Monday, March 31, 2008

April fool

In the UK we have a tradition known as April fool. Up until 12:00 on April 1st. it is OK to fool folk with any tall story you like. So here are three cancer related ones. TWO ARE TRUE - ONLY ONE IS A LIE!!!!!

1) More orgasms can protect against breast cancer.

2) You can treat breast cancer successfully with ordinary aspirin.

3) A plumber can fix a blocked toilet with aspirins.

To prove you are not an April fool, which one is untrue?


This last tale comes from our breast surgeon. He got home late one night after a heavy day. Returning at 23:00 he found his toilet blocked. He immediately phoned the plumber who exclaimed, wait till the morning, I am already in bed. No way said the doctor, I am a senior surgeon, I can get called at any time of the day or night to attend to urgent needs. My toilet is in urgent need of unblocking, I need you to come right away.

After 15 or so minutes of complaining the plumber could still not get the arrogant doctor to wait till morning, so reluctantly agreed to call that night. He deliberately drove slowly and reached the doctors house at midnight. Knocking on the door, the doctor answered and ushered him up to the blocked upstairs toilet.

The plumber took two aspirins from his pocket, dropped them into the toilet bowl, and made for the door. As he did so he passed the doctor his bill for a late night call out fee of £70.

But you've done nothing exclaimed the doctor, those aspirin will do nothing!
Oh yes they will said the plumber, if they don't fix the problem within 24 hours call me again and we can try another treatment.

The correct answer is number 3 is untrue, but for the others...

Orgasms are referred to by the BBC here

And for aspirins: Anti-inflammatory drugs like aspirin may reduce breast cancer by up to 20 per cent, according to an extensive review carried out by experts at London's Guy's Hospital and published in the March issue of IJCP, the International Journal of Clinical Practice.

"Our review of research published over the last 27 years suggests that, in addition to possible prevention, there may also be a role for NSAIDs in the treatment of women with established breast cancer" says Professor Ian Fentiman from the Hedley Atkins Breast Unit at the hospital, part of Guy's and St Thomas' NHS Foundation Trust.

"Recent studies of NSAIDs use have shown about a 20 per cent risk reduction in the incidence of breast cancer, but this benefit may be confined to aspirin use alone and not other NSAIDs."

Good Christian counselling links

Thanks to Google ads for these links. I cannot endorse them, they seem somewhat commercialised, Roman Catholic and American, but the summaries I have read match our experience exactly:

Cancer brings us closer to God
We need to plan for death
Our anger at friends who trivialise or say "buck up"

A comment posted to the blog was from someone caring for a parent with advanced lung cancer. These links could be a help

Wrestling with God and cancer

Being there for a parent with advanced cancer


Lift your life above cancer

These are all taken from a site named "caring spot"

Saturday, March 29, 2008

In praise of Poland

I had said Google look at this blog. Do the hospital staff? Or is it an answer to prayer?

So soon after moaning here we received an appointment in the post today to meet the oncologist next Wednesday. Hopefully she will give us the test results, if we get test results then it will have taken 34 days! Remember in the USA it is normally no more than seven days.

The letter arrived in an opened envelope that had been resealed with tape, almost as though our repeated phone calls of two days ago had awoken someone's conscience to check why Jan was not on their appointment system. Or do we praise the hospital for re-use of old envelopes?

Jan who trusted hospital team to extend her life and had felt completely let down is now back on track and eating again. But what damage has those two days of "knowing" yet again that the hospital is out of control done to her emotionally and even physically? Her wound opened today, leaking a clear fluid from the cut. Without the emotional stress would she not have had this?

I had said I would explain why I thought veggies might be more effective than radiotherapy. I am not an oncologist, so please excuse any errors in this explanation!

I have only researched figures and results for primary breast cancer in ladies past the menopause who have had the cancer surgically removed with good clear margins. The argument does not apply to younger women or lung cancer cases.

In typical breast cancer for older women the rate of recurrence is typically quoted in the UK as 22% over five years, conventional radiotherapy drops this to 12%. The absolute best radiotherapy results I have seen claim a drop to 9%, but their technique of hypofractionation is NOT endorsed by international experts, I presume either because they do not trust the figures or the technique is too new to have definite long term results.

Even using these best case figues radiotherapy only cuts the incidence of recurrence to just under a half. (22% drops to 9%).

These figures are in my opinion misleading because they ignore the damage radiotherapy does to other parts of the body, and the increased rate of deadly distant metastases in those who receive radiotherapy, plus heart and lung damage which can be fatal. There is a study underway at Edinburgh University that suggests these effects are so serious as to obviate any benefits from radiotherapy for ladies over 65 years of age.

Yet if we look at Polish women who emigrate from Poland to America their risk of cancer rises threefold. So I reckon if only we could find the secret that living in Poland gave these ladies we could cut risks to a third, better than the halving claimed by radiotherapy. Else of course one could emigrate to Poland. My son will help you, he runs a service here.

I only know one Polish family. What I see is far more alcohol use and smoking. As I posted yesterday they don't get worms! The plus points I see are they take far more exercise, they walk for miles as the family we know lost their car when communism fell. They also love cabbage, mushrooms, and eat fermented cabbage in sauerkraut.

So I cannot prove this, it may be a hunch, but I rate veggies and exercise. They also do NOT cause distant metastases. So if offered radiotherapy I expect Jan would take it, she has more faith than me in UK medicine. But we then add exercise and vegetables.

Friday, March 28, 2008

Veggy may beat radiotherapy?

The Professor who had specialised on cancer and nutrition had agreed to give a talk on nutrition the the local breast cancer support group. He normally spoke at learned international conferences, where he used technical jargon, talked about risk, probability, and produced scientific charts of his results. How was he to convey such a message to a group of local ladies? He hit on the idea of usinga simple visual aid.

He had four key points he wanted to make, don't drink, don't smoke, don't eat fat but eat healthy vegetables. To put this into a visual aid he hit on the idea whilst gardening of putting four worms, one each into four jars.

