Chemo – Round 1

I am writing this update a bit earlier than I expected. For reasons I’ll explain below, I finished my first round of chemotherapy a week early. Here’s a quick update.

On May 3rd, 2019, I went in to the Hawaii Pacific Oncology Center to start my chemotherapy treatment. After an educational session with the nurse, I took my first dose of oral Capecitabine. I was then hooked up to an IV. I started with anti-nausea medication and steroids to prepare for the chemo drug, Oxaliplatin. The Oxaliplatin itself was about a 2-hour drip.

Thankfully, I didn’t feel any reaction to the IV as it was entering my body. In fact, I was quite comfortable at the oncology center. I was sent home with instructions to take the Capecitabine twice daily for two weeks.

By the grace of God, over the next week, I did not feel any of the expected side effects of fatigue, mouth sores, cold sensitivity, or neuropathy, all of which I was dreading. However, I did get a few unexpected side effects.

By Day 3, I started feeling jittery, like I had way too much coffee. In the next few days, my hands or back muscles would lock up while typing on my work computer. My eyes would want to stay closed, so I was blinking a lot. My co-workers thought I was tweaking! And maybe worst of all, my mind was getting foggy and easily overwhelmed. A few times, I cried out to God at my work desk, asking for relief because work was so overwhelming with the brain fog and jittery symptoms. Maybe I should have just taken the day off, but the work was already pilling on.

On Day 7, I called my oncologist seeking advice and he told me to just stop taking the Capecitabine pills and they will reassess when I go back in on May 24th for Round 2 of my chemo. Later in the day, I felt much better, and the brain fog was gone. I feel like I am back in control, but I know I’m not taking full advantage of the chemo either. We’ll see what the game plan is for Round 2.

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An Abundance of Counselors

My oncologist recommended 4 rounds (12 weeks) of chemotherapy, which included a dual regimen of Capecitabine (an oral chemo pill) and Oxaliplatin (a platinum-based IV drug). I asked lots of questions. I was especially interested in recurrence rates. The initial numbers he gave me were not encouraging. Without chemotherapy, I had a 50% chance that the cancer would return. That percentage is probably lower due to my age but it was nowhere near what I was hoping for.

I went home, prayed, did more research, and talked to more friends and family. With a 50% chance of recurrence, it was really no wonder that the anecdotal evidence I heard about seemed split. So I decided to just make a decision based on what could reduce recurrence rates, while considering the long-term effects of chemotherapy, especially from the Oxaliplatin.

Through the generosity of Christian friends, I was encouraged and given the ability to get more opinions from North Hawaii Community Hospital, and the Mayo Clinic in Phoenix. I was reminded of Proverbs 11:14:

Where there is no guidance, a people falls,
but in an abundance of counselors there is safety.

Both NHCH and the Mayo Clinic concurred with my oncologist. I should do the Capecitabine + Oxaliplatin. A genetic test on my tumor indicated with the dual-regimen of chemotherapy, recurrence rates go down to 17% for me. That is obviously much better than 50%, though these numbers didn’t seem to matter to my doctors. For them, it’s just important to do everything I can to kill the remaining cancer cells. Due to my young age, I was encouraged not to worry about the side-effects from chemo.

By now, I know I would regret it if I didn’t try chemotherapy.

So that’s where I’m at today. I face 3 months of chemotherapy and hope to beat the odds of 17%. I start treatment on May 3rd. What happens to me after that in the coming years is a mystery. Only the Lord knows.

As a believer in Christ, I always knew I would face serious trials in life. 1 Peter 4:12 tells me so. But I always wondered what these trials would look like. At the very least, I can now say cancer has been a real trial for me. I have had to seriously face the prospect of suffering and death. Cancer brings new temptations, such as anxiety or focusing on my condition too much. It’s tricky enough to be a good husband, father, elder, and social worker without cancer.

But I am not discouraged. I am able to entrust my soul to my faithful Creator. I have unfailing hope in Christ, who conquered death. Grace in my life has manifested in new and amazing ways. May I do good in the name of the Lord.

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An Unforgettable Valentine’s Day

Prior to surgery, my oncologist told me that chemotherapy would be a likely recommendation. He knew I was hesitant to do chemotherapy but he was planning to recommend aggressive treatment because of my young age. I would know for sure after my surgery.

