Facing the Unknown

I’ll be seeing an oncologist for the first time on Tuesday afternoon next week, and I have some questions.

How far has it spread?  Cancer cells are cells that are out of control and can potentially invade other parts of the body, a process known as metastasis.  They can wreak all sorts of havoc in the liver, lungs, bone marrow, brain, and other organs.  In my case Dr. Rob Brown expertly removed a cancerous lymph node measuring roughly 1.5” x 1” x 0.7” from my neck.  Normally a lymph node in the neck is about the size of a grain of rice.  I had figured that I might have a significant scar after the surgery and thought I might start the first day of class with something like, “Hi, I’m Dr. Vogt, your chemistry teacher. You can call me Dr. Scar.” Well, Dr. Brown did such an artful job that at this point it appears that the scar will look like a crease on my neck, which isn’t at all out of place on a 58-year old bloke.  For some reason Dr. Crease just doesn’t sound as cool as Dr. Scar.

My cancer is in my lymph system, which circulates a clear fluid similar to blood plasma throughout the body.  The lymph system is an important part of our immune system.  Lymphocytes are white blood cells and in the lymph system they are located primarily in lymph nodes, but lymphocytes also circulate through the lymph system.  I have cancerous lymphocytes (hence the term lymphoma), and so it seems like some of those cancer cells must be circulating throughout my system.  Are there any other cancerous lymph nodes?  Not that we know of.  Will we find out?  I hope so.  I read the printed pathology report I got on Wednesday and it indicates that the particular kind of B cell non-Hodgkin’s lymphoma I have is called follicular lymphoma.  Of course follicular lymphoma is bad, but it actually has one trait that is good. You can look it up on Wikipedia if you’re interested.

How will the treatments affect me?  I assume that the oncologist will discuss chemotherapy and radiation with me, but of course I don’t yet know what treatments will be appropriate.  Radiation damages the skin in the area that it is administered and can result in blistering and, since the problem is near my throat, potential difficulty swallowing.  I hope it wouldn’t affect my larynx, because a lot of what I do in life requires me to speak.  Chemotherapy has a well-deserved reputation of causing serious side effects.  I rather doubt that I’ll look good without any hair, and so perhaps I’ll start a hat collection of some sort if that happens.  Then there’s the possibility of neuropathy, where the chemo treatments damage nerves and can lead to pain and numbness and can, for example, make it very difficult to walk.  Nausea is never fun, but there are drugs to help deal with that.  Being extremely fatigued is not fun, and it will also make it difficult to teach.  In college we don’t just call for a substitute. Who will take my teaching responsibilities if I can’t do it myself?  Thankfully I have very supportive colleagues who have already volunteered to help.  There is that one course, though, for which I’m the only person on campus qualified to teach.  What will happen there?  Who will cover my responsibilities as the chairman of my department?  One of my colleagues has agreed to do so.  Oh, boy, I work with wonderful people.  Who will cover my program coordinator job?  I’m the only academic advisor for one of the degree programs offered by my department, and I’m the only person that has ever advised students in this major.  Who will advise these students?  Oh, wait.  I’m also a husband, a father, a Sunday School teacher, an elder at my church, and co-owner of The Vogt Estate.  To what extent will I be able to fulfill these responsibilities?

Will I survive?  Survival statistics are just that, just numbers.  They are very helpful when describing large numbers of patients, but they don’t always apply to individuals.  The average U.S. adult male has a waist size of 39 inches, but there are lots of American men with waists of much different size (just look around the next time you’re in Walmart or McDonald’s).  Similarly, cancer patient survival rates are averages and don’t necessarily pertain to a given individual.  Here’s a similar example.  When my mother had heart bypass surgery in 1997, we were told that 97-98% of such patients survive.  She was in the other 2-3%.  So, although statistics may be helpful in making one feel better in a broad sense, one shouldn’t treat them as though they are accurate predictions of some sort.  The fact of the matter is, I don’t know how this is going to turn out.  My surgeon doesn’t know.  Doubtless my oncologist has experience, statistics, and reasonable expectations.  But he won’t know how this will turn out, either.

There’s enough here for me to spend a lot of time consumed by worry and fear, and I haven’t even mentioned everything that I’ve thought about.  How in the world am I supposed to deal with this?

Some of Christ’s most beloved words are recorded in Matthew 11:28-30:

Come to me, all who labor and are heavy laden, and I will give you rest.

Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls.

For my yoke is easy, and my burden is light.

I need this kind of rest, rest for my soul that rejuvenates me.  Without it I’ll be faced with unrelenting turmoil, and it could wear me out mentally, emotionally, and physically.  But this peace has a condition attached to it:  In order to get it, I must go to him and agree to have his yoke placed upon me.  A yoke is a wooden contraption used to connect two oxen for plowing a field, and here Christ uses the term figuratively.  He means that I must willingly embrace his commandments and obey them.  All of them.  I must give myself and my life to him.  He promises that in return he will deal kindly and graciously with me (my yoke is easy) and that the tasks he chooses for me will be light.  He will also give me refreshing, calm, quiet, rest in my soul.

Many years ago I took Christ’s yoke upon me, and after being diagnosed with cancer I examined myself and reaffirmed my commitment to him and his purpose.  A lot of people have been praying for me, and I am very thankful for that.  Christ is honoring his promise to me and he is answering the prayers of his people.  Most of the time since my diagnosis I have been filled with peace.  Yes, there are times of struggle.  For example, one evening last week about an hour before I went to bed I had a terrible struggle with fear.  I discussed it with God and it evaporated before I went to bed.  Most of the time I feel like I’m sitting in a river of peace, with peace sloshing around and over me in endless supply, and I can drink as much of it as I want anytime I feel like it.  This is not me gutting it out or deluding myself, nor is it the result of any medications or the placebo effect:  This is God keeping his promise and giving me rest in my soul.  This is the way to face the unknown.