Mark Shepard Shep's Journey

Well Rewind from today, April  4th. 
  The summer of 2021 Mark experienced occasional severe coughing.  On several occasions he had blackouts where his hands cramped and he was incoherent for a few seconds. Myself and our son Mark witnessed this. He had a third episode while I was in Florida .Extremely scary on my end.   


 August 2021 Mark went to his primary doctor. We were referred to several specialists.  Cardiologist , Pulmonary,  and Neurologists. Thus we began the myriad of tests ranging from CT's, MRI's and Pulmonary and ultrasound. A short time later Mark had an EEG checking his brain wave activity. (they were hoping to find activity, lol)  In typical Shepard form, all tests were NEGATIVE! One big exception. The CT on the lungs indicated a 'Crystalline  cloud' in the upper lobe of his right lung. At that time, the Pulmonary team was not concerned.


 A follow-up appointment/scan was scheduled for early December.  December 1st another CT on his lung was completed. The 'Crystalline cloud' as it was referred to earlier was now a cavitary mass measuring 3.9 x 3.7 x 4.3 cm located within the upper right lobe. It had become solidified, enlarged, and thick walled in comparison to the CT done in August. The reports indicated that the mass should be considered malignant until proven otherwise.  December Mark's Pulmonary team ordered AFB stains, which were negative, and proceeded to treat with antibiotics to eliminate his cough.


   On December 23, Mark had a bronchoscopy. Several biopsies were done. The surgeon was unable to get a tissue sample of the mass due to a portion of the lung being collapsed by the tumor.   January 19th a PET scan was completed.  The cavitary mass now measured 5.3 x 4.1 x 4.3 cm. A meeting with the Pulmonary team suggested Mark have an EBUS. This is a highly specialized bronchoscopy that includes ultrasound.  A trip to the cities was to happen as soon as possible since the Brainerd area doesn't have the equipment to perform an EBUS.  An EBUS bronchoscopy was performed  by Dr. Sharma  on January 31, 2022. She did get through the mass and obtain several biopsies including the lymph nodes as she promised. Dr. Sharma had a zoom meeting with us and explained the mass was malignant and included one of the lymph nodes. She suggested we consult with a Thoracic surgeon and proceed accordingly.  


 In the meantime, Dr. Sharma asked if she could present Mark's case at the tumor conference coming up later in the week. This conference is held every month.  The conference is multidisciplinary. In attendance were Dr. Sharma MD, members from Medical Oncology, Pathology,  Pulmonary, Radiation Oncology, Radiology and Surgery. After a lengthy discussion, the consensus from the team was a systematic approach. The cavitary mass now being identified as Non Small Cell Carcinoma, Stage 3a should be discussed with a Thoracic surgeon.  Dr. Louis Jacques is a highly-rated specialist in the field who was at the conference.  The conference felt the best approach was to perform a Pneumonectomy. (removal of the entire right lung) After conversations with Dr. Jacques and going through possible success rates and so forth we decided to seek a second opinion from Mayo Rochester. 


  Alot of information was given such that we both  felt very overwhelmed.  So, the best medicine in the world is warmth and awesome time with family in Phoenix.  We flew to Mark's sister's  for 10 days of relaxation and sun. A few days on the beach in Puerto Penasco , Mexico were just what we needed. A great trip with Meg and Steve released a lot of stress. Just having the support of two people who know Mark inside and out was a huge help to me. While in Phoenix we set a telemedicine consult with Mayo for when we returned home.   


 On February 21st we did the telemedicine consult with Mayo. Mark's sis, Diana and hubby came up to the lake for a few days. Having Diana there was wonderful. She's in the medical field and asked questions that we hadn't thought of. Mayo was somewhat in agreement with Dr. Jacques.  The big difference was they would attempt to only remove a part of the lung. They also felt Mark should have a brain MRI. Once this was completed,  we would have a surgery consult. On March 3rd, the brain MRI was done. The purpose was to verify that the cancer had not spread into the brain cavity. Results indicated no sign of cancer.  Celebrate,  yes indeed! I have expressed numerous times to Mark , WE TAKE THIS JOURNEY DAY BY DAY AND CELEBRATE THE LITTLE VICTORIES!!  


 We spoke again with Dr. Jacques. The Dr. ordered a Pulmonary test which was completed on February 28th. The purpose was to determine Mark's conversion factor. During our zoom call with Dr. Jacques on March 3rd he expressed that surgery was no longer a viable option. The test indicated Mark's remaining good lung would not sustain a quality of life.  A portion of the tumor and infected lymph node is on the pulmonary artery. Successful  "peeling away" from the artery would in fact be difficult. This term of "peeling away" was used by both Dr. Jacques and Mayo. Dr. J asked that we let Mayo know on our call set for March 9th of his final opinion. 


During our zoom meeting with the Thoracic surgeon at Mayo, the pulmonary test indicated to them that not even a Lobectomy would be possible. So, surgery was now off the table. Both surgeons were asked by us what Mark's odds are. Answer, possibly one to two years with nothing being done. Or, 50/50 shot at 5 plus years with treatment.  Both surgeons concurred -- hit the cancer hard with chemo and radiation. 


 So now we are in present time. Mark's Oncology team came up with a hard hitting plan that he can accomplish in Crosby and Brainerd. When Mark completes chemo and radiation he will undergo Immunotherapy. The idea is to catch any stragglers left from treatments and build back his own immune system. This happens once every 3 weeks for a year.