There’s something invigorating about a crisp, cool Friday night that seeps into your skin and makes you temporarily forget the long week. 

At least tonight it did.  

Guess what guys?  The pathology results from Anne’s second surgery showed that only three of the 20 lymph nodes removed were infected.  Woohoo!  

Two positive implications: All infected tissue is now gone. Buh bye. More importantly, it’s unlikely that the cancer spread beyond the breast area because so few lymph nodes were actually infected (they are the body’s special filters for collecting diseases).

Thank you Lord, for your mercy to Anne. 

Once Anne heals up from surgery, she’ll begin a new course of chemotherapy for 12 weeks with a different drug that promises less severe side effects. In fact, her hair should continue to grow back. Can’t wait to see those brown curly locks again. (Though I think Anne could totally rock the buzz-cut look she has going right now.)

Switching topics to “our sweet bears,” as Anne often refers to our kiddos, I love how so many of you ask how they’re doing. If there is one place where God’s grace and kindness is evident in the midst of our hardship – I’m talking tangible.real.miraculous.unmistakable evident – it’s in our children. They are doing remarkably well. 

Just before bed tonight, I gathered our bears on the boys’ bedroom floor for a little daddy powwow.  I told them how much I appreciated the ways in which they were caring for mommy. Thinking for her. Serving her.  Their sleepy eyes brightened when I told them that mommy was beating the cancer because she was doing everything the doctors were telling her to do, even though it hurt, made her tired, and changed the way she looked for a little while. 

As we sat in a little circle, Luke gently asked, “Dad, do you think mom will perish?” Then with his hand cupped over his mouth, Luke whispered, “I said ‘perish’ because I figured Sarah wouldn’t know that word. I didn’t want her to worry.”  Oh no, I thought. How’s my astute 5 yr-old  going to react to Luke’s question?

I quickly tried to answer Luke’s earnest question with a confident no, but not before I was interrupted by Sarah, who chimed in, “Daddy, she’s not going to die right now, but probably a long time from now.”  As the words flowed out, her face was smiling, not the slightest hint of fear or sadness. 

“Well love, that’s right. So why doesn’t that make you scared?”

As her brothers moved to reassure her by holding each of her hands, Sarah answered, “Because Daddy, Mommy is gonna go to heaven where Jesus lives.  So when she does have to die, we can see her again. But that’s a looooong time from now Daddy!”

Amen, sweetheart.  Amen. 

Here we are, camped out in our little curtained recovery area at the Blue Ridge Surgery Center.  Anne’s resting beside me, hovering in a semi-conscious state induced by the lingering effects of anesthesia, pain medication, and exhaustion.

I’m relieved to report that Anne’s radical lymphadenectomy was successful. All the thief’s little node-accomplices were yanked out of hiding and thrown in the slammer for good. If any of those suckers escaped Dr. Canale’s surgical extraction, they’ll be wiped out by radiation.

Deep sigh.

In her more vulnerable moments over the past two weeks, Anne has whispered, “This feels like a bad dream. I just want to wake up and have it all be over.”

Me too sweetheart. Me too.

“I will rejoice and be glad in your steadfast love, because you have seen my affliction; you have known the distress of my soul, and you have not delivered me into the hand of the enemy; you have set my feet in a broad place.”  ~ Psalm 31:7-8

“The thief comes only to steal and kill and destroy I came that [you] may have life and have it abundantly. I am the good shepherd. The good shepherd lays down his life for the sheep.” ~ John 10:10-11

Boy this particular post has been a challenge. I’ve started and stopped it at least half a dozen times. So much I want to convey.

So let me get this out before I get bogged down again: Things are looking up for Anne. Much more than we originally believed.

See, that wasn’t so hard, Van! Sheesh.

Because of Anne’s specific type of breast cancer, she required what’s called neoadjuvant therapy, a fancy term for “chemo before surgery.”  One of the benefits of this therapy approach is that doctors are actually able to see how the cancer responds to chemotherapy prior to surgery.

Despite learning that the ninja medicine didn’t completely kick cancer’s arse, Anne’s chemotherapy was still very effective. As I mentioned in an earlier post, the tumor all but vanished. The pathology report also showed that the infected ducts, lymph nodes, and surrounding tissue all had good therapeutic responses to the ninja medicine.

To put this in context, around 80% of breast cancer patients undergoing neoadjuvant therapy display remaining tumor cells in tissue sampled prior to surgery. What we initially considered disappointing news has become a normal, to-be-expected outcome.

Yet, the objective remains clear as day for Anne: K.C.A.