The plan for my surgery was to remove the tumor through laparoscopic surgery, which involves smaller incisions, resulting in a shorter recovery time. A section of my colon would be removed and the remaining ends would be reconnected. Lord willing, everything could be back to normal after the surgery. Being able to go this route was a huge blessing.

My surgery was scheduled for Valentine’s Day, one I’m sure I’ll never forget. Everyone was praying for me. Some even fasted. This was one of the best things about my cancer; it got people from all over the world praying for me. I didn’t care that people paused to focus on me for a moment, as nice as that may be; I simply loved that people were turning to God at all. People were also praying for my one-year-old son who fractured his arm the day before my surgery, and for my wife, who would have to care for both my son and I.

On the big day, it was surreal to roll into the surgical room. I never imagined going through major, life-saving surgery at age 34. But I felt calm with the assurance I would sleep through the whole thing, all while being covered by prayer. What I wasn’t prepared for was the incredible pain I immediately felt once I awoke from the procedure. For nine hours, I was in constant pain and the medications weren’t having any effect. Despite the pain, which was unusual, I was told the surgery went well. All signs pointed to a timely recovery. Sure enough, I was back at home in a few days, and back at work in two-and-a-half weeks.

I was thankful to God that the surgery was a success. I was thankful for a quick recovery, which would not have been possible without my wife and sister helping me and making me smile. I was thankful for my church which supported me in more ways than I could have anticipated. There was much to praise God about!

However, the biopsy results of the lymph nodes that were removed during surgery was pending. As I was recovering, I was praying that the cancer didn’t spread that far. Results came in soon after I was discharged from the hospital.

Sadly, three lymph nodes tested positive for cancer. This means I have Stage 3B Colon Cancer. There is a good chance the cancer is spreading and it just hasn’t grown to any detectable level. But there was good news too. Tests on the tumor indicated the cancer was not the aggressive type. It was negative for genetic mutations. And three positive lymph nodes is statistically better than four or more. It’s also possible the cancer is completely gone, but there’s no way of knowing for sure.

So I would undoubtedly have to face the daunting decision on chemotherapy. More on that next.

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The Cancer Debate

I was okay with going through surgery. I wanted this tumor out as soon as possible. But how did I feel about chemotherapy? I knew little about it but it sounded like the most difficult part of the road ahead of me. In the next few weeks after my diagnosis, I would go through the mind-racking process of trying to understand the different views on cancer and chemotherapy. I wouldn’t know the stage of my cancer until after my surgery which made it all the more difficult to focus my research.

At first I didn’t have any serious reservations about chemotherapy, but several people in my life, with good intentions, wanted me to consider alternatives to chemotherapy. I didn’t expect to take their suggestions seriously, but out of curiosity, I listened. I read the books and watched the documentaries that were suggested to me. As the argument goes, the food we Americans typically eat is the cause of our cancer and fuels its growth. Furthermore, chemotherapy is not worth the long-term side effects and risk of secondary tumors. These arguments were compelling at first, but I soon saw flaws in their research. Much of it was based on anecdotal or limited evidence. Still, it was compelling enough to push me to forgo traditional treatment if I felt I didn’t really need it. But I needed more information. I still didn’t know if I was at Stage 2, 3, or 4 or the corresponding rates of recurrence. My CAT scan seemed to rule out Stage 4, which was great news, but the possibility of Stage 3 remained.

In an abundance of caution, I started eating vegan, cutting out as much animal products, sugar, and non-organic foods as I could. It was difficult (it still is), but it felt good to make some kind of healthy change in my diet.

As friends and family learned that I was considering alternatives to chemotherapy, some were very concerned and wanted to talk to me. They offered just as much anecdotal evidence about the life-extending power of chemotherapy, and the deadly pitfalls of the naturopathic route. In other words, I faced a dead-end in both directions. People wanted to convince me that chemotherapy would kill me. Other people wanted to convince me that naturopathic treatment would allow the cancer to kill me. It was frustrating and overwhelming at times. I didn’t know what to do.

Don’t get me wrong, everyone was trying to help me and I appreciated that. In fact, everyone was so generous and caring, it made me realize how much I need to grow in the spirit of hospitality. But deciding about treatment was never going to be easy.

I prayed to God for wisdom and help. This process forced me to depend on God every step of the way.

Before God would answer my prayer, I would go through major surgery. More on that next.

