What I Haven't Told You

I praise God everyday that Andrew has a voicebox.

On the day of the surgery, in the evening the nurse said we were free to leave and have dinner.

Nonetheless, while we were at dinner, the doctor called me, unsure if he should remove Andrew’s voicebox. The music was playing loud in the restaurant and I was having trouble hearing him. They hadn't originally anticipated the cancer being this far down his throat. He said he didn’t want to do it without Andrew knowing it.

I was trying to convince the doctor that he must remove Andrew’s voicebox if it meant saving his life. I was breathing hard. I said, “I know that Andrew would rather lose his voicebox than his life.”

The doctor was trying to explain how based on what he could see, it didn't appear to him that it was the right thing to do.

“Andrew told me when he was trying to think of possible scenarios of decisions I might have to make that if it turns out the tumor is actually encasing his carotid artery,” I could feel my breath getting colder with each inhale; its coldness reaching deeper and deeper into my throat. I wasn’t sure if the doctor would care to hear this, since the carotid, a major artery, had nothing to do with the voicebox. “He said. He said,” I was trying to breath.

“Yes, he said…?” the doctor asked.

I took another breath. “He said if there is a chance of him dying on the table if they try to remove it, or if he will only live a month afterwards if they don’t remove it, then he wanted them to try to remove the cancer.”

“He said that?”

“Yes,” I said. I was on the verge of hyperventilating. I was scanning the room, looking for an answer to the question of how to keep myself from fainting. “Listen, I can’t make this decision right now. I brought my father-in-law with me to help me make any major decisions. Can I have a few minutes to talk with him and I’ll tell you back at the hospital?”

“Yes,” he said.

As my sister and my father-in-law and I rushed around the corner to the hospital, I had my sister call the church to get everyone to pray. Then, the three of us prayed that God would make clear to us what decision to make and that the doctors would be able to clearly explain to us the actual situation. We prayed that God would save Andrew’s voicebox but most of all his life.

When we returned to the hospital and Dr. Yueh came out of the operating room to talk to me, I was prepared with a vengeance to convince him to remove my husband’s voicebox. It was no use saving it if we were going to lose it along with the rest of him a short time later. But in the time that we had between talking on the phone and talking in person, Dr. Yueh had continued working in the operating room. He had removed the hyoid bone, the bone on top of the voice box. When they examined the bone, they found that the tumor had gone right up against the hyoid bone, but it had not reached the other side of it that touched the voice box. There was no decision to be made. There was no tumor on the voicebox.

Now that I have been able to hear Andrew's voice again - I wasn't sure if I ever would - I have been savoring it for the past few weeks. It is hard for me to imagine ever being so desperate to get his voice box out of him now that he is not on an operating table with only moments to make a decision.

Nonetheless, the surgeon explained to me that while they had removed the cancerous mass, the gross tumor, from Andrew’s body, when they put it under the microscope, they saw that there were scattered cancerous cells in the margin around the cancer. I will do my best to explain what he said, but it's extremely confusing and even perplexing for the doctors, so I'm not sure you'll understand it. The cancer was jumping around in an abnormal, unpredictable way, which can happen if a tumor returns to an area that's already been treated with surgery, radiation, and chemotherapy. They felt that there was no way to tell how far the cells had scattered, and for all they knew there could be a random cancer cell in Andrew’s big toe. They couldn’t keep cutting because they may never stop. Yet, because the cells were not in a mass, they could not be picked up in scans (scans only pick up things larger than a centimeter) and could only be seen when cut out of the body and put under a microscope. For this reason, our only option for treatment is radiation and chemotherapy. If this doesn’t work, the surgeon doesn’t think there is anything else he can do for him, as Andrew had an incredibly extensive surgery that they do not do for most people. They say this surgery is probably around the top three most extensive surgeries, open heart surgery being first.


Treatment

Early next week Andrew will be starting his 6 weeks of radiation and cancer treatments at either the University of Minnesota or the Mayo Clinic. He will do radiation 5 days a week, which takes about a half hour each time, and chemotherapy, which is given through an IV, once a week.

Short-term side-effects include a weak immune system, nausea, incredible exhaustion, severe burns and blistering in mouth and neck, acne, an ichy rash... Long-term there is a chance of destroying Andrew’s vocal chords, risk of radiation-induced cancer in 5 to 10 years, burning out any of the saliva glands Andrew has left, and destroying any chances Andrew has of swallowing again to name a few. We really don’t even know if we are doing more harm than good, but we don’t have any treatment options left.

As far as radiation goes, you’re only supposed to have it done once in the same area. This is Andrew’s second time. They will radiate the mouth and neck, all the areas that Andrew was operated on. They will not be treating his spinal chord, which is in that vicinity and had been radiated last time, because if you over-radiate it and destroy it, then he will be paralyzed from the neck down.

As for chemotherapy, in general, it cannot destroy a tumor for this type of cancer by itself. It is only used to enhance the effects of the radiation. We are still deciding whether to use two chemotherapy drugs or three – carboplatin, taxol, and maybe erbitux.

To sum up, this session of radiation and chemotherapy is the last chance the doctors have at saving Andrew’s life. A couple of our doctors slip that this is a “last ditch effort.”

All we know is that God is good and that He is in control, not the doctors, not us, not anything else.

Please pray for:

1. COMPLETE HEALING AND RESTORATION.
- That the treatments would be effective and that God would completely eradicate the cancer in

Andrew’s body.
- That Andrew would be able to swallow and taste one day again.

2. Wisdom and skill for the doctors and us as we finalize our treatment plans.

3. That there would be minimal to no side-effects while Andrew is in treatment nor long-term
side-effects.

Praises:

1. Praise that Andrew has been feeling physically better and more encouraged each day. Andrew says he has been encouraged by the Word, the brethren, and the preaching on Sundays.

2. That God answered Diane Dailey’s prayer that the kids would still be able to be children yet understand way beyond anything we could expect so that they could be a help to us rather than an additional difficulty. Since she prayed that at our weekly prayer for Andrew’s healing in our house, A.J. says all the time: “I will take care of you and Papa. And the way I will take care of you is to obey you. I love to obey you. I love to take care of you.” And he has been trying with all of his might to do so. He really has been such a blessing and a help in that way.