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Bound for Glory

Updates on George's journey through stage IV colon cancer

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The Big Guns

A few days ago I had the pleasure of joining my brothers, Mike and John, my son-in law, Kyle, and his brother, Derek for a Veterans' Day tour of the USS Iowa, a battleship with a long and distinguished history. That's John and me in the picture.

If a ship could talk, the Iowa would have some stories to tell.  She carried FDR and his advisors to the Middle East to meet Churchill and Stalin. She fired her great guns in in the South Pacific, Korea and Vietnam.  She plied the seas in the Cold War, loaded with missiles, sometimes the nuclear kind.

She's a museum now.  She's got some rust spots. Most of her teak deck needs restoration.  The lower decks aren't open to visitors.  It is unlikely she'll ever leave the Port of Los Angeles again.  But hundreds, probably thousands, have scraped and painted and rebuilt and repaired her over the years, a continuous process and a labor of love for volunteers and the foundation that owns her.  Although she's 77 years old, she remains a symbol of American strength, pride and sacrifice.   Well worth the visit if you find yourself near the Port of LA and you like battleship tours.

I especially liked seeing the Iowa's massive array of 16-inch guns.  If you've ever watched old newsreels from WWII with battleships of the Pacific Fleet, you've seen these massive cannons in action.  They are devastatingly powerful.  In the modern Navy, however, guided missiles and rockets -- smaller, more precise, and requiring far fewer personnel to operate -- have supplanted the old big guns.  

I have been on the big guns of cancer treatment for several years.  Some of them are old-fashioned in the sense that they are not precise, but affect cell growth in the entire body.  These are the chemotherapies, such as 5FU, oxaliplatin, and irinotecan. 5FU is the oldest but still works well in modern cancer warfare.  Then there are the guided missiles, like Avastin or Erbitux. These drugs are precise, targeting specific molecular pathways in cancer cells. Even newer cutting-edge weapons use the body's immune system to fight tumors.  But the two (and only) FDA-approved immunotherapies for metastatic colorectal cancer (mCRC) help patients who have a certain mutation in their tumor cells that I don't have.  So for now my doctors must use other tools.  Sometimes those tools are existing medications developed for completely different uses.

Based on my latest scans and tumor markers, the current regimen of Avastin and irinotecan has allowed the tumors to grow, albeit very, very slightly (about a millimeter or two a month). While the change from scan-to-scan (roughly every two months) has been minimal, my tumor markers (in the blood) continue to go higher; they are quite high now.  So the overall growth trajectory is not good.

Instead of switching to a new treatment altogether and risk losing control of the cancer, my medical team has added an existing non-cancer drug to the mix.  Selzentry (maraviroc) was developed to fight HIV.  Recent research shows that it has anti-tumor properties in mCRC patients. It is the subject of clinical trials going on now. Our hope is that selzentry will be another cruise missile that, in combination with the stuff I'm already getting, will slow or stop the growth of my cancer.  I'm also having additional genetic testing of tumor DNA to find mutations that might enable future targeted therapies.  

I feel like an old battleship at times.  I was decommissioned (from my work life) a couple years ago.  The old big guns may not work so well but the new ones might. I need continual patching, repair and restoration to keep afloat.  I could not survive long without the help of many.  

And I do have the help of many.  My medical team, those praying for me, the close family members who help me with my care, and friends who check up on me -- you all  keep me going. I'm thankful to the Lord God for all of you, and for every day he gives me on this earth.  For it is all a gift from him, he who holds the very fabric of the universe and, perhaps other universes, together; he in whom "we live, and move, and have our being." (Acts 17:28 KJV)

May you have a happy Thanksgiving Day. 

I'll do scans in another couple months and update you then.

 Soli Deo Gloria

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