2018 Blog

Phase 2 Trial of Potential Prostate Cancer Vaccine, ProscaVax, Soon to Enroll Early-Stage Patients

bjgabrielsen : August 17, 2018 12:25 am : 2018, Treatment Information

OncBioMune Pharmaceuticals will soon start a Phase 2 clinical trial of its investigational vaccine ProscaVax in men with early-stage prostate cancer under “active surveillance”. ProscaVax consists of a combination of the PSA protein produced by the prostate gland with the cytokines interleukin-2 (IL-2) and granulocyte-macrophage colony stimulating factor (GM-CSF). [Cytokines are molecules that participate in immune responses.] This will be the first time that prostate patients will be treated with a vaccine rather than waiting for disease progression or being exposed to more invasive treatment options that frequently are accompanied by unpleasant side effects such as incontinence and/or impotence. Scientists will evaluate whether the vaccine leads to a change in prostate cancer progression compared to patients on “active surveillance” in which disease progression is monitored before other strategies such as surgery or radiation therapy are considered. PSA doubling time and adverse effects will also be assessed.

Treatment arm-patients will start with a 4-month induction period, being given six (6) doses of ProscaVax at weeks 1, 2, 3, 7, 11, and 15. This period will be followed by maintenance injections once every month and alternating between low-dose IL-2 alone and the ProscaVax vaccine for six months.

OncBioMune reported results of a Phase 1a/1b study in January, 2018 showing that ProscaVax reduced tumor growth in 70% of recurrent prostate cancer patients after a minimum of 31 weeks of treatment. This result added to previously reported positive safety data. Trial results at 19 weeks of treatment also found that ProscaVax stopped disease progression in 80% of patients.

The single-site trial is expected to finish in August, 2022. It will be conducted at Beth Israel Deaconess Medical Center in Boston, MA and includes the Dana-Farber Cancer Institute. Information about this trial was published in the July 16th, on-line edition of Prostate Cancer News Today to which readers of this website are urged to subscribe.


----------------------------------------

Both Enzalutamide and Apalutamide Delay Prostate Cancer Progression in Men with Non-Metastatic Hormone-Resistant Prostate Caancer

bjgabrielsen : August 12, 2018 9:42 pm : 2018, Treatment Information

In catching up on some news from a few months ago, I realized that much had been written recently about treating men with an early stage of advanced  prostate cancer. So here is some information in addition to the following posts; The FDA Approves Apalutamide for Some Men with Prostate Cancer; and  Xtandi Extends Metastasis-Free Survival in Hormone-Resistant Men with Rising PSA according to Phase 3 Study.

Over the course of prostate cancer progression, there can come a time during which the cancer is progressing, but there are no treatments known to improve survival.  One of these “empty spaces” is when men who are being treated with androgen deprivation therapy (ADT) see their PSA levels begin to rise (indicating the cancer has become resistant to ADT and is starting to grow again), but no metastases are visible yet on scans.  This clinical state is termed “non-metastatic hormone-resistant prostate cancer” (non-metastatic CRPC).  Many of these men will ultimately go on to develop metastases and lethal prostate cancer.  Until today, there were no other options and these men often just continued to receive ADT despite its diminishing benefit.

At the 2018 ASCO Genitourinary Cancers Symposium, held February 8-10 in San Francisco, California, results from two randomized phase 3 clinical trials, SPARTAN and PROSPER, may have filled this empty space.  Enzalutmide (Xtandi®) and Apalutamide (Erleada®; ARN-509) are two highly similar hormonal treatments that when added to ADT (or whatever treatments were already being used) were found to significantly delay the onset of metastases and several other measures of cancer progression in men with non-metastatic CRPC.

In the PROSPER trial, investigator Maha Hussain, MD (Northwestern University), tested the addition of enzalutamide vs. placebo in 1,401 non-metastatic CRPC patients who were continuing to receive ADT despite a rapidly rising PSA.  Enzalutamide was found to delay the time to metastatic disease by 22 months on average, compared with placebo.

