Chris Thyroid Cancer Update

Ultrasound Negative!

2009-10-27T18:35:00.003-04:00

I found out the test results today, so no more waiting.

The ultrasound came back negative, and the enlarged lymph node was not a cause of concern for the doctors due to the shape and other characteristics.

As expected, the PET scan did show some activity in the chest area due to the lung metastases. Since the Tg levels continue to decline (and are at such a low level), no treatment is planned at this time!

I am now in a holding pattern until late next summer, when I will have follow-up tests to check the Tg and TSH levels.

Thank you all so much for your prayers these last couple of weeks. It is encouraging to have so many Christian friends who pray for one another in times of need!

Galatians 6:2 - "Bear ye one another's burdens, and so fulfil the law of Christ."

Day by Day

2009-10-21T10:23:00.002-04:00

Last Friday, I had follow-up blood tests, PFT (pulmonary function test), PET-CT scan, and an Ultrasound. There is an enlarged lymph node in my neck (about 3x the normal size), and the PET scan should show if it is cancer-related. Next Tuesday I will meet with the doctor to find out the results and next steps. In the meantime though, I did find out the suppressed Tg level is now 2.9! Also good news is the PFT results were normal.

While I wait to find out next steps, I am reminded of the old hymn "Day by Day":

Day by day, and with each passing moment,
Strength I find to meet my trials here;
Trusting in my Father's wise bestowment,
I've no cause for worry or for fear.
He, whose heart is kind beyond all measure,
Gives unto each day what He deems best,
Lovingly its part of pain and pleasure,
Mingling toil with peace and rest.
Every day the Lord Himself is near me,
With a special mercy for each hour;
All my cares He fain would bear and cheer me,
He whose name is Counsellor and Pow'r.
The protection of His child and treasure
Is a charge that on Himself He laid;
"As thy days, thy strength shall be in measure,"
This the pledge to me He made.
Help me then, in every tribulation,
So to trust Thy promises, O Lord,
That I lose not faith's sweet consolation,
Offered me within Thy holy Word.
Help me, Lord, when toil and trouble meeting,
E'er to take, as from a father's hand,
One by one, the days, the moments fleeting,
Till with Christ the Lord I stand.

Tg now 3.5!

2009-04-23T09:09:00.002-04:00

My lab results came in this week, and the thyroglobulin is down to 3.5. This is the lowest level since my journey began over four years ago! Thank you all for your thoughts and prayers throughout this time.

Tg Down to 4.1

2008-10-01T16:26:00.001-04:00

Based on lab results from this week, the Tg has dropped to 4.1. Still tracking the right direction!

No Treatment in 2008!!!

2008-04-16T15:20:00.003-04:00

Well, the results are in from my tests last week. The suppressed Tg is now down to 6.8! It has steadily declined since my latest round of radio-iodine treatment last summer. In Aug'07 the Tg was 9.9, and dropped to 8.5 in Dec'07.

Based on the results, I will not need treatment this summer! The doctors will continue to monitor my progress, and the next follow-up is in six months. While I am excited to have a summer to enjoy for the first time since 2004, I realize that I am not "cancer-free" and further treatment at some point in time is certainly possible.

I want to thank everyone who has supported me during the last three years through fervent prayer, cards, encouraging Scripture, meals, and so much more. It has been truly amazing to see the outpouring of God's love on His children in their time of need.

1 Peter 5:6-7

Humble yourselves therefore under the mighty hand of God, that he may exalt you in due time:

Casting all your care upon him; for he careth for you.

Chest X-ray Normal

2007-12-17T13:43:00.000-05:00

I had a chest x-ray on a recent visit to my doctor. He said if it was not my name on the x-ray, he would have thought it was from someone else...it looked normal!

Back to work after 3rd round of radio-iodine therapy!

2007-06-29T17:56:00.000-04:00

As scheduled, I received a 250 mCi dose of I-131 radio-iodine on 05/30/07. I was admitted in the morning and released the following evening. It took a little while longer for radiation safety to clear me this year, due to the increased dosage. I've been back at work for the last couple of weeks, and am almost at "full strength" now.

It will take several months of monitoring to know the full benefits of the treatment, but so far everything seems to be moving in the right direction. It is likely however, that I will need another treatment dose next year as well.

3rd Round of Radio-iodine Treatment Begins May'07

2007-03-29T16:40:00.000-04:00

My third round of I-131 Radio-iodine treatment begins in May. This means I start the low-iodine diet again and come off of the thyroid hormone, thus becoming "hypothyroid" for a month.

