Dr. Mullen Becomes the Patient

Hello, my name is Sawyer Mullen. I am 27 years old, and I have Stage 4 esophageal cancer. I am married to Amy, the best person I’ve ever known; she loves the Lord and people more than I can dare dream to this side of eternity. We are writing this from Houston, Texas, although our home is in Alabama. We are about to start chemotherapy at MD Anderson Cancer Center. We are hoping to use this medium to pass updates along to friends and family and to offer prayer requests as we go. Below is a timeline of the last 2.5 weeks, to give some explanation of how we got here and to exhibit the swiftness and grace of the Lord in providing us help immediately following our diagnosis and beyond. 

Our past couple of weeks:

7/20/2020 - I had an upper endoscopy for difficulty swallowing which showed a mass where my esophagus meets my stomach. The GI doctor said he was concerned for malignancy. Based on the photos from the scope, I knew that I had cancer.

7/21/2020 - The pathology came back as esophageal adenocarcinoma, moderately differentiated. 

7/22/2020 - We got scheduled for an appointment at MD Anderson Cancer Center (MDACC) in Houston, Texas for 7/29/2020. We also got a CT of my chest/abdomen/pelvis to try to see if the tumor had spread anywhere.

7/23/2020 - The initial read of the CT showed no tumor spread beyond the esophagus and could not identify any more distant spread, possibly indicating an early stage to the cancer.

7/27/2020 - I got my first Covid-19 nasal swab. Let me tell you, they swab you right nice and deep out here at MDACC. 

7/29/2020 - I met with the cardiothoracic surgeon who was the first stop of many at MDACC. Amy couldn’t accompany me, so she was on speaker phone. The surgeon reviewed my CT scan with me, and pointed out several lymph nodes indicating spread as well as multiple, tiny nodules in my lungs which were worrisome for metastasis. This means that we thought we might be early Stage, say 1-2, when in fact based on his assessment we were at least Stage 3, most probably Stage 4, or the highest. Based on these worrisome findings, I got a PET CT scan later that afternoon to assess the possibility of metastatic, Stage 4 disease. I also got scheduled for a surgical biopsy of a tiny nodule in my right lung to assess with finality if the lung spots were cancer or were inconsequential little specs. The PET resulted as definite lymph node involvement, so we were at least confirmed Stage 3, pending Stage 4. I really liked this surgeon, he knew everything he could about me as soon as I walked in the door, and he was very hopeful about my possible response to treatment, which is great to hear in the same visit as my cancer morphed from early to probably the highest stage. 

7/30/2020 - I met with my gastrointestinal oncologist who specializes in esophageal cancer. He agreed with the need to know if my lungs had cancer, and rightly explained to me that he couldn’t tell me much of anything in terms of a plan until we knew what the lung spots were. Basically, the generalities he could provide were Stage 3 meant chemo then surgery to cut the tumor and part of the esophagus out, Stage 4 meant no surgery and just chemo/radiation treatment. 

7/31/2020 - I had another endoscopy with an ultrasound to look at the shape/growth of the tumor in the esophagus. This again supported Stage 3 disease, but couldn’t tell us about the lungs. Later in the day, I med with a radiation oncologist to discuss possible treatment plans if I turned out to have Stage 4 cancer. 

8/1/2020 - I had a VATS (Video-Assisted Thoracic Surgery) with wedge resection of my right lung. Basically, they used cameras and tiny tools and snipped a very tiny piece of my lung out. 

I woke up and the surgeon came to tell me that he had taken the lung sample to the pathologist himself and it was in fact metastatic cancer, we were Stage 4. 

8/2/2020 - Back to the hotel with Amy, and this week was early on filled with Amy searching tirelessly for us a short term apartment to get treatment at MDACC as well as some ancillary appointments with a nutritionist, infusion clinic for a port for chemo, and a few other miscellaneous trips the lab for blood work. 

Starting tomorrow:

8/8/2020 - I will get my port placed and begin chemotherapy. I’ll be on Oxaliplatin and 5-Fluorouracil. I’ll take the Oxaliplatin via the port for 3 hours once, then take the 5-FU in pill form for 1 week. Then one week off, then repeat the cycle. For a total of 8 weeks, then we’ll reassess with a scan to see if the tumor has responded well to the chemo.

We ask that you pray for us, this has been a hard whirlwind of a couple weeks. But thankfully, we know our God is not shaken by this diagnosis and every bit of this wind whips and stills by His authority. Please pray in all these things that the Lord’s will be done, it is way better than ours, regardless of how we might perceive it. Please also join us in enjoying the grace of God that He gives us to ask something of Him and in His lovingkindness, gives attention to what we say. It is our desire that the Lord might use this place, these doctors, and these medicines as a means of his grace to us for healing. 

By the grace of the Lord via my brother Kam Pugh, I was guided to Psalm 46 on a day when I was quite well-exhausted from everything. This simple, profound Truth lifted and restored my soul in a way I haven’t been refreshed by the Lord before. Verse 1, “God is our refuge and strength, a very present help in trouble.” This rang true for me this week, and it will ring True for eternity to come. We’re definitely in some trouble, but we have our refuge, strength, and very present help in the midst of it.

Thank you for praying with us and encouraging us. May the grace and peace of our Lord Jesus be upon you. 

- Sawyer and Amy