In the SPARTAN trial, investigator Eric Small, MD (University of California, San Francisco), tested the addition of apalutamide vs. placebo in 1,207 non-metastatic CRPC patients with rapidly rising PSA,  in addition to whatever treatment the men were already receiving (mostly ADT). Apalutamide was found to delay the time to metastatic disease by over 24 months on average.   The full results from the SPARTAN study were simultaneously published in the New England Journal of Medicine.

This could be amazing news for patients with CRPC. “We don’t yet know if either apalutamide or enzalutamide increases the survival duration in these patients, although early indication is in that they will,” said Philip Kantoff, MD, Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center, who led the discussion on the trials at the Symposium.  “Patients do need to be aware that these treatments when used early, can cause greater treatment exposure and greater chance for toxicity including a small chance of unexplained death.  Nonetheless these trials may change practice patterns in a major way and provide treatment opportunities for men with no current effective therapies.”

These two treatments are highly similar oral medications, differing chemically by only a single atom.  They have since been separately licensed and developed by different pharmaceutical companies, namely Astellas Pharma (enzalutamide) and Janssen (apalutamide).  Apalutamide is a new medicine, whereas enzalutamide is already FDA-approved for metastatic CRPC.  Both of these treatments are now under review by the FDA for use in non-metastatic CRPC, and decisions – and the change in practice that will accompany an FDA approval — are expected very soon.

For additional information, see the Prostate Cancer Foundation Feb. 28th Newsletter.


----------------------------------------

The FDA Approves Apalutamide for Some Men with Prostate Cancer

bjgabrielsen : August 11, 2018 10:51 pm : 2018, Treatment Information

I realize this is somewhat old news but I’d like to share it anyway. On February 14, the Food and Drug Administration (FDA) approved apalutamide (Erleada) for men with prostate cancer that has not spread (non-metastatic) and is resistant to standard hormone therapy, also called androgen deprivation therapy (ADT). In the clinical trial that led to its approval, treatment with apalutamide decreased the risk of metastasis or death by more than 70% compared with placebo.

In the phase 3 trial (dubbed SPARTAN) that led to the FDA approval, men with hormone-resistant prostate cancer and no metastatic disease detectable by standard imaging tests were randomly assigned to receive apalutamide or placebo in addition to ongoing ADT. All participants were at high risk of metastasis based on rapidly rising prostate-specific antigen (PSA) levels. The study was sponsored by Janssen Pharmaceutical Companies, the manufacturer of apalutamide.

The median length of time from the start of treatment to when tumors spread (metastasis-free survival) or the patient died was 16 months in the placebo group and 40 months in the apalutamide group. Men treated with apalutamide also went longer without worsening symptoms of cancer progression. Even when their cancer progressed on apalutamide and they went on to receive another therapy, these men had longer time to progression with the subsequent treatment than men in the placebo group. The median length of time patients were alive after the start of treatment (overall survival) was 39 months for those who received placebo and had not been reached at the time of the study analysis for those who received apalutamide. An early analysis suggests that apalutamide may reduce the risk of death from prostate cancer, but longer patient follow-up is needed before the researchers can confirm this.

Apalutamide is the first drug to be approved by FDA based on an improvement in metastasis-free survival. Traditionally, most approvals are based on an improvement in progression-free survival or overall survival.

“These are very dramatic results and, in many ways, exceeded our expectations,” said lead investigator Matthew Smith, M.D., Ph.D., of Massachusetts General Hospital Cancer Center.  “We’re learning that using hormone therapy earlier in men with prostate cancer can delay metastasis and probably improve survival. But the balance of benefits and potential side effects will need to be evaluated on a patient-by-patient basis,” said William Dahut, M.D., head of the Prostate Cancer Clinical Research Section of National Cancer Institute’s Center for Cancer Research (NCI-CCR).