The first jar had a worm put in it, and he then poured in some Russian Vodka, to the initial delight of the worm. The second jar was prepared, he dropped in the remains of his still smoking joint. He was after all a university professor! The worm initially looked ecstatic. The third jar was prepared, into which he dropped pork crackling. And for the fourth jar he put the worm into a little soil in which was growing a baby carrot.

The next day he gave his talk, and produced the four jars for all to see. The first three all had dead worms in them, just as he expected. But the fourth had worm casts all over it, obviously the worm was happily enjoying his new environment. What does that teach us he asked the audience, hoping for an expected answer of keep a healthy lifestyle.

Quick as a flash a lady at the back raised her hand. When asked she responded "If you smoke, drink, and eat plenty of fat you won't get worms"!

We still wait test results and expect radiotherapy. The hospital have been so dismissive or useless when we chase them that were it a commercial arrangement we would go elsewhere. Remember the surgeon failed to attend the after surgery consultation, we still await test results, and when we expect to plan radiotherapy the hospital say Jan is not on their computerised system! Maybe as a protection measure I convince myself that we could do better by feeding Jan a diet high in vegetables than having radiotherapy. More later on the argument for vegetables.

So I carefully steam an evening meal with fresh carrot, potato, onion, cabbage, runner beans alongside a vegetarian mousaka. I am devastated that Jan refused any of it, maybe she is even more hurt by the hospital's callous handling of her case, and wants nothing to do with them or my diet.

But I am sure we will "recover" in time! Just when mental state is part of the cure why do our NHS do so much harm?

Thursday, March 27, 2008

Not proud to be British

Every time we deal with the treatment hospital we get depressed! So we carry on enjoying life and waiting. Two emails from Zimbabwe and South Africa put our troubles in context!

I do not want to lambast our health service, after all most of us need to use it.

Two weeks ago we were told to expect an appointment with the oncologist either 8 days ago or yesterday, we would be told by letter. We have had Easter disrupt post, but unfortunately cancer takes no holidays.

To make sure we did not miss an appointment I phoned the hospital on Tuesday afternoon, after 10 minutes of being passed from pillar to post over three phone numbers and two answering machines I got a message saying "we have all gone home at 15:00, please do NOT leave a message"

We try again every 30 or so minutes all yesterday, nobody can talk sense, but are told Jan does NOT appear on their computerised appointments system.

It has left us both feeling we no longer wish to deal with the hospital staff. How sad when Jan has worked at that hospital for 6 months, and at the one chosen for radiotherapy for about 20 years. How can our NHS so demotivate even their own? We know the University College Hospital London where we expect radiotherapy claims an international reputation, and had thought that was a good thing. But a reputation for what?

I look at a University of California San Franciso (UCSF) professor's blog and find this "Looking at all nations with some form of socialized medicine, other than England--which is apparently abysmal for cancer treatment and survival--outcomes are far better there than the USA" In other words she views the UK reputation as being for abysmal treatment. The blog entry is here

From the telegraph last year, so its not old news:

UK cancer survival rate are the lowest in Europe. England is on a par with Poland despite the NHS spending three times more on health care. "We have good evidence that survival for lung cancer has been compromised by long waiting lists for radiotherapy treatment."

A second article, which looked at 2.7 million patients diagnosed between 1995 and 1999, found that countries that spent the most on health per capita per year had better survival rates. Britain was the exception. Despite spending up to £1,500 on health per person per year, it recorded similar survival rates as Poland, which spends a third of that amount.

An accompanying editorial said the figures showed that the NHS Cancer Plan, published in 2000, was not working.

And again another article:

Thousands of women have been forced to wait years for hospital test results that will show whether they have inherited a deadly breast cancer gene. All breast cancer patients with a family history of the disease are supposed to be offered NHS tests to discover if they carry the faulty gene. However, an investigation by the charity Breakthrough Breast Cancer has found that half of the groups running the NHS laboratories that perform the tests are failing to meet a government target to provide results in eight weeks But in reality some women are forced to wait for up to three years for their results.

On the car radio today the UK cancer research charity was begging for funds. If we cannot use the info we already have what is the point of further research, unless to look for cost saving techniques or DIY cures using vegetables?

It ties in with a course my daughter ran for NHS management, when she said" if you pour money into the NHS without sorting out the organisation you will merely get an expensive health service". She was of course not invited back!

However there are obviously gems in the NHS. We still trust the surgeon, and I had dental treatment today. I discussed with the dentist when I should return for a checkup. NHS guidelines state after 2 years, she said that was rubbish, she recommended 6 months.

Wednesday, March 26, 2008

You are what you eat

Many of the health food sites I visit claim "You are what you eat". What a load of claptrap! Jan and I eat the same diet, she gets first choice, I get the leftovers. She has breasts and long hair, I have little of either. A living organism has the ability to synthesise complex molecules such as eyes, hair and a brain from simpler molecules such as fish and chips. So folk who claim "you are what you eat" miss out that God's gift of life makes us far more than just what we eat.

But obviously what we eat has a major impact on our health. Thanks to a blog by a female professor at UCSF, University College of San Francisco. It is here

She speaks more sense than most, she is motivated to understand as she had triple negative breast cancer, as we suspect Jan may have. She mentions nutrition is part of her follow up plan. Her blog has two excellent links: The first is a very simple list of "good foods" that even includes chocolate, so enjoy!

The second is an even more comprehensive list here.. Click on the link at the top of the page for a PDF version. I revisited this link at completion of treatment in June 2008, and find this data stands the test of time. After studying many other diet experts such as Professor Aggarwhal and having bought Professor Richard Beleveau's book "Foods that fight cancer" this summary still covers all their ideas, and gives scientific reasoning behind the claims.

