Update: 16th April

The breath of God has made me,
     and the breath of the Almighty gives me life.

- Job 33.4

Good news!
It has been a month since I had a CT scan that revealed the growth in my chest had shrunk to about a quarter of the size it had been in early December.

This morning, I had a PET scan at RPA Hospital. This involved being injected with radioactive glucose* and then being scanned to see where I was radioactive. The glucose is taken up into cells with high activity: the brain, liver, active muscles - and active tumours. The pattern of radiation thus reveals whether any tumours are active.
*Technically, radioactive tracer in a glucose solution, since the sugar itself doesn't undergo radioactive decay.

But my scan was clear. There was 'no evidence of viable tumour activity' . This means that the remaining tissue revealed last month on the CT scan is simply dead scar tissue. Praise God! This is what we've been praying for and the best outcome we could have hoped for after the diagnosis in December.

From here, I will continue to have tests every few months to check for relapse. If I remain clear for two years, the likelihood of it returning becomes much smaller. But for the moment, I have been spared. And for this, we are thankful.

I know there are many others who do not have such good news today, but who continue to struggle with illness and a variety of difficulties. Why have I been spared at this time? It is not a reward, but pure gift, like all life. We remain thankful for every day.

What has changed? In one sense, not much. I will still die sooner or later and I continue to trust the God who raises the dead. I still follow one whose path of faithful obedience meant suffering amidst a groaning and broken world. Health remains a good gift from God's Spirit, but not the goal of life. There are worse things than sickness and death.

Yet, of course, today's small mercy is worth celebrating: more life together with you; more opportunities to serve God, his world and his people; more time to tell of God's goodness to us all. I am looking forward to celebrating with friends and family, not having any more needles (at least until the next scan), and starting to once more think about the future beyond next week.

My health continues to improve after treatment ended two months ago. I have more energy and am able to eat most things. I am beginning to work at improving my vocal volume with the help of speech therapy. I have lost all my convenient excuses for avoiding the exercise regime that Jessica and I have been promising each other for years.

Thank you for all your prayers, love, cards, food, gifts, kindness and presence (even in spirit). We have really appreciated your company on this leg of our journey and look forward to more adventures together (hopefully for many years!).

At this milestone, we think it's appropriate to give thanks and celebrate God's kindness to us. And so, Jessica and I would like to invite you (and any interested others you know), who have supported and prayed for us, to a thanksgiving service. We haven't yet worked out any details, but we'd love to acknowledge that we are and remain recipients of undeserved grace from you and our heavenly Father. We'll let you know date and time soon.

Of course, we'd still love your prayers:
Give thanks: for so many things - I'm sure you can think of some!
Pray: for those who face disappointment and not joy today; for patience and discipline in trying to strengthen my voice; and that we will not forget the lessons we have learned.

Update: 22nd March

Taste and see that the LORD is good;
blessed is the one who takes refuge in him."

- Psalm 34.8

God is faithful in times of prosperity and adversity. We continue to be so thankful for all the good things we receive from his hand.

CT scan
Yesterday I had my first post-treatment scan (a CT scan) to begin to determine the effectiveness of all the chemotherapy and radiotherapy I received in January and February. The results were very encouraging. There were no secondary growths (i.e. the cancer has not spread) and the primary tumour had shrunk to about a quarter of the volume it was back at the start of December when I was first diagnosed (the only other time it was measured in a scan). On 1st December, it measured 35 mm by 30 mm by 25 mm but yesterday it was 25 mm by 17 mm by 16 mm - a very impressive reduction. The radiologist who reviewed the CT scan was also impressed at the comparatively minimal damage done to the surrounding area (esp lungs) by the radiotherapy.

However, yesterday's scan does not reveal whether this residual mass is merely scar tissue or active tumour. To find out, we need to wait another month to continue to allow the radiotherapy to have maximum effect and then I will have a second, different scan (a PET scan) to measure cell activity. More waiting - no wonder they call us 'patients'!

Side-effects
After finishing radiotherapy just over a month ago, I have been recovering from the various side-effects and feel as though I am well past half-way (though not yet 100%). I still have less energy than I used to and am still expanding the kinds of food my oesophagus can tolerate. For much of this month, I have been on a liquid diet but have recently been enjoying food with more substance.