While apalutamide—and, potentially, enzalutamide (Xtandi)—gives men with non-metastatic hormone resistant disease a new treatment option, this patient population may decrease in the future, Dr. Dahut noted. That’s because traditional imaging techniques such as a CAT scan may not be able to detect tiny metastatic tumors, he explained. But a technique being used in research studies called molecular imaging  can catch smaller tumors. If molecular imaging tests become part of clinical care, more men with prostate cancer might be classified as having metastatic disease. “It’s highly likely that apalutamide would be active in men with metastatic hormone-resistant prostate cancer, Dr. Dahut speculated. Trials to evaluate apalutamide in this patient population are already underway, Dr. Smith noted.

For additional information, see the March 8th, 2018 NCI Cancer Currents blog.

Related blogs describing apalutamide were published on this website. See February 16th, 2018 and  November 10th, 2017 posts.

 


----------------------------------------

Xtandi Extends Metastasis-Free Survival in Hormone-Resistant Men with Rising PSA according to Phase 3 Study.

bjgabrielsen : July 20, 2018 1:02 am : 2018, Treatment Information

Men with nonmetastatic, castration (hormone)-resistant prostate cancer (CRPC) and a rapidly rising prostate-specific antigen (PSA) level are at high risk for metastasis. Currently, only one recently approved treatment, Erleada® (apalutamide), is available to these patients. Xtandi®, an androgen receptor inhibitor, is an approved treatment for metastatic CRPC patients. It has been shown to delay disease progression and prolong these patients’ overall survival.  In a recent article published in the June 28th, 2018 issue of the New England Journal of Medicine, researchers hypothesized that enzalutamide (Xtandi®), which prolongs overall survival among patients with metastatic, hormone-resistant prostate cancer, could also delay metastasis in men with nonmetastatic, hormone-resistant prostate cancer and a rapidly rising PSA level. In this double-blind, phase 3 PROSPER trial, asymptomatic men with nonmetastatic, hormone-resistant prostate cancer and a PSA doubling time of 10 months or less and who were continuing androgen-deprivation (hormone) therapy received enzalutamide (at a dose of 160 mg) while men receiving only placebo and standard hormone therapy were randomized in a 2:1 ratio. The primary end point of the study was metastasis-free survival, the length of time a patient lives without cancer spreading or until death from any cause. Secondary goals included extension of the time to PSA progression and to the first use of a subsequent anticancer chemotherapy, patients’ overall survival, and safety.

A total of 1401 patients (median PSA doubling time, 3.7 months) were enrolled. As of June 28, 2017, a total of 219 of 933 patients (23%) in the enzalutamide group had metastasis or had died, as compared with 228 of 468 (49%) in the placebo group. The median metastasis-free survival was 36.6 months in the enzalutamide group versus 14.7 months in the placebo group. The time to the first use of subsequent chemotherapy was longer with enzalutamide treatment than with placebo (such therapy was used in 15% vs. 48% of patients) as was the time to PSA progression (37.2 vs. 3.9 months.) At the first interim analysis of overall survival, 103 patients (11%) receiving enzalutamide and 62 (13%) receiving placebo had died. So median overall survival had not been reached. However, the researchers noted that more patients receiving the combination therapy died without detectable development of metastasis than was seen in the placebo group. In these patients, no trend regarding the cause of death was found, and only two deaths were considered to be related to Xtandi treatment. The researchers noted that these patients were elderly, with a median age of 80 years in the Xtandi group and 81 years in the placebo group, and they had a high burden of other coexisting conditions. Subsequent follow-up and additional interim analysis are expected to clarify the benefits of Xtandi® in patients’ overall survival in the PROSPER study.

Conclusions from this PROSPER clinical trial indicated that in men receiving the combination therapy the time a patient remained alive and metastasis-free was significantly extended by nearly two years (21.9 months), the time to PSA progression by almost three years (33.3 months), and the time to the first use of chemotherapy by nearly two years (21.9 months), compared to single standard therapy. In men with nonmetastatic, hormone-resistant prostate cancer with a rapidly rising PSA level, enzalutamide treatment led to a clinically meaningful and significant 71% lower risk of metastasis or death than placebo. Adverse events were consistent with the established safety profile of enzalutamide. (Funded by Pfizer and Astellas Pharma; PROSPER ClinicalTrials.gov number, (NCT02003924).