It suggests that carrots, and cruciferous vegetables such as broccoli, cabbage, sprouts etc. protect from cancer, and can even kill cancer cells in the body. Wow!!!! I compare this detailed report with the fact sheet given us free by the UK NHS. Our NHS say "eat 5 fruit and veg a day" but don't list which ones, and mix it with data such as some find Chinese Yin and Yang philosophy helpful. I tended to discard the UK advice as it mixed in the "multicultural" talk of Yin and Yang with what is good science on nutrition as detailed by one of the USA's top universities.

Great fun. Our guests on Sunday helped us devour a pomegranate smoothie, and on Monday just four of us eat more than one whole cabbage. Have we gone overboard? I have a feeling diet could have more effect on Jan's outcome than a whole course of radiotherapy.

Easter Sunday

Easter Sunday service at church, followed by four family friends round for meals. We remembered that death was defeated, it could not hold Jesus, and it can no longer terrify those who believe in him. That certainty gives us great freedom.

We also celebrated Jan's birthday. I don't think we will ever treat birthdays so callously in future, as each year survival after cancer will be a successful landmark for which we will give thanks. No longer can we just assume life goes on unchanged.

James chapter 4 verses 13 onwards has: "Come now, you who say, "Today or tomorrow we will go to such and such a city, and spend a year there and engage in business and make a profit." Yet you do not know what your life will be like tomorrow. You are just a vapor that appears for a little while and then vanishes away. Instead, you ought to say, "If the Lord wills, we will live and also do this or that." But as it is, you boast in your arrogance; all such boasting is evil.

Cancer makes us more aware that we live only by God's grace.

Sunday, March 23, 2008

Easter Saturday

Easter Saturday

Thanks to a friend who emailed me today with these thoughts.

What were disciples doing on Easter Saturday, and why do we so concentrate on Good Friday and Easter Sunday? Our current state of waiting for results is so like the disciples state on that Saturday. Their world had been abruptly turned upside down by Jesus who they saw as their leader being crucified, and they were in fear of their own lives. Jan's has been put on hold by cancer, and indeed fear is part of that. The disciples' faith was tested as they waited to see if Jesus' promised resurrection would come true. Jan's faith is similarly stretched.

We empathise with their situation, and look forward in faith to the same power of Jesus that was demonstrated by his resurrection, be that by healing, or taking us with him through the "valley of the shadow of death" mentioned in Psalm 23.

Saturday, March 22, 2008

Designed for us by God?

John Piper says "You will waste your cancer if you do not believe it is designed for you by God"

We have yet to have it confirmed, but Jan and I are sure she has the rarer and tougher invasive cancer. The simpler more common DCIS cancer can have a 98% survival rate after 5 years. Is her cancer even receptive to simple hormone treatment? We wonder. Jan has waited now for 24 days for results of tests. To save costs the NHS test first for hormone receptivity, which most cancers are and which means cheap simple follow on treatment. If that test is negative one tests for progesterone, and then HER2 receptivity. The further one needs to go in testing the harder, more risky and expensive the treatment becomes.

We wonder if the delay in getting Jan's results means bad news. I found today a blog by a US lady who has the "triple negative" breast cancer. If Jan is triple negative all tests come back negative which could explain the delays in getting Jan's results.The blogger is a professor at a Californian university doing cancer research, so talks more sense than many. Her blog is at http://goodcancer.blogspot.com/. She states in the blog the far higher risk of recurrence if the cancer is triple negative, and in her opinion the need for chemotherapy in these cases. Interestingly the doctor Jan last saw closed with a comment that chemo might be necessary, are they trying to break news slowly?

In the meantime we know Jan has cancer, that it was awoken by multiple biopsies etc. about 2 months ago, and apart from surgery no treatment has begun. So Jan has restarted her Vitamin E capsules. One study we read suggests it cuts the growth rate of cancer cells to a third if the cancer is ER positive. However we know that other studies suggest Vitamin E has no beneficial effects on breast cancer, yet increases ones risk of a stroke by 10%, so don't let me push it too hard.

Another study suggests cruciferous vegetables (cabbage, broccoli, cauliflower) kill cancer cells. So we bought a cauliflower and two cabbages!

Two other concerns arose:

I read more about Kylie Minogue, the more serious reports say she is "in remission", not definitely cured.

By chance we found an old tape of a medical missionary doctor in Pakistan who had breast cancer. During her radiotherapy it was discovered her cancer was more extensive than had been thought, she needed further treatment. Yet her testimony was that thanks to prayer of many the side effects from the second dose of radiotherapy were miniscule in comparison to her first treatment. Why does God change the way he deals with us? She later returned to work as a doctor in Pakistan.

So can we trust that God designed this cancer and these circumstances for us? Some may think I am going mad, but I believe we can. God is using it as a "thorn in the flesh" to stop us relying on ourselves, our life needs to show his strength. Psalm 28 verse 8 says "The Lord is the strength of his people"

Friday, March 21, 2008

A blessing or curse?

Two days ago we attended "Stainer's Crucifixion". Thanks to the local Methodist Church for opening up this performance to all. What the non believing world saw as a curse on Jesus in reality was the means for us to receive the blessing of our sins forgiven.

So God turns curses into blessings. John Piper says "You will waste your cancer if you believe it is a curse and not a gift". His book adds "The blessing comes in what God does for us, with us and through us." He quotes the bible to explain this from:

James chapter 1 verses 2 to 5
1 Peter chapter 1 verses 3 to 9
Romans chapter 5 verses 1 to 5
and Romans chapter 8 verses 18 to 39.

We prayed for healing but received Jesus. We read today in Colossians chapter 2 verse 1 how St. Paul "was struggling for the Colossians, and those at Laodicea". He meant he prayed earnestly that they would stay true to the gospel of Jesus.

God enables Jan to share her hope that she has in Jesus and struggle in prayer for others in similar circumstances:

  1. Three weeks ago our church service had been led by a lady recovered from breast cancer about 9 years previously. A week later she hugged Jan, asked how we were, then said she had found a second lump. This happened whilst on her "holiday of a lifetime" with her husband, and to save spoiling his holiday she kept it secret until her return home. How horrible! She undergoes surgery this week by the same surgeon who operated on Jan, without even a biopsy beforehand which shows how seriously the medical team take it. Jan phones her regularly to re-assure her.
  2. Another friend whom Jan encorages is now on her first week of radiotherapy.
  3. Jan has waited now for 24 days for results of tests. It means she can empathise and encourage a friend who invited us for a meal this week and shared she is also awaiting test results.
So through these three recent examples we can see how God is turning what could be thought of as a curse into a blessing.