The tracer dose will be given on 05/21/07, and the subsequent imaging and calculations will be conducted throughout the week. On 05/30/07 (Memorial Day), I will be admitted to the hospital for the "megadose". If all goes well, I will be released the following day.

Tg Graph

2007-03-29T16:31:00.000-04:00

The following graph illustrates the drop in Thyroglobulin (Tg) levels between Jun'05 and Mar'07. Prior to Jun'05, the levels were "off the charts" so I excluded them from the graph. Since July 2006, the Tg has dropped from 120 to 18!

GREAT NEWS!!!

2006-09-22T14:50:00.000-04:00

My Tg is now down to 33.7, the lowest ever since this journey began! Also the chest x-ray showed a continued decrease in the lung tumors, and the pulmonary function diffusion test increased from 60% to 74%!

Tg down to 120

2006-08-14T13:52:00.000-04:00

I mentioned Thryoglobulin in an earlier post. In July my Tg went down to 120, which is slightly more than the lowest level which was in Jan'06. Next month I will have another follow-up appointment and more bloodwork. Hopefully the Tg level will continue to decrease. I'll also have another chest x-ray next month, which will show if the tumors have shrunk further since this latest round of treatment. I'll post again sometime in September after these next two appointments.

Radio-Iodine Treatment 05/31/06

2006-06-03T20:36:00.000-04:00

On Wednesday, 05/31/06, I received a 156 mCi dose of I-131 radio-iodine. This is the second treatment dose administered in less than a year; the last dose was 100 mCi. I am scheduled for a follow-up scan and blood tests on 06/08/06, which will hopefully show the doctors what areas were taken up by the radio-iodine and the impact on my white blood cells, platelets, etc. It will take a number of months though to determine how effective the treatment was, and how much cancer is still prevalent.

I was released from the hospital Thursday morning after being cleared by radiation safety. I'm not sure the unit of measure, but the geiger counter reading immediately after the dose was 27, and it has to be 14 or below before being discharged. My reading went down to 8 by Thursday morning.

The only side effects I've noticed from the treatment is mild nausea, change in taste, and dry mouth. This is similar to the last treatment, and the side effects were temporary. One of the consent forms I had to sign prior to the treatment was acknowledgement that repeated doses of radio-iodine can cause secondary leukemia. The dosimetry process helps minimize this potential impact though by calculating what dose is "safe" for each patient.

I am grateful to be off of the diet and back on the thyroid hormone. It will still take a couple of weeks to feel "normal" again though. In the meantime, I've been maintaining safe distances from everyone and have been sleeping a lot. I look forward to regaining my strength, so I can enjoy the summer with my family!

Treatment Still on Schedule

2006-05-27T16:45:00.000-04:00

So far, so good. My radio-iodine treatment is still on schedule, and I will be admitted to the hospital this Wednesday, 05/31/2006. It looks like I will not need any surgery prior to the treatment, although there is still a "hot spot" in the neck region.

Thank you for all the prayers for strength. When the doctors saw me on Monday, they expected that I would be in a wheelchair based on my blood test results and being hypothyroid. The average TSH level for a "normal" person is 1.0. When a thyroid cancer patient goes through withdrawal of the thyroid hormone in preparation for the radio-iodine treatment, the TSH level is expected to rise to 30 or 40. My TSH level was over 135! The doctors were even more surprised when they found out I had been driving. They asked that I give them a courtesy call when I get behind the wheel of my car : ) Seriously though, through your prayers I have been able to work from home after my daily trips to the hospital.

I've had to isolate myself for several days this week from the family, as I have been "radioactive". The tracer dose of I-131 radio-iodine administered on Monday, 05/22/2006 was only about 2 mCi. The treatment dose that I receive this Wednesday will be much larger, probably between 100 and 200 mCi.

This will be my 2nd round of radio-iodine treatment, and the nuclear medicine director agreed that it would not be the last round. The tumors are still taking up the radio-iodine though, which makes the cancer very treatable. The doctors will continue to administer as many treatments as necessary until I receive a "clean scan".

I look forward to returning to a normal diet and the thyroid hormone upon my discharge from the hospital. I'll probably be in the hospital for 1-2 days and will need to isolate myself from everyone for 5-7 days after discharge. Despite having been on the low-iodine diet for several weeks, I have not lost any weight. For those that know me, you know that this is great news! I thank my wife for all her hard work and effort to prepare meals that conformed to the diet, but that were still quite delicious. I don't know how she managed to make a chocolate fudge cake without any milk, eggs, or butter.