Voice
My voice, though a little stronger than it was a month or two ago, continues to be quite different to what it once was. It is likely that this will be a permanent issue since the damaged nerve that controls my left vocal cord may never recover. However, with some speech therapy over the next couple of months I might continue to gain a little more volume. I am able to preach and give talks using microphones, but conversation in noisy contexts is very difficult, as is singing - a loss I frequently mourn.

Church
Apart from these factors, Jess and I have been well. We are both enjoying our work, as well as the extra time we've had to rest and recover while both being part-time. We are settling well into our not-quite-so-new church at Leichhardt and have started a couple of small groups for people our age, which have been very encouraging.

We have really appreciated all the generous support from so many: gifts, practical help, people willing to listen, and a constant supply of food and prayers. God has given us all we need and so much more!

Prayer
For those who pray...
Give thanks:

• for God's generosity towards us all: giving us life and every good thing, especially his son.
• for the love and support we have also received from church, family and friends in a variety of forms.
• for the good result on yesterday's scan, and how far we've come on this little adventure since the start of December.

Pray:

• that the remaining mass will be all scar tissue and not contain any active tumour cells.
• that while waiting for a more definitive result next month, we will be patient and thankful for each day, without anxiously grasping after an answer or deferring our lives.
• that I might continue to regain strength and would use this to serve the God who loves life.

Update: 19th Feb

End of radiotherapy
Praise God - I have reached the end of this treatment cycle! I have just returned home from my final day of radiotherapy (#33) and last Wednesday received my 7th and final doses of chemotherapy. I am exhausted and in many ways at the lowest point I have reached physically, but remain filled with hope and feel great relief, since the next few weeks should involve gradual recovery. Since radiotherapy will continue to affect my body for the next couple of months, it will be many weeks before the effectiveness of this treatment cycle can be determined. I will have a full CT scan in a month (which will reveal how much of the growth remains) and then another full PET scan in about two months (which tests whether it is still active). We are praying that the growth will have entirely disappeared . However, it is more likely that a scarred area will still show up on the CT scan. If so, we're praying that it is no longer active.Side-effects
As for side-effects, the radiotherapy has really overtaken the chemotherapy in the last couple of weeks. Not only am I even weaker and more tired than ever, but recently it has become increasingly difficult to swallow due to radiation burns to my oesophagus. For the last week or so I have been limited to fluids (water, juices, thin soups, melted ice-cream (thank God for small mercies!), special dietary supplement drinks, yoghurt and the like) and even then require painkillers and an oral anaesthetic (which I gargle before meals) to get things down. It's not much fun. But this level of discomfort is only likely to continue for another week or two. I am now glad that I put on so much weight in December!

God is good
Each morning, Jessica and I wake up and remind each other "This is the day that the LORD has made", to which the other replies "Let us rejoice and be glad in it!" (Psalm 118.24). Despite not being able to do all that I once could (and might, God willing, one day be able to do again), life is good, very good. We are so blessed by the generosity and support of family, friends and strangers, by having a beautiful new church family at Leichhardt where God is clearly at work, by living in a country with a (largely) functioning medical system, and by having a sure hope that as we have died with Jesus to our old lives, so we will also rise like him when God makes all things new.

Work update
Jessica continues to enjoy her social research position at St Leonards and the occasional continued support she can offer to the EU Graduates Fund (where she was working for the last few years). Our time at All Souls, Leichhardt has started well. We have met many people, welcomed a number of newcomers even more recent than us and started a weekly small group for 20-30s. I have also preached twice (sermons can be downloaded here), led some services, done a little reading, begun planning a few outreach events in coming weeks and attempted to keep the church and many of you in my prayers.

Prayer
Speaking of prayer, here are some suggestions for those who pray.
Give thanks:

• For reaching the end of this treatment cycle and for its apparent effectiveness.
• For Jessica's thoughtful concern and love as primary carer. Also for the many others who give their time, energy, friendship, food and prayers in support.
• Because our Father is faithful, because Jesus' blood never fails, because the Spirit blows with the promise of a new age.

