James has sailed through his first round of the "gentler" chemo. It is a mix of topotecan & cyclphosphomide, and is administered daily over the course of two hours through is central line for five days. This is done at the Oncology Clinic at St. Jo's right here in Peterborough, which is very convenient. We are extremely grateful to all those in the local medical world who have made this possible. James goes to school when possible and always gets a warm welcome from everybody. At home he plays noisily with his brother and sister, laughs at this own jokes, feeds the hamster, and lifts everyone's spirits with his joyous attitude.

     Although to all outward appearances James looks great, the results of his latest set of scans tell a different story:

1. Cancer can be found more or less throughout his body (widespread metastatic disease)

2. When comparing with the scans of 10 weeks ago, it is apparent that there is less cancer in certain area (e.g. abdomen) but more in other area (e.g. bones)

3. The recent bone biopsy was positive for neuroblastoma (James' type of cancer)

     All of this is a stark reminder that a relapse of stage IV neuroblastoma post bone marrow transplant is no picnic. The Hospital for Sick Children is at the forefront of worldwide research into neuroblastoma, but the sad truth is that none of the many clinical trials going on around the globe have found a cure. We know that HSC will facilitate any treatment worth doing.

     Your support and friendship continues to mean a great deal through these difficult times and we continue to be inspired by your prayers and expressions of love. We are planning another time of prayer and laying on of hands (Murray St. Baptist Church). Thank you for helping make every day a gift.

Syd & Pam Birrell, and family

     P.S. We continue to appreciate soups and fruit salads, especially during times when we're at the hospital.