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Introduced to Cancer

Today, I turn 35 years old. This is the first birthday I am celebrating since being diagnosed with Stage 3 Colon Cancer. One way I want to celebrate this birthday is by sharing what God is teaching me through this ordeal. I also hope to educate anyone reading this about the reality of cancer. It was certainly the furthest thing from my mind until earlier this year.

Sometime last year, I can’t remember when, I started having concerning bowel symptoms. I didn’t have a PCP for the last 5 years because, well, I’m a typical young man who never felt the need for one. So it took several months to get an appointment with a PCP. My first check-up was in October 2018. I ran some tests and took antibiotics but the symptoms persisted. I was then scheduled for a colonoscopy to be done in early January 2019. This was when I started asking for prayer. I was confident the gastroenterologist would find something, but I was worried about what he would find.

Because of the blockage in my colon, prepping for the colonoscopy was difficult and very painful. The colonoscopy itself was a harmless experience. But when I woke up from the anesthesia-induced nap, the doctor was right there with some big news. With a sympathetic tone, he informed me he found a large mass in my colon, not too far from the end. A biopsy was sent to the lab. The doctor and nurse looked at me like “cancer” was written on my forehead, but I hoped and prayed it was not cancer.

My family and church prayed for me; I trusted in the Lord.

On January 15, 2019, I got a call from my gastroenterologist. The biopsy was positive for cancer. To say I was disappointed may be an understatement, but that’s mostly what I felt at that moment. I wasn’t upset with God. I wasn’t in despair. I was just sad that I had such a difficult road ahead of me. Intellectually, I knew that God was in control and my affliction with cancer would be good for me, but I didn’t know what else to think or feel.

The first person I turned to was John Piper. His pastoral guidance was just a few clicks away. I didn’t realize he also had cancer at one point, so he’s been through this.
1 Thessalonians 5:9-10 was helpful for him:

For God has not destined us for wrath, but to obtain salvation through our Lord Jesus Christ, who died for us so that whether we are awake or asleep we might live with him.

As a Christian, my cancer is not a result of God’s wrath against me. Through faith in Jesus Christ, all of God’s wrath against me was absorbed by Jesus on the cross. My cancer is not punishment. My cancer is actually for my salvation! With that scripture alone, my cancer made perfect sense to me. I always need a deeper understanding of my salvation in Jesus Christ and God was going to give that to me through the affliction of cancer, even if it kills me. Understanding the depth of God’s grace can be a costly lesson sometimes. It was a deal I was willing to accept.

I was told the next steps would be a CAT scan, surgery, and possibly chemotherapy. What I didn’t know was that I would need to become an expert in colon cancer to deal with the difficult decisions regarding my treatment. More on that next.

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Book Review – Superheroes Can’t Save You

I just finished reading Superheroes Can’t Save You by Todd Miles (2018).
The book’s sub-title: Epic Examples of Historic Heresies. Miles is one of my professors at Western Seminary, and that’s how I heard about this book. I’m so thankful; this book is a gem. Superheroes Can’t Save You is an amazing book on Christology, but it also covers theology of the Trinity, church history, and, of course… Marvel and DC superheroes!

The premise is truly ingenious. Miles noticed that every Christological heresy can be illustrated by a comic book superhero (Docetism/Superman; Liberalism/Batman; etc.). By comparing the heresies/superheroes with the truth of Scripture, Miles helps the reader see how amazing the Son of God is. Jesus is better than anything our creative minds could invent!

Think about it… Superheroes are supposed to be the champions of the fictional worlds we immerse ourselves in. Miles ponders, “Isn’t it interesting that the best they can do is make up a character that looks suspiciously like a deficient view of Jesus?” (6). Indeed. I’ve always found pop culture movies/comics to be both fascinating and disappointing at the same time. I think this book tells me why. Only the Bible offers the true story of our greatest Savior.

One of Miles’ goals is to show that in order for Jesus to be able to do everything that the Bible says he does, then he has to be everything that the Bible says he is, without any alteration (7). In each chapter, Miles introduces a superhero, describes the heresy illustrated by that superhero, explains who commits the heresy today, explains what the Bible actually says about Jesus, and then argues for why this is important. I would say the first four parts feed the mind, while the last part feeds the soul.