Wednesday, March 19, 2008

Celebrities with cancer

Watched a lovely concert by Kylie Minogue the other night. She looked fabulous, seemed energetic, able to throw her arms around, which is giving Jan trouble at present after removal of underarm lymph nodes. So we took heart.

It seems Kylie was one of the first to openly admit to having breast cancer, before that it was something of a taboo. She has probably helped no end to demystify and make the disease more normal. Only snag is she was wearing a wig. I'm sure that was for the show and not that her hair had yet to recover after treatment! http://www.femalefirst.co.uk/celebrity/Kylie+Minogue-8117.html.

She reports that cancer has had some positive experiences. She says "“What I believed before my illness has only been enhanced since, and that’s that beauty comes from within." http://fametastic.co.uk/archive/20071008/7962/kylie-minogue-cancer-utterly-changed-how-i-think-about-my-body/

As Christians we agree with Kylie, but would say its more that God uses cancer to refocus one's direction, and make one more loving to others - same as Kylie's "beauty within".

Another famous encouragement is Lance Armstrong. http://en.wikipedia.org/wiki/Lance_Armstrong He is one of my son's heroes, as he recovered from testicular cancer that had spread to his brain, yet went on to win the "Tour de France" cycle race seven times in a row. He inspired my son who races cycles internationally, and started his DVD business selling DVDs of Lance's exploits. His DVD store in at http://www.classicmoviestore.com

Lance does great work to raise cancer awareness here

Both these folk give encouragement that cancer need not be the end. It also shows something of power of mind. Those who rise to top in their very competitive careers have the mindset to not give way to cancer. I also see this in medical trials where placebos are so often effective!

I don't want to go too far into "Power of Positive Thinking" as we believe Jesus is the power healing Jan, but it does show the need for a positive attitude full of praise. Jan has some of these characteristics, after all she won in a competitive field to marry me! She interrupted me last night to show me how far she could now raise her arm, still in pain after lymph node removal.

Saturday, March 15, 2008

Can we complain to God?

I believe I was right to complain to the hospital. If one studies Nehemiah one sees a man who used both prayer and practical skills in rebuilding the walls of Jerusalem. But can I complain to God?

A wise lady who had hugged and encouraged me two weeks ago said "Don't worry, complain to God, he is a great God and he can take it"

Yet I read this morning about the Israelites murmuring against Moses and even God in Numbers chapter 11. And I received this email from Bob Snyder, again warning us to trust in God, not to murmur or complain http://www.pursuantgroup.com/ihs/0308_2.htm

Murmuring sees what is negative rather than the possibilities for good. When I’m murmuring I focus on unbelief rather than belief. A whining, grumpy mood overtakes me rather than a spirit of gracious gratitude.

The apostle Paul in 1 Corinthians 10 verses 10 and 11 gives a warning to me, "And do not grumble, as some of them did – and were killed by the destroying angel. These things happened to them as examples and were written down as warnings for us......."

I need a spirit of gracious gratitude and trust that God has his best plans for us in this disease.

Yet if I go wrong I am sure God can take my grumbles and still bless us. If one looks at Exodus chapter 11 verse 24 one sees the people grumble at Marah because there was bitter water, yet soon afterwards God leads them to Elim where there was an oasis, and God promises in verse 26 to put on them none of the diseases that he put on the Egyptians

That promise of disease free living made a great impression on me in my youth, when I read the book "None of These Diseases". The author, who was a medical missionary has already lived to 102, and has recently updated his book available on Amazon here:

http://www.amazon.com/review/product/080075719X/ref=cm_cr_dp_synop/002-3182446-1820


One reviewer says:

This book really could change the way we eat, the way we live has serious health consequences, therefore higher doctors bills etc. This book will help you to cut through so much of the rubbish being written about diet and health, and help you to set a lifestyle that is healthy. Forget fad diets this is the way to go, not just for losing weight but for every aspect of healthy living.

Also it goes a long way to proving that God really knew what He was doing all those 1000's of years ago, as science plays catch up with Biblical revelation.

The original book written in 1963 and 1984 was a wonderful example of explaining how the Bible can be used to help us live healthier. This book, however, is so full of sermons and posturing, that it is difficult to see where the Bible is being quoted.

We purchased this book and after reading half of it, decided to purchase the original book (through the used books section of Amazon.com) and now wish we had the option of returning this book and only keeping the original book. The original book is really a great read and extremely helpful.

Another review: The book is well written. I found it very informative and a good guideline for living life in the 21st century. I first read NONE OF THESE DISEASES in the middle 70's and was very pleased to find the revised edition. Please read and take it to heart.

Friday, March 14, 2008

Time to complain

The hospital encourage me to attend consultations and to take notes on what is said. This is good advice that we follow, for example Jan is in such a turmoil that after our last visit she didn't know at which hospital her next appointment with an oncologist would be. We are now after all now planning going to our fifth NHS location for this treatment.

During the last consultation I took detailed notes on results that were available, timings etc. and documented 10 inconsistencies. On return home Jan read these notes, and we talked till 00:30 the next morning trying to understand how such inconsistencies arose.

We discussed for an hour with a wise christian friend. He said we should look at it from the oncologists point of view, in other words the viewpoint of the next doctor to treat us. What would she need to give Jan the best treatment, and push for that. He felt it was so urgent that we should ask the medical staff to check the accuracy of the results if the oncologist would be using these to plan follow on treatment. He would hate the next appointment to be wasted, and treatment delayed by two weeks because of incorrect hospital records that we had not asked them to check.

