December 13:  On Tuesday, December 11, my gastroenterologist met with the AMC Tumor Panel to review all the scientific information that had been gathered from various scans and other tests.  Their counsel is for me to undergo chemotherapy followed by radiation therapy to attempt a shrinkage of the tumor on my pancreas.  This protocol will include procedural assessments to determine whether progress is being made toward the goal of shrinking the tumor, and if so, to what extent will the achieved condition provide surgical resectability either in part, or complete removal of the pancreas.  Even if after chemotherapy, surgery may not be an option if particularly the intricate web of veins that intersect with the pancreas have been compromised by cancer cells.  So, each stage of the process has to have a reasonably good outcome before surgery may be feasible. A frightful reality!  The statistical data on the success of these procedures are small.  Yet, there are anecdotes of people who have been in my situation, submitted to chemo, radiation, surgery, and have come through the ordeal to live on, some for five to ten more years!  So, where am I in the process of deciding where to go with these options?  At this particular point in time I'm still bewildered by what has befallen me.  I'm in ongoing conversation and prayer with my family on a daily basis.  Diane will join the rest of the Portland-based family from December 18 onwards!  Your ongoing prayers for clarity and peace of mind for all of us as we counsel and pray together will be appreciated as always.

Thank you so much to the many of you who have remained in actual contact with us. We are overwhelmed by your love, encouragment, assurances of prayer, and even tangible tokens of care and concern for our spiritual, emotional, and physical wellbeing.  We also appreciate your understanding that it's well-nigh impossible for us to respond to everyone's kind overtures.  Hence this blog to do it in collective insallments.  Thanks again, then, for making this journey with me and the family, even if it may be marked at times for all of us by bouts of anxiety, fear, tears, hugs, expressions of love, and fortunately also - settled peace in God's will.  These are all responses to an assault on our mortality which we typically think of as a reality that can be postponed  to some distant future we cannot now see.  But no! When that reality shows up at your front door -everything changes.  I have a new appreciation for the Prayer of Moses the man of God: 'So teach us to number our days, That we may gain a heart of wisdom'.  Psalm 90:12 NKJV.  

December 7:  During the past two days I have had consultations with a surgeon and also my gastroenterologist, both associated with Adventist Medical Center (AMC) here in Portland, OR.  Although I've not yet signed up through his office to perform surgery on me, if feasible, this Christian stalwart has taken time to visit and call me several times in recent days to pray with me, find out how I am doing, discuss options with me based on information to date, and assured me of his personal interest and ongoing prayers.  Today, Estelle, Ray (our son) and I, also visited with my most kind and personally caring physician/gastroenterologist at AMC.  But for my ethical constraints to protect their professional anonymity, I wish I could shout the names of both these physicians from the hilltops, as it were.  Like the surgeon, my gastroentrologist is also a Loma Linda graduate - incredibly gracious and extremely skilled and knowledgeable in his field.  He has gone way beyond duty to intervene with Health Net, my insurance provider, to have them overturn some ill-founded  decisions against tests required to arrive at the best diagnosis of my condition.  These stalwarts are both a credit par excellence to the medical profession in general and to AMC in particular for its pervasive caring culture. I could go on, but let me get to their preliminary opinions about the treatment direction I may be pointed to over the next few days. 

Arising from the endoscopy and biopsy which was performed on me on Tuesday of this week, the following:  I do have pancreatic adenocarcinoma (pancreatic cancer).  The abnormal lymph nodes in the gastrohepatic ligament which were identified by the earlier CAT scan, and a spot on the liver which was identified during the endoscopy procedure on Tuesday, were both found to be benign.  However, my case is still so 'borderline' that surgery on the pancreas would not be recommended at this time.  My consulting physicians lean in the direction of recommending that I first consider undergoing chemotherapy/radiation treatment to shrink the tumor on the pancreas. Once that goal may be achieved, the surgery option might be feasible, and would include a removal of the pancreas as part of the very major so-called 'Whipple' surgery procedure.  (You may wish to Google 'Whipple surgery' to find out more about it?).  This combined chemo/radiation and potential follow-up surgery option is a very hazardous undertaking, inasmuch as the success rate associated with this treatment protocal ranges around ten percent!  A group of physicians comprising the Tumor Panel at AMC will meet next Tuesday at noon to consider my case, and make the final recommended treatment option/s for the Birch family to consider.  Meanwhile, I need to undergo another CAT scan at AMC on Sunday, and will next Wednesday also consult with an oncologist and radiologist/oncologist about the risks, success rates, and prognosis of these respective treatments. My family are also open to researching other holistic treatment strategies that may complement the noble efforts of the medical fraternity.  Anything that may arise from that could come later.  We have enough to process at this time and into the coming week.