Thanks again for all the prayers and encouragement to our family during this time.

Patience

2006-04-25T12:33:00.000-04:00

I took my two young children to the park yesterday evening to enjoy the beautiful weather with them, while I still had some energy. We had a great time playing 3-on-3 basketball; my 7 year old son was on my team. He made a hook shot with two older kids guarding him!

Last night I was tucking my son in bed and explained I would not have as much energy over the next 6 weeks to play basketball with him. (Yesterday was the last dose of the thyroid hormone until after the treatment on 05/31/06.) My son said that he wished I did not have the cancer. I told him that God has a reason for everything, even if we do not always know the reason or His plan. My son told me he was going to think that night what the reason is for my cancer.

Well, this morning on the way to school, my son said he thinks I have cancer so that God would teach me patience. He said I'd have to rely on God since I won't be able to take the thyroid pill. I smiled because I know that patience is an area in my life that needs work. Of course my 7 year old son probably knew that as well. I told my son he is a good thinker :)

The little boy and the surgeon

2006-04-25T12:27:00.000-04:00

A friend sent this to me today. I hope it moves
you as much as it did me.

"Tomorrow morning," the surgeon began,
"I'll open up your heart..."

"You'll find Jesus there," the boy
interrupted.

The surgeon looked up, annoyed "I'll
cut your heart open," he continued,
to see how much damage has been
done..."

"But when you open up my heart, you'll
find Jesus in there," said the boy.

The surgeon looked to the parents, who
Sat quietly."When I see how much
damage has been done, I'll sew your
heart and chest back up, and I'll plan
what to do next"

"But you'll find Jesus in my heart. The
Bible says He lives there. The
hymns all say He lives there. You'll
find Him in my heart."

The surgeon had had enough. "I'll tell
you what I'll find in your heart.
I'll find damaged muscle, low blood
supply, and weakened vessels.
And I'll find out if I can make you well."

"You'll find Jesus there too. He lives
there."

The surgeon left.

The surgeon sat in his office, recording his
notes from the surgery, "...damaged aorta, damaged
pulmonary vein, widespread muscle degeneration.
No hope for transplant, no hope for cure. Therapy:
painkillers and bed rest. Prognosis:, "
here he paused, "death within one year."

He stopped the recorder, but there was
more to be said. "Why?" he asked aloud.
"Why did You do this? You've put
him here; You've put him in this pain; and
You've cursed him to an early death. Why?"

The Lord answered and said, "The boy,
My lamb, was not meant for your
flock for long, for he is a part of My
flock, and will forever be.
Here, in My flock, he will feel no pain, and
will be comforted as you cannot imagine.

His parents will one day join him here,
and they will know peace, and
My flock will continue to grow."

The surgeon's tears were hot, but his
anger was hotter. "You created that
boy, and You created that heart. He'll
be dead in months. Why?"

The Lord answered, "The boy, My lamb,
shall return to My flock, for He has
Done his duty: I did not put My lamb
with your flock to lose him, but to retrieve another
lost lamb."

The surgeon wept.. The surgeon sat
beside the boy's bed; the boy's
parents sat across from him. The boy awoke and
whispered, "Did you cut open my heart?"

"Yes," said the surgeon.

"What did you find?" asked the boy.

"I found Jesus there," said the
surgeon.

Author Unknown

2nd Round of Radioiodine Treatment 05/31/06

2006-03-20T17:45:00.000-05:00

Today I received the schedule for my second round of I-131 Radioiodine treatment:

04/24/06 Last dose of thyroid hormone

05/01/06 Begin low-iodine diet

05/22/06 - 05/26/06 Dosimetry Process

05/31/06 Admission to Washington Hospital Center for Radioiodine Therapy

Once I am off of the thyroid hormone, I will become hypothyroid, which will leave me very weak and tired. I appreciate everyone's prayers during this time for physical strength.

The Good That Pain Can Do

2006-03-09T09:14:00.000-05:00

Following is a short devotional from today's Our Daily Bread.

It is good for me that I have been afflicted, that I may learn Your statutes. —Psalm 119:71

Affliction, when we accept it with humility, can be instructive, a discipline that leads us to a deeper, fuller life. “Before I was afflicted I went astray,” David said, “but now I keep Your Word” (Psalm 119:67). Peter would agree: Affliction leads us not to live for ourselves “but for the will of God” (1 Peter 4:2).