As mentioned above, these findings were recently published (“Enzalutamide in Men with Nonmetastatic, Castration-Resistant Prostate Cancer”) in the New England Journal of Medicine and also summarized in the July 5th Prostate Cancer News Today. (I strongly encourage readers to subscribe to this valuable email resource.)

 


----------------------------------------

Immunotherapy: How the Immune System Fights Cancer

bjgabrielsen : July 14, 2018 3:51 am : 2018, Treatment Information

The National Cancer Institute (NCI), the largest institute of the National Institutes of Health (NIH), recently posted a short (3-4 minute) but very illustrative video showing and describing three ways how our immune system fights cancer. These methods include: a) non-specific immune stimulation, as illustrated in bladder cancer; b) T-cell transfer therapy, somewhat similar to how Provenge works against prostate cancer; and, c) immune checkpoint inhibitors, such as Keytruda and Opdivo, currently the subject of many combinatorial clinical trials against several types of cancer including prostate cancer. This video appeared in the July 11th, 2018 e mail edition of Cancer Information Highlights from the National Cancer Institute, nci@updates.cancer.gov to which one can subscribe at www.cancer.gov.


----------------------------------------

On-going Re-design of this Website and Posts

bjgabrielsen : June 29, 2018 12:14 am : 2018, General Patient Information

This website has been active for some years now and it is about time for an update of the site in general as well as indiviudual posts. The first change we have made is that all of the hundreds of posts have been separated into one of the following categories: 1) General Patient Information; 2) Diagnostics, Genetics and Imaging; 3) Treatment Information; and 4) Encouragement. Each of the four categories will eventually have sub-categories which will facilitate searching. The latter is yet to be done as I have to perform this manually. When  you now see a post, there is: 1)  a box linking the most recent posts as well as an archives area; 2) an area listing the four major categories above; 3) an index to other portions of the site such as lessons learned through my cancer, medical resources, scriptural medicines, my own story updates, and an area which describes how God can help you personally in this disease process; and, 4) an area wherein you can subscribe to receive the blogs automatically as they are posted as well as a comment area (which are greatly appreciated). The home page will also be streamlined. Thank you for your readership over the past years. I pledge to personally continue writing this site as God blesses me with health and ability and the technological help from CrazyTreeMedia, who have been my source of web technology since the site’s inception. I will soon be 77 years old and a cancer survivor since 1995. Thanks for your patience and support.


----------------------------------------

Zytiga Rejected in England as First Line Treatment for Advanced Prostate Cancer

bjgabrielsen : June 14, 2018 6:33 pm : 2018, Treatment Information

The following is bad news for men in England with advanced prostate cancer. The rationale behind making this drug unavailable to men was cost. If anyone here in the US recommends we switch to the British system of health care, this should serve as a wakeup call against it. The therapy as described in the link below has been approved in the USA on the basis of two major clinical trials.

Janssen’s medication Zytiga (abiraterone) was recently rejected as a first-line treatment for newly diagnosed advanced prostate cancer on the National Health Service (NHS) in England following an initial draft recommendation from the National Institute for Health and Care Excellence (NICE). The negative recommendation means Zytiga won’t be made routinely available for men with newly diagnosed metastatic prostate cancer. As it is recommended now, Zytiga will only be prescribed through the NHS for these men once standard hormone treatment or chemotherapy has failed.

In two recent Phase 3 trials – STAMPEDE and LATITUDE – first-line therapy with Zytiga along with steroids and hormone therapy was found to  reduce the chance of cancer recurrence and improve survival, compared to hormone therapy alone. Patients were all at high risk of their disease spreading, and treated earlier, before their disease become resistant to standard hormone therapy. After three years, 83 percent of patients taking Zytiga, prednisolone, and hormone therapy remained alive, compared to 76 percent in the control arm. Also, the combination reduced the risk of disease worsening or death by 71 percent.