I can assure you that to process all the information we're dealing with as a family is a very formidable task. This includes some emotional rollercoasting, and processing thoughts that you never imagined you would ever have to deal with.  Suddenly facing one's mortality brings one head on to very imaginable ramifications of that reality.  This is where our faith and immense apprecation for God's all-sufficient Grace is bouying our spirits.  Yes, know that your prayers are indeed sustaining the Birch family as we're experiencing God's embrace through this trial.  His grace is giving us unquestioning peace and trust in His sovereign will about my future.   So, again, many thanks for your support and ongoing prayers.  Feel free to leave us any responses and comments you may wish to post on this blog.  We love to read them.

December 6:  My gastroenterologist very thoughtfully and kindly called me at home early this morning to share the results of the biopsy that was done on me on Tuesday.  The tumor on the pancreas was found to be malignant.  However, some abnormal lymph nodes that were identified 'in the gastrohepatic ligament' were found to be benign.  In addition, the suspicious 6.00 mm lesion in the left lobe of the liver which was detected during the endoscopy procedure, was also found to be benign.  These indications suggest that although I am definitely a 'borderline case' as far as medically determined treatable options are concerned, those options may now be available to me.  My next appointment with the gastroenterologist is tomorrow, Friday (December 7) at 1.00 p.m.  Amongst other things, the feasibility of treatable options will be discussed.   I want to also pay tribute to my beloved wife, Estelle, who is very intentionally providing me with the most healthful and fibrous diet that one can imagine.  My neighbor John, and I had a wonderful walk around adjacent neighborhoods yesterday while a late Fall outpouring of gorgeous sunshine poured down on us.  My energy level remains good.  My outlook is very positive.  My faith remains stedfast and secure in the Lord.  Please continue to join me and Estelle, and our family in prayer as this journey continues. 

December 4: Estelle and I have just returned home from AMC after I had undergone the gastro-endoscopy procedure. Based on my physician’s ‘impressions’ arising from the ultra sound probe of the pancreas and liver, his report, as follows: ‘2.90 x 2.72cm ill-defined mass in the neck/body of the pancreas, with associated involvement of the portal vein and SMV (Superior Mesenteric Vein). There appears to be extrinsic compression of the splenic vein. Preliminary results are suspicious for malignancy vs. chronic pancreatitis. Final results are pending. There does appear to be a suspicious 6.00 mm lesion in the left lobe of the liver, and final cytology is pending’. Recommendations: (a) Await cytology (biopsy) results, presumably by Thursday or Friday; (b) Follow up with a visit to my physician at 1:15 p.m. this Friday, December 17, to learn about medical treatment options, if any.

In recent days, Estelle and I have been overwhelmed by the outpouring of immense love and empathy of friends and loved ones from around the world. Scores and scores of emails and phone calls have been received expressing support for us and our precious children. Thank you so very much to all we’ve heard from in Australia, New Zealand, South Africa, and around the United States. Please understand that with our lives turned as upside down as they are at this time, that we are just not in a position to respond to every email. However, the support that is conveyed in your messages are truly uplifting. We feel near to all who who’ve been in touch with us. Just consider yourselves truly loved and hugged, despite the distances that separate us.

Our trust in God remains strong. I have a great sense of peace about my future. My beloved son, Ray, reminded me a few days ago that God always heals. Ray said, 'Dad, we just need to allow God’s sovereign will to determine whether he will heal you on this side of the curtain or the other side’!

Thanks for your ongoing prayers for me, Estelle, and the family. I’ll stay in touch as long as I’m able to. Alf

WELCOME TO MY BLOG!

November 23: Ever since the middle of October I’m experiencing some cramp-like discomfort around my upper abdominal area.  My physician recommended that I have a CAT scan, which was done at Adventist Medical Center (AMC), Portland, on November 23.  Imagine my surprise when the radiologist informed me after the procedure that I had a tumor on the upper region of my pancreas.  My doctor then referred me to a gastroenterologist, whom I saw on Thursday, the 29^th.  He immediately scheduled for a gastroendoscopy procedure on Tuesday, December 4.  My understanding  is that this procedure makes use of ultra sound to examine the tumor tissue, and determine whether the pathology has spread to other organs, particularly the liver.  At the time of the procedure a biopsy will also be taken of the tumor tissue.  Once this procedure is completed and documented, it will be reviewed by a Tumor Panel at AMC to determine and recommend the most appropriate treatment options for my condition.

I so much appreciate the excellent care and skill of the medical practitioners with whom I’ve counseled to date.  Believe me, I am in good hands!  Meanwhile, I am fully resigned to whatever the future holds for me.  My faith and trust in my Heavenly Father remains as strong as ever.  My family’s support is also amazing.  Estelle is researching how she may complement my medical treatments with the most optimal diet that my body needs at this time.  She may be contacted at estellebirch@comcast.net.