys and monkeys were amazing. On an uphill hike through an island forest, hoping to reach a waterfall destination, Stu became completely winded; so much so we needed to turn back before reaching the falls. Knowing Stu would have pushed through if he could, this was not a good sign.
Upon returning home Stu contacted his doctors and a chest CT scan was added to the normally routine three-week visit already scheduled for yesterday (March 3). The scan confirmed that the cancer has in fact returned. Although it is not a dramatic change from three weeks ago, it is quite clear that it is cancer and it is progressing.
To better understand what they are dealing with and why Stu's cancer has now found pathways around two targeted therapies, the oncologists need to look at the new tumor cells, decode their genetics (again), and decide on the best next course of treatment. Since Stu doesn’t have a tumor mass, they will need to take a piece of lung from the cloudy area which contains the cancer cells. Next Friday (March 11) he will have a VATS (Video Assisted Thoracic Surgery) procedure to remove a postage-stamp sized piece of tissue from his right lung. VATS, similar to laparoscopic surgery, is far less invasive than traditional thoracic surgery, so he'll only be in the hospital one or two nights. We met yesterday with the surgeon who will be performing the procedure at Brigham & Women's Hospital, and he seemed very confident that he'll be able to get a good sample and all will go smoothly.
The current plan is for Stu to remain on the trial drug at least through the surgery and recuperation. Then we'll decide--based on future scans and clinical symptoms--whether he remains on the trial drug until the genetic sequencing is available (which will take about three weeks) or whether to switch him to traditional chemotherapy. He responded well to two rounds of chemo prior to the trial so the doctors are optimistic that he'll respond well again. Once the genetic sequencing is done, we hope to have better ideas for what may work next.
Stu is recalling Yogi Berra, who said, "When you come to a fork n the road, take it." We don't yet know the precise direction, but we'll follow the best road our doctors and their science can offer us.
I see it as novelist J.R. Ward so eloquently put it, “But that is life: Nobody gets a guided tour to their own theme park. You have to hop on the rides as they present themselves, never knowing whether you will like the one you are in line for...or if the bastard will make you throw up your corn dog and your cotton candy all over the place.”
As always we thank you for your continued love and support as we continue on our roller coaster ride. Please continue to send positive energy our way.