She’s young, healthy, and can handle more treatment, so now that the tumor and infected breast tissue are gone, Anne has green-lighted additional treatment at the recommendation of her physicians.

On Friday Anne has surgery to remove remaining infected lymph nodes.  Those lymph nodes sit under her left armpit, so the surgeon will simply reopen the incision from her last lymphadenectomy (performed at same time as mastectomy) and go to work.

Following her surgery, Anne will begin another course of chemotherapy for 12 weeks with a drug called Navelbine (Nav-ul-bean). Fewer side effects, which is welcome news. I chuckled when I heard the name of the drug, telling Anne that I’d mix her a glass Ovaltine to go along with her Navelbine. As a side note, Navelbine is partially derived from the vinca vine, commonly known as periwinkle. Little did I know we are growing Anne’s cancer drug in our front yard.

After chemotherapy ends, Anne will undergo radiation five days a week for seven weeks, which should clean up any trace of the cancer in the previously infected lymphatic area.

In the time between my last post and this one, Anne and I have learned a great deal more about the nature of her cancer, the trajectory and specifics of her treatment, and most importantly, reasons to be hopeful.

As you all continue to love and reach out to our family, two questions come up the most often: How can you help? And how are we doing?

Regarding help, a couple of things come to mind my friends.

1. Dinners. Guys I can’t express what a huge ministry this has been to our family. With surgery on Friday and another course of chemotherapy through January, we would still love your help with family meals. Here is the sign-up link, which I believe Manning has updated in light of our extended road: Fletcher Meal Sign-up.
2. You know what else blesses our socks off? Taking our kids for fun outings. They LOVE it.  Anne and I feel so encouraged when we know our children are being cared for and loved by our village of friends and family. It’s the best feeling.

As to how are we doing? I’ll give it to you straight: weary. I chuckle as I type that because if I weren’t so doggone tired I would elaborate.

Yesterday afternoon was our follow-up visit with Anne’s breast surgeon.

When he walked in the door, I could tell something was up, I told Anne afterwards.

The mastectomy was successful.  Tumor and infected breast tissue, gone.  Also, Anne’s decision to remove her right breast prophylactically was smart, said Dr. Canale. Essentially, her right-breast tissue was just the kind of soil in which breast cancer loves to grow.

Now for the not-so-great news.

The pathology analysis of her left-breast tissue (location of the tumor) and surrounding lymph-nodes revealed that while the chemotherapy was effective, it did not completely wipe out the cancer. Some of it didn’t respond to the ninja medicine.

Yeah. Sucker punch. A few friends and family we’ve told may have blurted curse words. Permission universally granted.

Before you go there: this ain’t a death sentence. She hasn’t been told that she has some rare breed of incurable cancer that resists all forms of treatment. The ninja medicine did work: shrinking her tumor dramatically, diminishing its presence in her lymph nodes, and largely wiping out those nasty cells. There are certain cells that resisted the chemotherapy treatment she was given. So we go after ’em with other weapons.

As far as what’s next, here’s what we know today:

All of her lymph nodes surrounding her left breast need to come out.  So, surgery next week.  Bummer.

Radiation is still on the docket after Anne’s lymphadenectomy (say that ten times).  We have to napalm her left side to make sure we incinerate every last one of those S.O.B.s.

In light of the pathology findings, Anne’s oncologist is advising we move more aggressively with hormone-therapy, especially estrogen-blocking drugs. Because Anne’s cancer thrives on estrogen (aka “estrogen-positive”), the basic science goes like this: block the estrogen, and the cancer cells won’t/can’t grow and spread.  She’ll start on Tamoxifen right away, as well as start receiving a monthly shot that essentially shuts down those estrogen factories: her ovaries. We’re hopeful. Hormone therapy is quite effective, we are learning.

After that, we know the doctors will continue to provide guidance as to what’s best.

Lord, you are the Fletchers’ portion. Help us to know, to experience Your all-sufficient, never-failing love.

With hope,
Van

 

So Anne came home the same day of her surgery (Tues).  If you think that seems awfully quick,  so did I!  But seeing as how her sleeping arrangements would be much better at home (staying overnight in a surgery center is something like trying to sleep in an airport), she welcomed the chance to begin recuperating in her own bed. 

Understandably, she’s sore and uncomfortable, which my tough cookie of a wife has to be reminded is normal after something as major as a bilateral mastectomy. (Side note: why does the third day always seem to be the hardest?!)

Her surgery went smoothly, I’m happy to report. As you may remember, there were a couple or more cancerous lymph nodes needing surgical removal, the sum and scope of which only being determined  during the actual surgery. Thankfully, her surgeon only had to remove three, which is a wonderfully low number. We rejoiced. 