LATITUDE  included men with prostate cancer whose cancer had already spread at the time of diagnosis but who had yet to receive hormone treatment. The LATITUDE trial compared patients treated with standard hormone therapy to those treated with hormone therapy plus Zytiga and the steroid prednisone. The combination reduced the risk of death by 38 percent.

“Two clinical trials published last year provided compelling evidence of the huge potential benefit of abiraterone [Zytiga] for these patients,” Sir Harpal Kumar, chief executive of Cancer Research UK, said in a press release, expressing his disappointment.

NICE highlights its key reasons for not recommending the therapy because it couldn’t accurately estimate the drug’s cost-effectiveness based on the data submitted.  NICE concluded they could only recommend drugs that are clinically effective and show value for money compared to current treatment options. In this case, abiraterone has fallen short.  Janssen can now submit additional data to help NICE resolve these questions and review the revised data later this summer, before a final decision is made.

Following this draft recommendation, the Institute of Cancer Research (ICR) also expressed disappointment that Zytiga will not be made available to these patients as a first-line treatment, at least for now. The ICR is now calling for urgent discussions about the data supporting the drug’s effectiveness earlier in treatment as well as the drug’s price.


----------------------------------------

New 2018 Patient Guide from PCF April 2018

bjgabrielsen : June 10, 2018 10:39 pm : 2018, General Patient Information

The Prostate Cancer Foundation recently published a comprehensive patient guide. I may have sent this post before but if not see the following link.


----------------------------------------

A No-Nonsense Look at Prostate Cancer Surgery

bjgabrielsen : June 1, 2018 12:55 am : 2018, General Patient Information, Treatment Information

I recently came across an excellent review on the pros and cons of prostate cancer surgery as published by the Prostate Cancer Research Institute (PCRI). I am linking the review. If you are contemplating surgery, please read it and discuss it with your surgeon. You might also want to verify the opinions expressed in this article with him or perhaps consider other therapeutic options if they apply. This post and its contents is for informational purposes only. Even though I was a satified surgery patient in 1995, and speak highly of my Johns Hopkins surgeon, I realize each man’s situation is different so read and apply it accordingly.


----------------------------------------

God’s Love Endures Forever

bjgabrielsen : May 30, 2018 8:43 pm : 2018, Encouragement

A few nights ago, I could not sleep so I sat up and decided to read something light until I got sleepy. Instead a still small voice inside me suggested I use the time alone to talk to God in conversational prayer. As I often do after thanking Him for a number of blessings in my life and asking for sleep, I began to pray about some medical issues I was going through. The still small inner voice seemed to say to me look back on your life. Since 1986, I had a number of serious medical and physical issues which I had not had prior.  That still small voice (which I believe is God’s Holy Spirit) began to remind me to look back and see where I have been protected by God and His wisdom even through these various physical trials. The book of James 1:2-3 admonishes us to “consider it all joy when you encounter various trials knowing that the testing of your faith produces endurance.” So that night, I recounted past trials in my mind.

Even though my career was in the health sciences, I had been a smoker since the age of 17. After considering quiting several times, in 1989, God told me specifically it was time to quit. He also gave me a plan to do so, namely replacing one bad habit with another less harmful one. While I am not advocating this for everyone, I used the nicotine chewing gum as my replacment habit from which I was weaned some weeks afterward. So with God’s suggestion, power and the gum, I quit smoking on my first try and have not smoked since. However, as a result, to this day, I have a mild case of COPD which is under control. I am sure it would have been a more severe or cancerous  situation had I not followed God’s suggestion. My experience exemplifies a spiritual lesson as evidenced from the life of David in the Old Testament. God may deliver us from various conditions but we may have to live with the consequences.

