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“I can do all things in him who strengthens me.” (Phil 4:13)

Dear Friends & Family,

I’ve learned that I have metastatic melanoma again.  Actually there is a good chance that it’s just been there since 2007.  Right off the bat I want to say that I want only God’s will to be done.  I’m praying that if it be for my good and my family’s, I will be healed.  The first time around it took a lot of work and spiritual direction to get to the point of abandonment to the will of God.  I came to believe that it’s the best approach.  Asking, “why me?” accomplishes nothing, and I’ve got too much joy and too much to be thankful for to start asking rhetorical questions.

Kendra has a blog post here that summarizes the first time we went through this.  It’s been smooth sailing since I got through the year of treatment and surgeries in 2008.  I have felt fine and about 5 years ago my oncologist encouraged me to stop coming to see him.

A few months ago, I noticed a bump under my skin right on top of my collarbone, and assumed it was a benign lipoma, which I have had previously in other areas.  My dermatologist took it out a few weeks ago.  Then I waited for two weeks for results.  In my experience, waiting two weeks for biopsy results means they tell me I’ve got cancer.  Counting the recurrence that Kendra mentions in her post, the two week wait followed by a positive melanoma diagnosis has happened 3 times now.  I dropped a note in the doctor’s suggestion box requesting that they knock it off.

Next we waited for confirmation of the results, which required a few additional pathology tests.  Meanwhile I went back to see the medical and surgical oncology team that had taken care of me at UCLA.  They weren’t able to tell me anything definitive at that point, but gave me the good news and the bad news.

The bad news is that the tumor was under my skin, not on the surface.  Since the dermatologist couldn’t find any suspicious spots on the skin, the most reasonable explanation seems to be that this tumor is the result of melanoma cells hanging around since 2007.  Puzzling and concerning.  The tumor might be a lymph node, but it’s in an unusual place to have a lymph node.  The other possibility is that a cancer cell got deposited there by circulating blood at some point.  Either way, the cancer was probably beat down by the year of interferon (Thanks, interferon.  I’ll never badmouth you again.) and my immune system, then started growing again at some point.  That’s all the bad news I got from those first oncologist appointments.

The good news is that I feel completely fine.  There is no indication that I’m sick, and I don’t seem to have any other swollen lymph nodes.  In addition, there’s a lot of good news with the therapies for melanoma, which have taken huge leaps forward since I did my year of treatment 10-11 years ago.  They’ve really figured out how to attack melanoma with targeted therapies or with improved immunotherapies.  Some potential good news on the tumor is that if it’s a lymph node, it could turn out to have been sort of miraculous that it worked its way to the surface so that I knew it was there.  It also could be that this node is the only tumor – that it was doing its job, caught cancer that broke away from the original tumor, and held on to it.  So one of the oncologists said his guess was that the next test, a PET CT scan, was going to show nothing more.

Back to the follow-on pathology studies – those came back positive last week, so it looks like this is the real deal.

The next step is to take a PET CT scan to look at the whole body picture and see what’s going on inside.  That’s scheduled for 7:30 AM Wednesday.  We should have results Thursday or Friday and will keep you posted.

I’m going to provide updates through this blog so that people can opt in if they want to get updates and I don’t have to manage long email lists. To receive new blog posts via email, click on “subscribe” at the top. This first update is going out to a small number of family and friends.  Once we have a clearer picture of what’s going on, we’ll make the news more public.  The kids know, and I’ve made it clear to them that I am not getting myself anxious or upset about it.  We really don’t know enough to be worried yet.  And even if it’s an advanced case of the disease, there are a lot of options on the table.  Plus there’s the mysterious will of God that we’re just better off to be grateful for, whatever it is.

I’m calling this blog “Fortitudine.”  It is pronounced for-ti-tude-in-ay, which means “with fortitude,” and is the original motto of the Marines.  The image on the header is the Marines’ cap emblem from the War of 1812 era.  The title Fortitudine is intended to remind me of how I want to approach this situation – boots on, face to the enemy, running to the sound of gunfire.  Please pray for me that I’ll be able to do that.  Be assured that I will offer up every worry, frustration and discomfort for you and your intentions.

With fortitude and prayers for you,