...and it all comes crashing down (yet again)...

Man, I have felt good over the past three months.  I have been getting used to my new body modifications and learning the nuances of what it means to be a neck breather and electrolarynx talker.  The boys have been playing basketball and recently transitioned into baseball for the duration of the spring and all has been right with the world.  Well that all came to a screeching halt on Thursday morning about 8 am when my doctor walked in and said "It's in your bone."  I had prepared myself for a lot of things that morning, but to hear that the cancer has now spread into the bone of my sternum was NOT something that I was ready to hear.  I think both Jessica and I nearly passed out and there was a rush of activity as we tried to come to grips with what we just heard.  In my bone.  That is just so deflating, crushing, maddening, etc...to hear that I didn't know (and still really don't) what to do or think or say.  I have always held out hope that I could somehow beat this against all the insurmountable odds, but being told that it's in my bone just about popped any and all thoughts I had of my life extending beyond the next year or so.  Damn the bad luck.
So after the initial shock of the news, we settled back in to what needs to happen next.  There was to be a PET scan that afternoon to determine where else in my body it has spread (because it is in the bone, the felt it very likely to be in other places) and the results of the PET would help determine the next course of action.  I had the PET scan at 1 pm and went about my day.  We had a wonderful meal at our favorite German restaurant in Houston and prepared for the next day.  I guess I convinced myself that my best chance would be for it to still be localized in the area I have been dealing with and not to have spread elsewhere in my body.  Appointments yesterday were with my surgeon and the medical oncologist that I see at MD Anderson.  Once again, they only see the cancer in this one area, and once again there is no evidence that it is anywhere else.  Oh how I wish I could get rid of it, but it just will not go away.  Anyway, this development means that I at least have some decent options going forward.  It will again all depend on what happens in the next 3 to 6 months, but there are options and I have expressed to them my desire to continue fighting and do whatever I have to do to give myself a chance for survival.  They were very happy to hear that I am still willing to continue the fight and their demeanor changed the minute I said that I am all in.  I really do have a special place in my heart for this surgeon and her PA, they bring such a dynamic human element into this dark, bitter place and it has been and continues to be refreshing to me in such a depressing clinical setting.  The option going forward is going to be 3 to 6 months of chemo (more on that later) while tracking the tumor progress and hoping for minimal growth or even better would be some shrinkage of the tumor itself.  At the end of this time-frame, if things look favorable I could have YET ANOTHER surgery to remove the section of my sternum and surrounding tissue that contains the offending cancerous growth.  This would be done by a separate team of surgeons, this time cariothoracic specialists.  I don't know the details about this surgery, but it would be dangerous and leave me with not very adequate protection for my heart and other sensitive structures in the center of my chest.  There are ways around that and still many concerns and hurdles to overcome, but it is an option out there in the not too distant future.  I have lots to think about in the coming months and many very important decisions to make regarding my future and the future for my sweet little family.  I can only hope to handle this process as gracefully as I can, but I will go down fighting to the bitter end.  I will not give up on myself or my family and I will put myself through whatever I have to in order to get as much time with them as I can.
I am scheduled to meet with some additional MD Anderson personnel late next week.  On Thursday, I meet with the head of a clinical trial that my medical oncologist is recommending me for and this will likely be the road I go down for chemotherapy this time.  It is a trial of a combination of standard chemo treatment with a new immunotherapy agent that shows promise in advanced metastatic head and neck cancers.  I don't know the details yet, but I should find out more in the next week.  That seems to be the teams advice for the best course of action.  Get me in this clinical trial and see how I respond to treatment and then reassess and go from there.  It's not the greatest option, but it is what I have and what I will do.  I have told them that I will see my 40th birthday, so that is the goal.  Get me two and a half more years minimum here with my kids and I will consider myself a lucky man.  On Friday of next week I will meet with a cardiothoracic surgeon to just talk about what that surgery would be like and what my options are with that approach, should it become viable down the road.
That's about it, I just wanted to throw out a quick note about the recent developments to any who are interested.  As long as I continue to draw breaths in this world, I remain ever hopeful that I can overcome the challenges before me.  Thank you for the support you have given me and my family throughout this entire process.  And so it continues...