Treatment Continues

This week marks the end of the 4th week of my combination of treatments with both the Radiation Oncologist and the Integrative Oncologist. I have a week and some change left of all the treatments and will then move to the next steps. As was expected from the beginning, there have been no significant changes in the mass size or any major side effects from any of the treatments. My arm is getting pretty red and irritated from the radiation and I’m a little bit more tired than usual, but everything else is the same.

Fun Medical Fact (from someone with no medical qualifications): The radiation isn’t expected to change the size of the mass or result in the post surgery biopsy showing many dead cells. This was initially pretty confusing to me and I was skeptical of the radiation, but the radiation oncologist said that their goal is not to kill the cancer cells, but to instead ‘lethally wound them’. The goal of the radiation is to damage the DNA of the cancer cells enough that when the cancer cells go to split, they don’t have all the necessary information they need, get stuck in a half split state, and then trigger a “self destruct” mode and die off. The mutated cells in my bicep are different from many other cancers in that they split/reproduce every few months rather than every few days or weeks. What this means, is that in the 5-weeks of radiation, the cells in my tumor will be damaged, but aren’t attempting to split yet, so they won’t have a chance to die off yet. My oncologist said that if we did 5-weeks of radiation and then waited for 2-3 months, we would likely start to see the tumor size decrease or at least the cells start dying. What this means for me is that during surgery, they can take out a smaller ring (margin) of good bicep muscle around the tumor since they’re more confident that any extra cells that may be left in there aren’t able to reproduce anyways. In my case, this will hopefully result in having less bicep removed than the 80-90% of my bicep they would have to take to get good margins if they didn’t radiate.

Next Steps

My last radiation appointment is 22 September. After that, they want to give me roughly two weeks for my skin to heal somewhat before doing surgery on 08 October. My Integrative Oncologist also recommended I pause all my treatments with him for 2-weeks before surgery which means I have two weeks without any treatments. During this time I’ll get “restaged.” Staging is the process you go through to find out what “stage” of cancer you have, i.e. Stage I, Stage II, Stage III, or Stage IV. While they don’t expect to see any changes, they perform the same staging tests (CT, PET, and MRI) they did initially on me to decide exactly how they want to approach the surgery. I’m still working on getting dates for these staging tests, but the hope is that I can get them as soon as radiation is over so MD Anderson can review them before my surgery and give their opinion on their approach and expected outcomes to compare to the Dr. at BAMC. There’s a chance that during this two weeks I can go back to MS to get the rest of my things out of my dorm as well as potentially go back to Florida for a few days.

Long Term Planning

Unfortunately, the 6-nodules in my lungs complicates any long term treatment plan for me. As a healthy 24-year old, there isn’t any real reason I should have the nodules in my lungs and they’re likely cancerous, but since they’re so small and difficult to biopsy, it’s hard to make a good long-term treatment plan. The current strategy is to monitor the size of them through a CT scan every few months while we primarily focus on the mass in my arm. There’s about 3-ways that this could go:

1. They continue to spread or grow: This is where the more hardcore drugs would likely have to kick in.
2. They look the same and aren’t showing growth: This means 1) they are non-cancerous and completely separate from the cancer or 2) with the primary mass gone, they will stop growing and will just sit there and not spread for the rest of my life. It would likely result in many follow-up CT scans but no hardcore drugs.
3. They are gone: This is obviously the best outcome and means 1) miraculous healing or 2) a phenomenon that can sometimes occurs where when you treat the primary tumor, the body suddenly recognizes that tumor as cancerous and will start fighting that specific cancer throughout the body.

All of these long term scans and the administering of different drugs doesn’t necessarily have to take place in San Antonio though. This week, an Airman who works at the medical treatment unit I’m at asked me if I’d prefer to be back with family after surgery. He told me about a way that I could PCS to a base right next to my family while I do the longer term scans and potential drug administering. The details are still being worked out, but the plan would be for me to stay in San Antonio on TDY orders for a few weeks after surgery to continue with my Integrative Oncologist and recovery from surgery. After that, I would PCS to Florida and would have my Integrative Oncologist and Traditional Oncologist still calling the shots, but executing both kinds of treatments at a couple different clinics near my family. The Airman told me about this just in time for me to ask my home station to keep me on TDY instead of PCS. Overall, I think all the doctors and my command don’t love that I’m here by myself and would like to be able to get me back home. There are a lot of details that need to be figured out so I’m being careful to not get my hopes up, but I think the fact that the Lord had this Airman reach out just a few hours before my PCS orders to were sent in to move me to San Antonio for the next 3 years is a sign that He is going to work it out for me.

Prayer Requests

There are a few specific ways I would really love everyone to pray for me:

1. With my left arm having cancer in it and not being an ideal option for the Integrative Oncology IVs, my right arm is getting poked a lot. It’s getting harder for the people at the clinic to get a good vein and they’ve been having to usually try a couple times. I don’t like needles and I’m getting tired of it. Please pray that the veins in my right arm would start healing quicker and would cause less problems.
2. Pray that the timeline for my 2-week break would work out for me to be able to see get my staging scans done, get the rest of my stuff from MS, and hopefully be able to go back to see family for a bit before surgery.
3. Pray that when they do the follow-up staging, the lung nodules would be gone and that they could remove a minimal part of my bicep.
4. Pray that I would be able to PCS to Florida and continue to receive the treatment I need from there.

Random Thoughts:

1. This past week I was driving through Austin and got a chance to ride in an autonomous Tesla Robo Taxi with no steering wheel. It was pretty strange but kind of amazing.
2. I’m fasting once a week for 24-hours as a tool for fighting the cancer. I have been amazed by how much it affects me for just a 24-hour fast. I didn’t realize just how much I had trained my body to expect to always get food.
3. I’m at over $18k for my GoFundMe. That is amazing. What’s even more striking to me is the number of people who have donated. I’m at 51 people who have donated. With all the giant financial numbers floating around I think I have a tendency to not realize just how much money $18k is, but the 51 people feels a lot more personal. I would have never imagined I would have 51 individual people willing to give to me if I asked for it. Not only that, but if I have 51 people willing / able to give me money, just how many more do I have praying for me and that care about me. Lifting much of the financial burden has been a blessing, but even more than that, seeing everyone rally has been encouraging and a good reminder of just how many people support me.