For example, Batman (my favorite superhero) is really just a man. He has great motivations, lots of money (how he gets all those wonderful toys), martial arts training, a loyal entourage, and the mind of a detective. But he has no super powers. Miles explains that people had, and continue to have, the same view of Jesus. According to Liberalism, Jesus was just a remarkable man, maybe the most remarkable man. Miles affirms that the Bible says much more than that. Not only did Jesus and the biblical authors claim that Jesus was God, but Jesus did things only God could do. He created all things (Col. 1:16), he forgave sins (Mark 2:1-12), and he accepted worship (Matt. 14:33, 28:9). Miles explains this is important because humanity was and is absolutely and fundamentally unable to save itself (49). We are dead in our sins (Eph. 2:1). It takes more than a Batman-like Jesus to save us. It takes the precious blood and life of Jesus (see 1 Peter 1:18-21). He was much more than a man.

Just like this, in each chapter, Miles did well in building my affections for Christ and my confidence in the claims of the Bible.

Don’t think that you are above any of these heresies. For me, I was surprised to learn how I have a tendency to believe Apollinarianism, a.k.a. “the Hulk heresy.” I’ve always affirmed that Jesus was fully human, yet I had to ask myself: Do I really believe he fought temptation as a human?

Superheroes Can’t Save You is relatable, educational, funny (this is a book where you won’t want to skip any of the footnotes) and most importantly, Christ exalting. I think it would be a fun book to go through in a Sunday School class or Bible study. The timing of this book was perfect. The comic book genre and culture is only growing in popularity. Marvel’s Avengers: Infinity War, the highest grossing superhero movie to date, reached over $2 billion at the box office. Hundreds of thousands flock to Comic-Cons each year. Now is the time to show people how only Jesus Christ can save us.

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Messianic Music

“The words of the Psalter are either about Christ or by Christ.” – Jason DeRouchie

While most would agree that some of the psalms are about Jesus Christ, I am learning to see how all the psalms are about him. Can psalms that are usually viewed as songs about David or Israel, be primarily about Christ? Could many of those psalms actually be prayers that belong to Christ? Should we read all the psalms as messianic first?

Here’s a few reasons you can answer the above in the affirmative:

  • Psalm 1 and 2 serve as an introduction to the entire Psalter, and both psalms are messianic. Jesus is the blessed man of Psalm 1:1 who mediated on the law. Jesus was the begotten son of Psalm 2:7. He was the one against whom the nations raged (Ps. 2:1, Acts 4:25-27). If the introduction to the Psalter is messianic, it is because the whole Psalter is messianic.
  • All the prophets foretold of Christ’s suffering for the sins of man (1 Peter 1:10-11, Acts 3:18-24, 10:43). This includes David, who was not just a king, but a prophet. He had the messiah in mind when writing his psalms.
  • Peter said in Acts 2:29-31 that David explicitly spoke, with foreknowledge, about the resurrection of Christ when writing Psalm 16. I think David had access to this foreknowledge when writing all of his psalms.
  • For example: John 19:36 reveals that David was talking about Christ in Psalm 34:20 when talking about the righteous one keeping all his bones.
  • John 13:18 reveals that David’s words in Psalm 41:9 truly belong to Christ when talking about a friend who ate his bread and lifted his heal against him. Judas fulfilled that role.
  • When Jesus said “Father, into your hands I commit my spirit,” (Luke 23:46) he was reciting Psalm 31:5. All of Psalm 31 is truly about Christ.
  • Jesus referred to himself in Matthew 21:42-43 as the cornerstone that the people would reject. This was first written about him in Psalm 118:22-23. All of Psalm 118 could be a song sung by Jesus.
  • What about the psalms that imply the author is a sinner? Consider Psalm 22:1, “My God, my God, why have you forsaken me?” Jesus prayed these words in Matthew 27:46 as he suffered on the cross.  If David was being disciplined by God (in Ps. 22), why would Jesus pray these words for himself?  Because Jesus experienced separation from God on the cross. Though Jesus never sinned and was worthy of no discipline, all sin was imputed to him in his crucifixion. Therefore, even psalms of lament and confession can belong to Jesus through the cross.

The explicit connections between Jesus in the New Testament and Psalms are not likely the only connections the prophets intended. It can be argued that every psalm was either fulfilled by Christ (with the author having the messiah in mind), or could be prayed by Christ (with the author having the messiah in mind).

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