Armed with his carefully chosen words I phoned the consultant's secretary this morning, to ask for such a check. I suspect she labeled me as "insane", or in denial. A Google research documents testing problems in Newfoundland, so I am sure that I am not mad! http://www.nationalreviewofmedicine.com/issue/2007/06_15/4_patients_practice03_11.html

In considering this I listened to program on Premier radio by "Focus on the Family" yesterday. http://www.focusonthefamily.com/ Focus on the Family is not my normal fare, however today's broadcast spoke to this situation. It dealt with how to complain to schools if your child was being bullied, and again suggested that non aggressive open questioning was the best approach.

I also read in Exodus chapter 15 verse 28 how the Israelites "grumbled against Moses" who with God had earlier saved them from slavery in Egypt. I do not want to complain against a team whom we need to extend Jan's life, nor show lack of trust in God's over ruling provision.

It throws us back again onto Jesus, and the necessity of prayer to find peace whilst also using polite common sense with the medical staff.

Fortunately I was phoned back five and a half hours later by a nurse who understood exactly what concerned me, and said she would get accurate mamagrams available for the oncologist. Eventually I believe our concern was handled very well. I can wait another two weeks for test results, after all they make no difference until one is planning treatment.

Wednesday, March 12, 2008

Post op consultation with surgeon

90% good news, we await follow on radiotherapy. However key results were NOT present at that morning's multidisciplinary discussion of Janet's case. The possible need for chemotherapy was mentioned dependent upon the awaited test results. The ER, PR, and HER2 results were NOT available though these are vital for planning suitable follow on treatment. Without those test results surely Jan's case might as well have been discussed by my plumber and car mechanic?

Neither the consultant nor registrar who operated on Janet were available to us, though the consultant had set the time for the meeting.

I feel I may need to post less frequently to this blog for the time being, and will restart once test results are known by us.

I had earlier said we need to rely on God's provision, rather than medics. This waiting throws us back onto God. Do not worry about us, 90% of news was good. We plan assuming the most likely outcome of the tests.

Our plan is to return to the East coast and celebrate Easter as normal.

Waiting, waiting, and more waiting

I believe folks in USA would not be able to understand why in UK we wait after 13 days, when their standards would be seven days maximum. After waiting 13 days we are told to wait another week or two for the important ER, PR and HER2 test results. The analysis lab is at the entrance to the hospital where Jan's tumour was removed, so there is no excuse for transport delays.

But if I trust God does it matter? I don't worry or complain about waiting.

Tuesday, March 11, 2008

Talk about death

I need to be sensitive, two of our friends attend a funeral today. One of Jan's relatives was run down and killed by a car last Friday, so we can "mourn with those who mourn" as commanded by Paul in Romans chapter 12 verse 15. I don't know how long the newspaper will keep this event as news, at present it is here http://www.eadt.co.uk/content/eadt/news/story.aspx?brand=EADOnline&category=news&tBrand=eadonline&tCategory=News&itemid=IPED09%20Mar%202008%2011%3A51%3A46%3A847

An interesting blog entry on the passage in Romans is at http://tiffsniff.blogspot.com/2007/07/mourn-with-those-who-mourn.html

Cancer does not take us away from the day to day joys and tragedies of life, we share the care and grief of our friends.

In writing a sympathy card to this lady's son I scanned the first ten entries in the obituary column of our paper. All ten described the event as "so and so passed away". It seems we cannot talk about death! I found no help in the sentimental clap trap of the obituary column, so instead wrote to remind the son of the great impact his Mum had on us during her life, and reminding him of Jesus' promise of eternal life in John chapter 3 verse 16.

It reminds me of the epithet of a friend of mine, Pastor John Barr. He would have enjoyed the epithet on his funeral programme – ‘gone to another meeting’. He excited my Christian life. Details of John can be found here http://www.river-church.org.uk/NetSite/?Page=History

In looking at Jan's cancer we have had to face death. Earlier I had said the five year statistics were good, but the 10 and 20 year far more alarming. It seems to me there are three likely reasons:

  1. if you have had one cancer it seems likely that your body is more susceptible than general. Frequently women with cancer in one breast have a second in the other breast at a later stage unless hormone treatment is used.
  2. radiotherapy is good at stopping local recurrence, but after 5 or so years it seems to increase risk of distant metastases, or even start second cancers in lung or heart. These new cancers are probably caused by damage from the radio treatment itself. Radio is so damaging it cannot be repeated to the same breast. Two colleagues' wives have died from matastases, one in the liver, the other in the brain.
  3. the standard drug Tamoxifen seems to lose effect after 5 or so years, the cancer gets adapted to it and even thrives on it.
I read there are about 1 million women in USA taking Tamoxifen. There must be a similar proportion in the UK. At first I think it means we need a mission to such people who should be prepared to meet God. But on reflection we are all in this situation, death is part of God's plan, even Lazarus who was raised from the dead by Jesus eventually died.

As John Piper says "you will waste your cancer if you refuse to think about death". Ecclesiastes chapter 7 verse 2 says "it is better to go to the house of mourning rather than feasting. for death is the end of every man, the living should take this to heart."

When I worked with young people I used to point them to http://www.deathclock.com/ to remind them that they should plan for certain death. Maybe it is not a site for the squeamish! But deathclock is a serious site bringing home the importance of our life, the certainty of death, and how to increase our healthy life. For example it has many good links to general health at http://healthclock.healthology.com/main/condition_centers.aspx and specifically for breast cancer here http://healthclock.healthology.com/breast-cancer/breast-cancer-treatment/focusareasub.htm

Monday, March 10, 2008

Preparation for consultation

This could be a boring post to anyone who is not battling breast cancer. I had researched what treatment was available in readiness to discuss with the surgeon. On reflection it was a complete waste of time, he didn't turn up. Skip forward a day unless such preparation is of interest. Don't expect the UK NHS to have time to discuss such matters!

I guess one could just sit back and trust the doctor to give one the best possible treatment. I am 90% sure he would, but prefer to understand what is happening. Look up proceedings of the St Gallen 2007 conference on "primary therapy for early breast cancer" for good information on what current best practice is. I do not attach a link as I believe the medical staff restrict access to this information to medical professionals.