Far from being an obstacle to our spiritual growth, pain can be the instrument of it—if we’re trained by it. It can push us closer to God and deeper into His Word. It is a means by which He graciously shapes us to be like His Son, gradually giving us the compassion, contentment, tranquility, and courage we long and pray for. Without pain, we wouldn’t be all that God wants us to be. His strength shines brightest through human weakness.

Has God set you apart today to receive instruction through suffering and pain? Endure this training patiently. He can turn the trial into a blessing. He can use it to draw you close to His heart and into His Word, teach you the lessons He intends for you to learn, and use it to bestow His grace on you.

God is making more of you—something much better—than you ever thought possible. —David H. Roper

By faith a Christian can have poise
And rise above all that annoys—
Sustained and strengthened by God’s power
To live in victory hour by hour. —Hess

Whatever God teaches us through pain is gain.

A Glimpse Of God’s Love

2006-03-03T13:26:00.000-05:00

I was intrigued by today's Our Daily Bread entitled A Glimpse Of God’s Love.

"He who glories, let him glory in the Lord." —2 Corinthians 10:17

Nadine was in the last stages of cancer when I met her. The doctor said chemotherapy would no longer help. She was a dedicated Christian and had a wonderful peace from God. She spent her last weeks making scrapbooks for her adult daughters and planning her memorial service.

Nadine’s joyful spirit was inviting to be around, and people looked forward to spending time with her. She kept her sense of humor and always shared the ways that the Lord was meeting her needs. She gave everyone around her a glimpse of God’s loving character.

When a man who had been born blind was healed by Jesus, he too had the opportunity to show others a glimpse of who God is (John 9:1-41). Neighbors asked, “How were your eyes opened?” (v.10). He told them about Jesus. When Pharisees questioned him, he told them how Jesus had given him sight, and concluded, “If this Man were not from God, He could do nothing” (v.33).

We may wonder how we can show others what God is like. God can be clearly seen in the way we handle life’s difficulties, such as problems at work or home, or perhaps a serious illness. We can share with others how He is comforting us—and let them know that the Lord cares for them too.

Who in your life needs to see the love of God? — Anne Cetas

Believers who are Spirit-filled
Are unaware that God may be
Revealing through their Christlike ways
A glimpse of His reality. —Hess

You can be a glimpse of God’s love to someone.

Thyroglobulin Update

2006-02-24T13:21:00.000-05:00

What is Thyroglobulin? I'm glad you asked. It is the form that thyroid hormone takes when stored in the cells of the thyroid. If the thyroid has been removed, thyroglobulin should not show up on a blood test. Doctors measure thyroglobulin level in blood to detect thyroid cancer cells that remain in the body after treatment.

The normal range for serum thyroglobulin (Tg) is 0 to 30 ng/m. In early 2005, my Tg was 789 and rose to 1,050 after the thyroid was removed on 04/15/05. In May my Tg rose to 1,119 and then as high as 5,200 before my neck dissection in June. Three weeks after my neck dissection, the Tg fell to 540. A month following my radio-iodine treatment (July 2005), the Tg dropped to 249. In October, the Tg dropped to 200. Just last month, my Tg dropped to 116!

It's encouraging to see the Tg continue to fall. However, any Tg is an indicator that I still have the cancer. Since I now have no thyroid, my Tg should be zero. An average Tg range is 10 to 20 for someone who has a thyroid.

Based on the results, my next treatment will probably be sometime in May. The date is still being coordinated with the nuclear medicine department at Washington Hospital Center. I'll post the schedule once I receive it.

Thank you all for your continued thoughts and prayers.

Inspirational Scriptures

2006-02-10T13:18:00.000-05:00

The following Bible verses were really a help to me during this journey. I'm thankful I have the Lord Jesus Christ to carry me through this trial. Without the Holy Spirit as a Comforter, I cannot imagine going through cancer. I have peace knowing where I will spend eternity when I die.

I've included the dates of when I came across these verses, which you can relate to the time of my surgeries/treatment.

7/8/05 - Philippians 4:6-9
Be careful for nothing; but in every thing by prayer and supplication with thanksgiving let your requests be made known unto God. And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus. Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things. Those things, which ye have both learned, and received, and heard, and seen in me, do: and the God of peace shall be with you.

7/1/05 - Matthew 6:19-21
Lay not up for yourselves treasures upon earth, where moth and rust doth corrupt, and where thieves break through and steal: But lay up for yourselves treasures in heaven, where neither moth nor rust doth corrupt, and where thieves do not break through nor steal: For where your treasure is, there will your heart be also.

