"Maybe when your big picture is in place, all those bumps in the road along the way get sort of smoothed over” – Author Michelle Dalton

“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses” – President Abraham Lincoln

“Hardships often prepare ordinary people for an extraordinary destiny” – C.S. Lewis

-------------------------------------------------------------------------

Waiting to undergo a PET/MRI scan to check for any reoccurrence of cancer, Sep. 29, 2016. My cancer treatment has transitioned to a new milestone - ongoing cancer scans every three months for a year. Since being diagnosed with cancer on June 3, I've underwent surgery and chemo/immunotherapy treatment. Now, together with my oncologist, we now maintain vigilance to monitor for any further reoccurrence of melanoma cancer.

It has been just over three weeks since my last update about my cancer treatment. During that time, I have been busy with work and with other responsibilities, while at the same time dealing with post-infusion side effects. However, despite how I currently feel … one moment with amazing energy and the other times feeling like I “hit a brick wall” … this round of fighting cancer – 1st round in 2007 and the 2nd in 2013 – is definitely a “cakewalk,” compared to the second round in 2013.

The first round was in December 2007, when Teresa and I were living in Germany. A German dermatologist excised a malignant melanoma from my left shoulder (Stage I), a simple in-and-out procedure; although, he had to perform two excisions in the same area.

The second round was significantly more difficult on me. When I was diagnosed with this disease (Stage III) in November 2013, the treatment took more than year to finish (but all cancer survivors ultimately know that there is no such thing as “It’s over!”), with regular cancer screenings every three to six months.

In May 2016, I detected another lump in my left leg, which led to blood tests, MRI/PET scans, and more blood tests. Then, on June 3, 2016 my oncologist informed me that my cancer had in fact returned … officially making it Stage IV melanoma. Thereafter, a musculoskeletal tumor surgeon resected the cancerous tumor from my left leg, then a month and a half of chemo/immunotherapy infusions.

Again, this current round is definitely a “cake walk,” compared to the previous second round. However, I encountered a new bump in the road, if you will.

Unfortunately, a new ‘complicated’ bump in the road

Last week (Thursday, Sep. 29), I was diagnosed with Ipilimumab-Induced Lymphocytic Hypophysitis, an uncommon autoimmune disease in which the chemo/immunotherapy treatment damaged my pituitary gland (just under the brain), and subsequently negatively affecting the rest of my endocrine system.

I must keep in mind that I was made aware of the risks associated with this type of treatment, particularly the relatively new drug involved. The drug they used on me is called, “Ipilimumab” (also known as “Ipi”). Ipi was approved in 2011 by the U.S. Food and Drug Administration for the treatment of my type of cancer: metastatic melanoma. When I underwent chemo/immunotherapy treatment at the infusion center, they injected Ipi into my system, a human monoclonal antibody, to hopefully improve my survival against metastatic melanoma. In fact, the drug blocks a cytotoxic T-lymphocyte antigen-4 (an inhibitory molecule that acts like an ‘on-and-off’ shutoff valve on the antigen-stimulated T cells), and in so doing enhances T-cell activation. Basically, in layman terms, the chemo/immunotherapy treatment enhanced my immune system considerably, taking it from a one-shot rifle musket to a Thompson submachine gun (aka Tommy Gun). In a physiological sense, it gave my immune system the capability to bring its wrath down on the remaining cancer cells in my body. Conversely, as with any battle, innocent bystanders may also unwittingly be a target as well. And in my case, the pituitary gland and endocrine system unfortunately took a few shots from Ipi as it wreaked havoc on the melanoma cancer cells.

What’s next

The Human Endocrine System

When my oncologist detected the inflammation of my pituitary gland, he immediately ceased the chemo/immunotherapy treatment and initiated a corticosteroid treatment to mitigate the hypopituitarism in my pituitary gland. Soon after, we scheduled and met with an endocrinologist to determine the best course of treatment for my Ipilimumab-Induced Lymphocytic Hypophysitis. From what has initially been conveyed to me from both my oncologist and endocrinologist, this new diagnoses may be permanent as well, along with my Stage IV melanoma.

Faith, family, and friends and support network

Yes, it’s a hit … literally!

And yes, it pretty much sucks!

However, if it takes a few bumps in the road to ensure a long life, then I am willing to accept it.

When I wrote my introduction on my site on CaringBridge.org, I mentioned that I do not want to make this about cancer, because, in effect it doesn’t deserve to be on center stage. Instead, I write about my faith in Him…the love of my family…and the support of my friends and network here in Virginia. Altogether, it is my faith, family, and friends and support network that are center stage during this fight. And I intimately know that your cards, phone calls, gifts, prayers, support, and much more…are the best medicine a cancer patient needs.

As I continue to face bumps in the road, and there will be many more throughout my life (including yours), I hold onto the truth that life's bumps in the road brings about new strength, girded by my faith, family, and friends and support network.

ajh

To learn more about the Endocrine System here (also a good presentation can be found here). Also, for more information about Lymphocytic Hypophysitis, click here.