What we are still waiting for is the pathology report. Microscopic examination of her breast tissue will tell us if there are any cancerous cells lurking. Boy do we pray not. THAT comes back clear and you are going to this guy doing high kicks, cartwheels, and street dancing. 

Flowers, notes, and food have shown up this week, soul-giving tangible reminders that we have the bestest friends in the world. Thank you guys. Tearing up as I type. 

Pray for us. The road is long, dusty, and hard. There’s still radiation. Eventual reconstruction. And recovery. 

Anne is so eager to start feeling better. I love her spirit. But I told her this week, “Don’t forget you were given poison all summer long, love. And now you just had major surgery. You should feel like sh#%.”

Yes, I did say that. 

I hate cancer. 

I’m up late trying to resolve technology issues, frustrated.

But I’m thinking about Anne.

Today was my sweet bride’s birthday.

Tomorrow she goes in for surgery to remove both breasts. Every time I think about it I well up with tears. Hard.

As I’ve been waiting for my callback from the Microsoft tech guy, I thought of the word…

Courage.

That’s what Anne has displayed. Every step. Like today, when she finished having some sort of radioactive dye shot into her left side to make it easier for the surgeon to see stuff tomorrow. Burned, she said. Yet the radiologist kept asking in perplexed manner, “you’re okay?” As if he expected her to hit him, wail in pain, or curse like a sailor.

I’ve heard Anne mention “war” the past few days in processing what’s ahead. Her metaphor has really stuck with me.

In war, you march on. Towards the enemy. To the battle front.  No matter how dog-tired, discouraged, scared, or famished you are.

That’s courage. And I like the Oxford dictionary’s nuanced definitions…

“The ability to do something that frightens one.”  

and…

“Strength in the face of pain or grief.”

That’s Anne.

Happy birthday to my courageous wife. You’re taking no captives in this fight with cancer.

We’re marching with you. I’m marching with you, sweetheart.

With love,

Hubby

Jack returned home from seeing his first hockey game last night to find me asleep in his bed.  His brother Luke, so used to having big bro in the room at bedtime, asked if I would stay as he tried to find sleep.  I am pretty sure I found it first.

“Hi, Mom.”

“Hi, buddy!   How was it?”

I scooted over and patted the bed.  Jack climbed in to share the single person space, our heads side by side on his Star Wars pillow.  He’s almost as big as I am now.  The aroma of the sports arena still lingered in his hair.

“It was awesome. Those guys can skate probably twice as fast as I can.”  (Jack has never ice-skated.  I love the confidence.)

Jack told me stories of fights, body checks, and getting tossed a puck as he and our dear friend, Manning, watched from the front row.  This was her birthday gift to Jack, and in the words of our boys, it was epic.

And then, as he often does, he checked in with me, “Mom, how’s your cancer?”

“Jack, I’ve waited all day to tell you some good news.  The doctors took special pictures of inside my body and the tumor is gone.  They can’t see the cancer anymore.”

Smiling, Jack slipped his arms around me and snuggled in close whispering, “This has been a really good day.  God is good.”

“God IS good.  Bad days or great days, God is always good,” I whispered back.  And once again, I think I found sleep first.

In the next few days we will tell the kids about my surgery.  Would you pray for wisdom as we tailor the conversation to each child?

And would you pray for the road ahead?  The two steps of treatment remaining – surgery and radiation – are the clean-up crew.  The ninja medicine certainly worked!  Hallelujah!  The tumor disintegrated, and the assumption is that the cancer cells anywhere else vaporized too.   As we all know, cancer is a war at the microscopic, cellular level.  Surgery will remove the areas where the cancer was visible, but it will also provide the tissue needed for the pathologist to determine if any cancer cells remain.  Radiation is the special-ops forces with gamma-ray laser guns to zap any lasting hold-out cells.  We’re gonna blast those suckers into smithereens.

While the war goes on, we are rejoicing that the hardest part is done and was so effective. Thank you for rejoicing with us!   Your messages and comments have been like throwing a party this weekend.  And thanks be to our good and mighty God, the Great Physician, who has tended to me so well, body and soul!

Pressing on with hope,

Anne

Mammogram, ultrasound and MRI show no visible signs of cancer in my body!  CLEAR! Tumor is GONE.

Happy, happy, happy tears.

Van and I met with my surgeon today who said it well, “It is great to know that all you have endured the last few months has been well worth it.”

Yes!  It certainly is!

Surgery is Tuesday at 10 am.

“Let your steadfast love be upon us, O Lord, as we hope in you.” Psalm 33:22.