Pray:

• That the treatments will have been effective, that God will have used it to bring complete healing, that the test results will show only scarring and no active cancer anywhere in my body.
• For patience with eating difficulties and that I'll be able to maintain adequate nutrition despite limited options and little desire to eat. Also for patience and peace as we wait the next few weeks for results.
• For energy when I need it and the ability to rest at other times. For Jessica to also have good rest during this time of stress.
• For the new small group at All Souls, that it will be a place of life and peace, where we speak the truth in love to one another, welcome newcomers and care for those who are struggling.

Update: 6th Feb

Tiredness
The main development in the last week or so is that I've been feeling more and more tired. This is partially the chemotherapy taking a lot of energy as my body destroys and replaces cells quickly, partially the cumulative effects of the radiotherapy as the weeks progress, and partially the effect of coming off steroids after being on them for the last six weeks or so. Also contributing has been a reduction in the quality (and quantity) of my sleep again; this time due to some back pain from lack of exercise and proper stretching. This is something I have experienced on and off over the last few years and is the result of poor posture and a largely sedentary lifestyle. No one to blame but myself! Though at the moment, I rarely feel like exercising or stretching.

Tiredness has been a significant part of why I still haven't finished the FAQ. Apologies, and I do still intend to get there before my treatment is over...

Keep praying that I would have energy when I need it and would be able to get good rest at other times.

Update: 24th Jan

      The Psalms end with this invitation:

Let everything that has breath praise the LORD.

- Psalm 150.6

      I have plenty of reasons to praise God at the moment, since I am now halfway into my treatment cycle and my breathing is basically back to normal. Although it will be a number of weeks before we have any more scans, at this stage, it seems that the tumour is shrinking (at least my bronchial tube no longer feels obstructed). Things have changed a lot since Christmas, when I would wake every few hours to find my left lung wasn't getting any air! I have exchanged some of the direct effects of the tumour (breathing and coughing) for side-effects of the treatment (mainly tiredness and weakness, but also some difficulty swallowing, which will grow as radiotherapy continues).
      Today I had my fifth (weekly) chemotherapy and seventeenth (daily on weekdays) radiotherapy sessions. They have all been going smoothly, apart from a sudden reaction two weeks ago during the administration of one of the chemotherapy drugs. Although not uncommon, the speed and intensity were quite scary as within sixty seconds I flushed, became very short of breath and had intense back pain for a couple of minutes until I was given drugs to counter it. Since then, I've been given an extra-strong dose of steroids before each chemotherapy, which has prevented another reaction but disrupted sleep on Wednesday nights (and given me a big appetite - I am still putting on weight, having been told by my dietician to enjoy a high protein, high calorie diet (!)). Generally, however, my sleep has been better and our daily life has been fairly 'normal' during January, albeit a little slower than usual with both of us feeling tired much of the time. I have also sometimes been having difficulty concentrating and find my increased absent-mindedness frustrating.
      Jessica and I have both started work for the year. Jess is working 3 days/wk in St Leonards as a social researcher. On Sunday I also began 3 days/wk (or some fraction of it, depending on energy levels) at All Souls Anglican Church, Leichhardt as a lay ministry assistant. I had energy on Sunday and enjoyed meeting new people. We're looking forward to getting to know and be part of this community at greater depth, as well as trying to reach out to the local area, particularly to those in the 20-30 somethings. If you're looking for a church around Leichhardt, feel free to drop in on a Sunday (10.00 am or 6.30 pm, cnr Norton and Marion Sts).
      We've been thinking recently about how it's important for the cancer to not become the centre of our lives and routine. Life is a gift and staying healthy is a good aim, but is not the most important thing. More important is continuing to grow in our love for God and those around us.

      For those who pray, we continue to appreciate and thank God regularly for your support. Here are some suggestions.
      Give thanks:
            • For continued improvements to breathing and the reduction in the growth.
            • For new opportunities to work and serve, especially for the community at All Souls, Leichhardt and what God is doing amongst them, which we'd love to join in on.
            • For unexpected acts of generosity and support from a wide range of people.

      Pray:
            • That the treatment would continue to reduce and remove the tumour with minimal and manageable side-effects and no further reactions.
            • That as we enter new contexts we would both have energy to keep caring for one another and strength to build new relationships of trust and grace.
            • That our focus would remain on the primary things (loving God and neighbour), with secondary tasks taking their appropriate place.