To review the possible outcomes I expect we will be told on Wednesday in ascending order of risk:

1) we could be told all clear, no need for extra treatment - highly unlikely
2) could be told all clear, we need radiotherapy and hormone therapy - expected result.
3) could be told we need a second lumpectomy to get adequate cancer clear margins - 10% risk
4) could be told cancer found in lymph system, needing further radio or chemo therapy - 10% risk
5) could be told the impossible has happened, there is more extensive cancer than expected, immediate chemo needed....should be impossible after what we have been told already, but lets prepare to handle the worst. The aim is to remove the cancer without disturbing it to minimise risk of spread around the body via blood or lymph systems. However every biopsy, guide wire etc. raises this risk and Jan's two guide wires were a bloody shambolic mess. Sorry, I am not swearing here, the ultrasound was covered in her blood, and what the nurse assured us was impossible happened to Jan.

Option 1: possible, see http://www.cancerhelp.org.uk/help/default.asp?page=10250#prime

Option 2:
To prepare for option 2, one needs to know whether cancer is estrogen receptor positive. 80% are, and in these cases Tamoxifen is effective for the first five years, expect to take Tamoxifen for at least 5 years, and worry about recurrence once that is stopped unless replaced by aromatase inhibitors.

In 15 - 20% cases the cancer is HER2 receptor positiive, where herceptin may be a wonder drug. Is this cancer HER2 positive? http://www.cancerhelp.org.uk/help/default.asp?page=19867
If so will NHS pay for it? It believe it costs up to £25,000 per patient and many NHS trusts refuse to pay for such expensive treatment. http://www.bmj.com/cgi/content/short/333/7578/1118?ehom= The BBC ran a report http://news.bbc.co.uk/1/hi/health/6176008.stm It also has nasty effects on the heart.

If radiotherapy is given, the doctor has already stated he favours hypofractionation (the use of fewer, higher fractional radiotherapy doses. This eases our transport to hospital, cuts cost to NHS, increases risk of cosmetic damage to skin, yet seems to have same effectiveness in preventing cancer recurrence.

I would like to discuss a safer option in research http://www.cancerhelp.org.uk/help/default.asp?page=10250#targit

Option 3: I want to know how they find site for next incision, after the previous shambles in using wire guidance that needed two wires. I presume the scar tissue shows up easily, but want re-assurance

Option 4: I would hope we just need radio therapy, without chemo. This link supports this view
http://annonc.oxfordjournals.org/cgi/content/full/16/3/383

To get a Christian perspective, let me quote John Piper "you will waste your cancer if you take comfort from your odds rather than from God." In 2 Corinthians chapter 1 verse 9 Paul says "in our hearts we felt the sentence of death. But this happened that we might not rely on ourselves but on God, who raises the dead." We need to trust solely on God.

Sunday, March 9, 2008

Secret of contentment

I feel I need to know about the side effects of cancer treatment before next Wednesday's meeting with the surgeon to discuss follow on treatment. I looked at how to minimise the side effects, it shocked me. Side effects discussed included hair loss, lymphedema, peripheral neuropathy and memory loss. But on lymphedema and hair loss I believe we have some encouraging tips:

Jan had been told by our UK medical team that she should not lift more than 15 to 20 pounds with her left arm. If true how could she do heavy washing, or vacuuming? In looking at lymphedema on American web sites I found their view is that the jury is out. Some doctors say that a gradual return to full previous activity and lifting helps protect against lymphedema. I pass the good news on to Jan immediately, and within a hour hear the vacuum being used again. Great news, the power of the Internet!

For those of you who think I am a callous chauvinist this data came from a top team in the USA, which included an MD from Cornell University, not a group of health food quacks. It is still available as an audio from http://www.cancercare.org/get_help/tew_details.php?tew=breast_112906&ret=%2Fget_help%2Fhelp_by_diagnosis%2Fdiagnosis.php

We went to church today, it was a great encouragement:

  1. the service started with an interview of a Chinese christian nurse. She had worked treating the rich and famous alongside probably the world's most famous doctor. She had given that up to work for a pitance at risk of persecution in a chinese village. The life changing power she saw bringing young drug addicts and HIV sufferers to new life in Christ was "unbelievable". I would love to say more, but as yesterday's Observer newspaper said there are now 54,000 Chinese government officers checking emails for "unlawful" activity to say more could jeopardise her ministry in China
  2. the sermon was so relevant to our needs: based on Philipians chapter 4, verses 4 to 13. St Paul says "I have learned the secret of being content in any and every situation." This is a repeat of what we read ourselves 2 days previously, God must be emphasing it to us"

Some of Paul's secrets must include giving up his claim to safety and wealth, laying it all before Christ, just like the chinese nurse. Then Paul says twice in verse 4 "rejoice". And in verse 6 "do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God."

replace worry with prayer
replace complaining with thanksgiving

After the service Jan spent so long encouraging a fellow cancer sufferer that I was able to talk to the Chinese nurse at length! We were the last to leave the church that lunchtime. To say more about the situation in China, I attach a link to a book we read over our last summer holiday, titled "The Heavenly Man" http://www.crossroad.to/Excerpts/books/faith_under_fire/heavenly-man.htm This link has excerpts from the book, quite a read. It is reviewed, and gets five stars here: http://www.amazon.com/review/product/082546207X/ref=dp_top_cm_cr_acr_txt?_encoding=UTF8&showViewpoints=1

Saturday, March 8, 2008

Power of Google

Yesterday we had some wonderful weather, I walked for hours through woods on the ancient Roman road of Ermine Street. I probably saw three cars and five people in a two hour walk, wonderful unspoilt countryside with broom now in flower.

It gave me time to listen to two sermons by John Piper. They were so relevant as we come towards Easter, when we remember Christ's sacrifice, the greatest proof of God's love for us.

