Our God is the God of Miracles

Today was the day.  After we met with Dr. Zuckerman (Dan) Zach turned to me and dryly asked how we were going to make today's post funny.  I told him I didn't think that it was possible.  Some days the news will just be dark and there's no way around it.  

We received almost the worst news possible today.  Zach was diagnosed with stage 4 esophageal cancer.  We are looking at prolonging and maintaining his quality of life for as long as possible.  Neither Zach, Nathaniel or myself asked how long that might be.  Dan told us he won't say that stage 4 esophageal cancer is not curable, but it is going to be tough.  The saving grace that keeps Dan from saying Zach is not curable is the cancer has not spread to the liver, lungs or the brain.  

Some cancers have clear, definitive and well-researched studies that point to a single regiment to give a cancer patient.  For esophageal cancer there is not one single standard of care. No one has been able to definitively show there is 1 perfect regiment.  Zach was given 2 options to battle this cancer: a 2-drug treatment (FULFOX) or a 3-drug treatment (DCF).  The 2-drug treatment won't cause hair loss, the nausea is manageable with drugs and Zach would be able to continue to work.  But it is a conservative approach for the stage of cancer Zach has.  

The 3-drug treatment is very aggressive, extremely toxic, will tear Zach up and may lead to a hospitalization. DCF will nearly wipe out Zach's immune system so he is at a high risk for infection.  Even given this information there wasn't much of a discussion; Zach is ready to tackle this with everything he has and everything his body can take. Dan said he wants to "push the envelope in Zach's case for what would typically be done for a stage 4 patient because he is young and fit." 

The chemotherapy treatment of DCF starts next week.  It will last 3 months with 4, 3-week cycles.  

• Day 1: The D and C drugs are given during an 8-hour day at the MSTI clinic.
• Days 1-4: The F drug is given as a continuous infusion.  Zach will have a "chemo ball" that he will have to wear in a fanny pack (insert bad 80s joke here).  
• Days 5-21: Recover from the chemotherapy and gear up for the next cycle.  

Week 1 of each cycle will be the hardest in terms of fatigue and nausea. Week 2 Zach will be at the highest risk of infection.  Week 3 will be the most manageable.  But each cycle of chemotherapy will be harder and harder for Zach to completely recoup his strength from.  Zach will tackle 3 months of chemotherapy.  Then another PET scan will verify the cancer cells are responding positively to the treatment.  Radiation will then be used in conjunction with more chemo to kill more of the cancer cells.  If the cancer does not respond the way Dan would like then we look at leaving the state for clinical trials. 

Zach's goal is to face this cancer head on.  He plans to take the next 3 months off of work in order to deal with the side effects.  God-willing he overcomes the odds and can work some based on how he is feeling.  Zach has come to grips with his situation and wants to do everything he can to attack the cancer.  For the next 3 months we need your prayers for successful eradication of the cancer and that the side effects don't destroy Zach.  

Nathaniel will fly back to Louisville on Saturday.  His leaving will be difficult on us.  We can't wait until he returns…hopefully soon and permanently and we are keeping that in prayer too.

As I finish tonight's blog and listen to Zach and his brothers laugh and joke around, I am hopeful.  We are his team and he can't succeed without us.  It is scary to be on this journey.  But I'm thankful many are sharing it with us.  I believe our God is the God of miracles.