Introduction: read this first

Welcome & blog introduction
Welcome to my second blog. My main blog, nothing new under the sun, is for general personal and theological reflections, links, commentary and discussion. Please come over, check it out and join in sometime. This new blog is specifically for personal and health updates, frequently asked questions about my life with cancer, prayer points and discussion. Feel free to browse and make comments, even if you don't know me personally. Latest updates will appear at the top of the page as things develop.

About me
I am a twenty-eight year old Christian from Sydney, Australia recently diagnosed with cancer. My wife Jessica and I live in Camperdown and from this week will church at All Souls Anglican Church, Leichhardt, where I am beginning work serving part-time as a lay ministry assistant (we have just moved from St Barnabas' Anglican Church, Broadway), having recently completed a four-year Bachelor of Divinity from Moore Theological College.

Initial signs and diagnosis
Back in early October last year I began to lose my voice (mentioned here and here). It was a very stressful time at college and personally and so for many weeks, I simply rested my voice and waited for it to return, unfortunately missing some speaking engagements and mercifully giving my classmates more chance to speak.

However, after a couple of months, exams were over and life was slowing down, but my voice hadn't fully return so I went to get it checked out. A nasal endoscopy quickly discovered that my left vocal chord is paralysed, greatly reducing my volume and range. A CT scan the next day was intended to rule out one possible cause: a compressed nerve. This scan discovered a growth (3.5 by 3.0 by 2.5 cm) in the middle of my chest, extending between my oesophagus and the base of my trachea, and growing into my left main brochial tube, partially obstructing my breathing. I received this news on the 4th December and so regular readers might realise that all the posts since here are coloured by this news.

Weeks of tests and hospital visits ensued, at the end of which it has been determined that I have a primary squamous cell carcinoma of the upper aero-digestive tract. There are no secondary growths (praise God), but as it presently stands, the tumour is inoperable, being trickily located at the junction of primary tubes for food, breath and blood (aorta).

Treatment
I began chemotherapy on 27th December and had my first radiotherapy session on 2nd January. I am physically tired and sometimes have difficulty concentrating, but am generally quite well. My breathing, which had been getting progressively more difficult throughout December (and which was affecting my energy and sleeping), has eased even in the last couple of days - another reason to rejoice.

Reaction
It's hard to say exactly how Jessica and I are feeling, because there are many aspects to the experience and the last few weeks have been such a whirlwind of responses and new challenges. There is shock at the ugly presence of sickness and wrong in God's good world. There is sadness at lost or delayed plans. There are bouts of some anxiety and uncertainty, mixed with pragmatic necessities and reflective moments of insight and new perspectives. There is joy in the love of friends and family and the daily gifts God gives. There is a yearning for Christ to return and bring healing to his entire groaning world. Overall, we are feeling well in spirit, trusting the God who calls into existence the things that are not and raises the dead. There is no reason to fear, because the light has dawned on all of us who sit in darkness, in the shadow of death.

Prayer points
For those who pray, here are some suggestions.
Give thanks:

• For so many positive reasons to rejoice: life and new life in Jesus; overwhelming support and offers of help; providential proximity to hospital (just a few hundred steps down the road); reasons to live found in all those around whom I can serve and from whom I receive so much; hope despite brokenness because Christ is the author of life and through his death destroyed the power of death and rescued us all from slavery to the fear of death.
• For a deeply encouraging celebration of 'God with us' over Christmas: God thinks this life is worth sharing - and fixing.
• For a health system that provides hours of medical expertise and attention, a wide variety of drugs and equipment for basically no charge.
• For easier breathing and sleeping since soon after treatment began.

Pray:

• That the combined chemotherapy and radiotherapy are effective in reducing the size of the growth (down to nothing!).
• That side-effects will be minimal and for patience to endure what is necessary, growing in perseverence, character and hope.
• That Jessica and I would stay thankful, loving and hopeful, trusting God to give strength each day. "The steadfast love of the LORD never ceases, his mercies never come to an end; they are new every morning; great is your faithfulness." (Lam 3.21-22)

There is more to come.