Google is amazing in the relevance of some of the adverts it places on my blog! Yesterday on Ermine Street I listen to John Piper, today they had a link to John Piper's sermon backlog http://www.logos.com/piper?googleads&gclid=CM_n7pmc_ZECFQxTQgodBkDp9w Scarey! I am being watched!

I find John Piper a treasure. His material is available free of charge from http://www.desiringgod.org/

A relevant study for us at present is http://www.desiringgod.org/ResourceLibrary/AskPastorJohn/ByTopic/24/2649_What_is_so_important_about_Christian_hope/

John would sum it as:

"The most important verse in the Bible for me, probably, is Romans 8:32:

He who did not spare his own Son but gave him up for us all, how will he not also with him graciously give us all things?

Now that last part is hope producing! But it's grounded in the rock-solid statement that "God didn't spare his own son.""


Friday, March 7, 2008

Prayer replaces worry

For years I subscribed to an encouraging Christian email by Bob Snyder. He sees his mission as training doctors in Hungary to match their care with Christian testimony. His site is at http://www.internationalhealthservices.com/pages/ihs_about_author

He produces a weekly devotional email at http://www.internationalhealthservices.com/pages/ihs_llj The last two issues have spoken directly to our situation. One follows, so applicable to winning a battle against cancer:

"Winning isn’t everything, it’s the only thing." These words from the famous Green Bay Packer football coach, Vince Lombardi, express the ultimate preoccupation with results. While playing college soccer, focusing only on winning resulted in my failure to enjoy any part of the practice process.

At times in my spiritual life I focus only on results and fail to enjoy the lessons to be learned on the way to the end point. Since the journey to the results can take time and occasionally the result can be fleeting, finding joy in the results alone leaves much joylessness on the journey. Spiritually, joy on the journey can be as important as the results.

The apostle Paul told us to Rejoice in the Lord always (Philippians 4: 4-6) - implying that the journey to God-ordained results can come with joy. How?


By replacing worry with prayer
By replacing complaining with thanksgiving

Results are important but the journey is important as well. Enjoying the journey can be harder for me than enjoying the outcome.


This makes an interesting challenge for us as we so worry about results of Jan's treatment.


I found a useful NHS web site for anyone in my position. It has a booklet produced by the NHS, so I had ignored it for the first five weeks. On looking it is a useful tool to help spouses of cancer sufferers or probably any other major illness such as stroke or heart attack. The whole NHS site is good, the booklet is available as PDF download or free booklet from this link

http://www.breastcancercare.org.uk/content.php?page_id=3067


Thursday, March 6, 2008

Physical setbacks, faith advances

We are thankful for the support of a christian friend who is about four months ahead of us in going through treatment for breast cancer. Jan was regularly phoning her to support her, now she is doing the same for us.

She was triumphant that she had just managed to take a week away at a friends 10 miles away from her city flat. How cancer reduces our horizons, our last week away was to the Italian lakes and alps.

She phoned last night somewhat depressed as her planned radiotherapy was postponed on the day it started. No explanation was given, she must wait for a week to see the consultant for an explanation. How callous the NHS is in handling the emotions of those they treat.

Fortunately Jan was able to lend a sympathetic ear, promise prayer, and a group from her church will visit within 24 hours.

We again read from the bible in Ephesians chapter 5 verses 19 and 20. "Sing and make music in your heart to the Lord, always giving thanks to God the father for everything, in the name of our Lord Jesus Christ." This is so similar to 1 Thessalonians chapter 5 verses 16 to 18, "Be joyful always, pray continually, give thanks in all circumstances, for this is God's will for you in Christ Jesus."

We struggle with these passages. John Piper and David Powlinson who have both had cancer take them literally, that we thank God for our individual cancer, whereas a book by Michael Baughen suggests one thanks God in our circumstances, but not for our circumstances. We are not sure of the answer, but certainly at present Jan sees our circumstances and this cancer as God ordained to draw us excitingly close to him.

We wonder whether singing in our heart as commanded by Paul to the Ephesians could be a technique to help us put God and his power first in our minds and lives

Wednesday, March 5, 2008

Use of time - purify your life

Since diagnosis we have tried to use the time to best prepare ourselves. We have spent more time with the family, and daughter will visit next weekend.

In preparing for treatment I had see the risks as:

Surgery - very small risk
Radiotherapy - slightly more risk such as damage to heart and lungs
Chemotherapy - really nasty, far worse than just hair falling out
Hormone treatment - nasty effects such as causing cancer of the uterus, but one can stop at any time.

We therefore concentrated merely on emotional / faith issues and preparation for the surgery, ignoring the later treatments until the surgery was complete. We tried to spend about 10 hours in prayer and considering God's provision and goodness for every hour we spent thinking or learning about cancer. It may seem strange, but I think that ratio was correct.

Before surgery one has to face the possibility of death, and spend time in prayer. To do this we reviewed our lives. Some challenges we faced were:

  • How can one claim the promises on Malachi chapter three if ones finances aren't right in God's sight
  • James chapter 5 verse 16 says "the earnest prayer of a righteous man has great power and produces wonderful results."
  • John chapter 12 says we must pray according to God's will. We must clear out selfish motives.
  • Colossians chapter 4 verse 12 records how Epaphrus "wrestled" in prayer. We need to learn how to pray that earnestly.
John Piper says "you waste your cancer if you treat sin as casually as before". Only when we were clear on these issues could I peacefully allow Jan to go to surgery. Between surgery and the next consultation I want to learn as much as possible about follow up treatments.

So far I only have two regrets:

  • We took the decision on lumpectomy versus mastectomy with poor preparation. It was not explained that lumpectomy almost always has follow on radiotherapy. However I suspect we would have made the same decision, but options and relative risks were not discussed sensibly beforehand.
  • I had not researched surgery options until after surgery started. Only that day did I learn of alternatives such as carbon nanotube or laser surgery, ROLL versus WGL and ELIOT to almost completely remove the risks from radiotherapy. But in discussing with Jan we agreed these were esoteric new treatments for which we would probably have to travel abroad, and even had we known about them beforehand we would probably not have taken them up. I am using initials to save time in this blog. Anyone suffering with cancer can look them up in Google for more information.

