Sitting in the chemo chair for round 14As I write this, I'm sitting in the chemo chair, waiting for the pharmacy to mix my chemotherapy for Round 14 of treatment.

During Round 13 of my chemotherapy treatment with Oxaliplatin and 5-FU, I had an allergic reaction to the Oxaliplatin which resulted in immediate discontinuation of the drug and administration of steroids and Benadryl to halt the reaction.

Last week, I returned to MD Anderson for blood work and CT scans, which confirmed that my cancer has continued to spread. The existing cancer sites in the lymph nodes have grown, and new potential sites of metastasis are appearing. Based on the progression of the disease, my oncologist at MD Anderson offered me the option of entering a clinical trial or trying a second-line conventional chemotherapy regimen. I spent some time doing research on the drugs being used in the clinical trial, and came to the conclusion that they were unlikely to be effective against my cancer, given the results of published research where the drugs were found to be of no benefit in treating cancers similar to my gastric adenocarcinoma.

As such, I elected to try a second-line traditional chemotherapy regimen with Irinotecan and 5-FU. I will have another CT scan in 4-6 weeks to determine whether it is working, and will switch to a third-line treatment if it is not. In the meantime, I am still hoping to get access to an immunotherapy trial, but must wait for the trial to open again.

Over the past week, I've been in significant pain much of the time, as the growing lymph nodes begin to put pressure on nerves in my back. I've been prescribed new pain medications that work well most of the time, but I've found that if I sleep through a dose, it takes quite a while to control the pain again. This has been a discouraging week, with the ratio of good days to bad days becoming increasingly lopsided in favor of bad days. It is hard not to view this as the beginning of the end, but we are hoping and praying that the second-line treatment will give me a little more time.

Over the past several days, I have had one Bible passage that keeps coming to mind:

Do not be anxious about anything. Instead, in every situation, through prayer and petition with thanksgiving, tell your requests to God. And the peace of God that surpasses all understanding will guard your hearts and minds in Christ Jesus.

Philippians 4:6-7

Note that this verse doesn't promise that our requests will be answered exactly the way that we hope they will. It doesn't promise that everything will be fine. It does promise that God hears our requests and promises us "peace... that surpasses all understanding."

I have known that peace during these past few weeks. As my condition worsens and the likelihood of long-term survival shrinks, there is no earthly reason for the peace that I feel. Certainly, we continue to grieve the loss of our future together, but we have faith in our Father who will supply all of our needs.

My wonderful wife, the love of my life, Melissa, has been such a wonderful caretaker over the past months. She is so strong, and patient, and kind, and loving. I can't imagine how hard it has been for her to watch her husband go through this cancer, but she has been my best friend and most trusted ally through it all.

Thank you to all who continue to lift us up in prayer, send meals, write notes of encouragement, and stand by our side through this trial. Please continue to pray for the following:

• For strength and peace for Melissa
• For patience in the waiting
• For uncommon effectiveness of this second-line chemo regimen
• For wisdom with all of the decisions we face in the coming weeks and months.