7/1/05 - Psalm 61:1-4
Hear my cry, O God; attend unto my prayer. From the end of the earth will I cry unto thee, when my heart is overwhelmed: lead me to the rock that is higher than I. For thou hast been a shelter for me, and a strong tower from the enemy. I will abide in thy tabernacle for ever: I will trust in the covert of thy wings. Selah.

06/22/05 - II Corinthians 1:3-4
Blessed be God, even the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort; Who comforteth us in all our tribulation, that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God."

06/15/05 - Isaiah 40:29-31
He giveth power to the faint; and to them that have no might he increaseth strength. Even the youths shall faint and be weary, and the young men shall utterly fall: But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint.

05/27/05 - Philippians 4:13
I can do all things through Christ which strengtheneth me.

Radio-Iodine Treatment Effective

2006-02-10T13:16:00.000-05:00

The radio-iodine treatment continued to take effect months after the dose was administered. The tumors have shrunk in my lungs, and there are less of them!

It looks like my next treatment will be in May or June 2006. The treatment intervals have to be spaced apart about 10 months, otherwise the bone marrow and white blood cells could be suppressed too much.

Thyroid Cancer Prognosis

2006-02-10T13:02:00.000-05:00

There are various prognosis staging methods for thyroid cancer. Following is my prognosis using the three different methods:

MAICS - 20yr Survival Rate 56%
TNM - Recurrence 7%, Mortality 11.6%
AMES - High Risk, 46% Mortality

According to another source, the 5 year survival rate is 48%.

One thing going for me is my age (under 45), but the distant metastases to the lymph nodes and lungs doesn't help.

Radio-Iodine Treatment 07/07/05

2006-02-10T12:44:00.000-05:00

On 07/07/05, I received a 100 mCi dose of I-131 radio-iodine via capsule. I was held in a lead-lined room in isolation for 30 hours before being cleared by radiation safety. Basically, they measured my radiation levels with a geiger counter before releasing me.

Once I was released, I was told to keep a safe distance from people for 3-5 days and to especially stay away from young children and nursing mothers. This was difficult, as my children were ages 5 and 7 at the time. I didn't want to expose them to unnecessary gamma rays though, so I stayed in the family room (basement) for the next week.

Bilateral Modified Radical Neck Dissection 06/01/05

2006-02-10T12:14:00.000-05:00

On 05/23/05, I received my first Thyrogen injection to increase my TSH levels. The dosimetry process officially started on 05/25/05, when I received my first dose of I-131 radio-iodine via capsule, 2.2 mCi. The dosimetry scanning commenced that afternoon and continued Thursday and Friday. Based on Friday's imaging (05/27/05), there was a new development.

The radio-iodine scanning shows where any thyroid tissue or tumors are present. The tests confirmed that the tumors were present in my lungs AND in the lymph nodes in the neck. Since the cancer was in the lymph nodes, the lungs would not receive the necessary radio-iodine treatment without first having the lymph nodes removed.

I left the hospital on Friday, 05/27/05 at 12:00pm, and received a call from my doctor before arriving home that I would need Bilateral Modified Radical Neck Dissection. In preparation for the surgery, my doctor had already arranged an MRI for the following Sunday and an Ultrasound on Tuesday. The inpatient surgery was scheduled for the following Wednesday, 06/01/05.

The surgery took much longer than expected, as the surgeon was having to slice through scar tissue from the thyroidectomy, which took place two months earlier. I remained in Phase I recovery for several hours as my heart rate was extemely high.

The pathology report on 06/15/05 indicated that 17 lymph nodes from the neck and sternum and 2 tumors removed from trachea were positive for papillary carcinoma.

Referred to World-Renowned Thyroid Cancer Expert!

2006-02-10T11:58:00.000-05:00

My Oncologist referred me to Dr. Leonard Wartofsky at Washington Hospital Center in D.C. Following is what THYCA has to say about him:

Dr. Wartofsky is a past president of the American Thyroid Association and was the 2001 recipient of the Distinguished Educator Award of The Endocrine Society. His specialty is endocrinology, and he is a world-renowned authority on thyroid disorders and thyroid cancer. He has published over 300 articles or book chapters in the medical literature, and is editor of the medical textbook titled “Thyroid Cancer: A Comprehensive Guide to Clinical Management,” and the co-editor of the patient and caregiver reference book titled “Thyroid Cancer: A Guide for Patients.”