So we rest trusting in God's support through this, and will continue to place more importance on our fellowship with him than worry about cancer.

Tuesday, March 4, 2008

Premier radio

We have stayed near north London to get treatment, where Premier Christian radio is easily heard on 1413 metres medium wave. It is on the Internet at www.premier.org.uk.

Many of their broadcasts have helped us in the past, and two helped this week. One was by Chuck Swindell, http://www.insight.org/. I ordered the CD recording from their UK office on 0800 9159364. Chuck was talking about Jesus going to Calvary. He said "remembering your mission helps one navigate through any storm". We need to see that this cancer is just a rock in the path on our walk with Jesus.

The second was a session by Rev John Ryeland from http://www.healingmission.org/. He answered phoned in questions about healing, and said that sometimes prayer made things initialy get worse, only for God to finally triumph. He then answered phoned in questions on the Premier Radio lifeline. May I commend these ministries:

Premier Lifeline: 0845 345 0707, email lifeline@premier.org.uk, www.premier.org.uk/lifeline - It is a christian run helpline offering information and a listening ear to the general public on a range of emotional and spiritual issues.

Monday, March 3, 2008

Waiting

Seems waiting is part on the strain of cancer.

  • Firstly has one got it
  • Then what has one got / how dangerous is it
  • Then has surgeon got it all out
  • Then what else has one got.....i.e. lymph nodes, even secondaries?
  • Is follow up radio or chemo needed
  • Then every year an annual exam to see if one hasn't got another or a recurrence.
It is dawning on us that what we had hoped would be a quick snip, and away with cancer like my earlier scare with a suspected skin cancer is more a long term membership of a club. Recurrence will be a constant risk.

Trusting and resting in Jesus can take some of the strain. A friend emailed to encourage us. Having had cancer himself he stated he just rested in Jesus, and trusted him to keep to God's perfect timing.

But could the doctors help? Do they make us wait unnecessarily? We have still only been told it is cancer to be treated by a lumpectomy and to expect radio and Tamoxifen afterwards. We are expected to wait till 12 March to be told any more.

So who is playing what game?

By 29 Jan we had worked out it was invasive cancer near the chest wall.
By 20 Feb we could give it the medical name "Non palpable invasive lobular breast cancer"
By 26 Feb we could see the ECG was OK
By 28 Feb we could say that only one lymph node had been taken.

So why increase our agony by not confirming this information as we go on? Instead we have to wait another 13 days.
We need to be treated as equal members of a team treating this, not second class "bodies" on whom they work. As from the 28th Feb. we have to take care to prevent lymphedema. Why even after we asked three times do the doctors refuse to tell us how many nodes they removed?

The apostle Paul must have had similar waiting experiences waiting for years in prison in Rome before his execution under the emporer Nero. Yet in Hebrews chapter 12 verse 1 he writes "let us run with perseverence the race that is set before us. Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross."

I read some bible notes which suggest we should meditate on heaven for 15 minutes each day. The certainty of heaven encourages Janet, the healing merely changes when she gets there. So much of the strain of waiting is taken away.

Sunday, March 2, 2008

Getting the right perspective

We read the bible on God's grace and peace that is offered to us. We read the early chapters of Job, where four disasters happen to Job in just one day, yet he will not blame God.

I went to church by myself today, Jan felt too week. The service was led by a lady who had overcome breast cancer herself nine or so years ago, and the piano was played by a widower whos wife had died when breast cancer spread to her brain. So two people, both with the same faith, prayed for by the same church, one healed and one went to be with Jesus somewhat earlier, leaving young children without a mother. So I believe God works to his plan, and it can be a mystery to us as to who is healed and who is not.

The service focused on AIDS orphans in Uganda, and showed a film about a 13 year old girl named Rachel. She was left as an orphan at the age on 6, and was acting as head of the household bringing up three of her siblings, and three other orphans from another family. So here am I worried about managing the washing, when in Uganda a girl of 13 is managing to bring up a family of 6, albeit with the help of a local church pastor. Info on TEAR fund here http://tilz.tearfund.org/hiv

Just weeks before a friend had explained how his wife was trying to stop girls going into prostitution to earn a living in Zimbabwe. He said that he thought that for a small sum he could buy them a sewing machine, and teach them to make and sell souvenirs to tourists or clothes to Africans. For what Jan's treatment must have cost the NHS so far he could set up 20 girls in such industry.

When asked what he would do if money was no object he said bring some of his church folk from Zimbabwe to visit us here in the UK. He said they were poor materially, but rich spiritually.

I pray that I will get my problems in perspective, and catch some of the spirit of these Africans. I want to see God glorified across the world, not just for my selfish needs.

Thanks to a friend who lent me the book on prayer "Getting through to God" by Michael Baughen, bishop of Chester. He states God answers prayer for his glory, not for our selfish whim. I know that he is working for our ultimate good through this trial, and is bringing us closer to him. Michael's book is here: http://www.amazon.co.uk/Getting-through-God-Michael-Baughen/dp/0850095662

Saturday, March 1, 2008

God uses our difficulties

Yesterday we were reading about how the eagle teaches its young to fly. Last night we watched "Spartacus" on TV, which showed Roman cruelty in St. Paul's time. Today we read how God used the apostle Paul's imprisonment in Rome. It is in Philippians chapter 1 verses 12 to 26. Paul says "what has happened to me has really served to advance the gospel". He emphasises the unlikely truth of this by using the word "really". Paul's imprisonment in Rome was costly, it was the last step before execution. Eusebius of Caesarea, who wrote in the fourth century, states that Paul was beheaded in the reign of the Roman Emperor Nero.

However had not Paul been imprisoned he would probably not have written Ephesians, Philippians, Colossians and Philemon.

We pray that God will use this suffering of Jan to increase our usefulness to Jesus.