Late one February evening in 1991, I had worked late and was on my way home driving through a rural farmland area where I lived. I inadvertantly dozed off and hit a tree head-on at 50 mph without a seat belt. I suffered severe life-threating head trauma in addition to multiple bone fractures. I spent the next month in the hospital. Once I regained a semblance of understanding, I received a hospital visit from a Maryland policeman who told me that “something told me to go to the quiet road where you were traveling and I witnessed the entire accident.” He was on site within 1-2 minutes of my accident. Had this not been the case, I would have bled to death from head wounds.

In 1995, I was diagnosed with early stage prostate cancer which has been documented on this website under My Story (link). It is now 2018 and my cancer is still present somewhere in my body though I am physically asymptomatic. God has given me excellent physicans to this day for which I am extremely grateful. This condition led to the inception of this website which I have had the blessing of writing and trusting it may have helped a few other men along the way with similar conditions.

In the winter of 2000, I was newly married. One Saturday afternoon, I developed chest pains which could not be distinguished initially from angina or acid reflux. After an overnight hospital stay, doctors concluded it was angina and a helicopter was summonned to fly me to a Washington D.C. heart center. However, it was a bitterly cold and snowy day and the chopper blades were frozen. My wife Marie to whom I was newly married. Being a person devoted to prayer, she immediately asked God for His help. Within minutes of her prayer, she was informed that the chopper blades were defrosted and I was on my way to Washington. A stent was placed in my right coronary artery and two days later I was back at work. I am asymptomatic to this day.

Most recently in March, 2018, I was working in my Florida yard when I noticed my speech was slurred. I recognized this immediately as a stroke symptom and was rushed to a local hospital emergency room which was surprisingly totally devoid of patients at the time. Fortunately, the stroke was minor and I suffer only mild speech impairment. Subsequently, I was prescibed a full strength aspirin as a prevention of future strokes. However, this full strength aspirin led to a bleeding condition which I have had. Instead, an 80 mg “baby” aspirin was substituted by my neurologist which seems to be working to this day as a compromise stroke inhibitor without the subsequent bleeding.

Looking back, I have seen God’s hand in delivering me through these events. The next morning, I happened to read a devotional in the May 17th edition of Our Daily Bread in which the anonymous writer of Psalm 136 encourages the reader to remember the events of God’s deliverances and praise His goodness. The psalmist describes God’s attributes as the One who does wonders, who created the heavens, earth, sun, moon and stars. The writer cites numerous examples of God’s mighty deeds for the Jewish people through the years. These include protecting them from the pursuing Egyptians by parting the Red Sea, protecting them from other enemies, and providing physical nourishment in the wilderness.  At the end of each citation through the entire Psalm, the writer states the refrain “His love endures forever.”  While He did not part a Red Sea for me, He protected me through all the experiences above. It prompted me to see God’s protection for me personally and verify that indeed “His love endures forever”. For other personal life lessons, see the following website section; Lessons Learned. 

One day, my life will most likely end. But I pray that God’s mercy will be manifested therein as well knowing I will be transported to heaven and eventually a new earth with a new body forever.  Then I will experience the ultimate example of “His love endures forever.” According to 1 Peter 1 3-6, “Blessed be the God and Father of our Lord Jesus Christ, who according to His great mercy has caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead, to obtain an imperishable inheritance reserved in heaven, …….even if for a little while we are distressed by various trials.”  Putting faith daily in God’s promises and looking back on His past protection and mercy, takes a lot of anxiety out of the aging process. Truly “His love endures forever.”

For more information about experiencing God’s love personally, see the following link.


----------------------------------------

New Prostate Cancer Screening Recommendations for Men Aged 55-69.

bjgabrielsen : May 17, 2018 3:15 am : 2018, Diagnostics, Genetics, Imaging

In early May, the United States Preventive Services Task Force (USPSTF) finalized its new prostate cancer screening recommendation, which upgrades its recommendation for men 55 – 69 years old to a C rating. While the updated rating is a step forward, many say it’s not enough. The decade-long message that discouraged men from getting tested has led to an unprecedented increase in prostate cancer deaths this year – an anticipated 10 percent jump, according to the National Cancer Institute. The previous recommendation deterred men from a simple blood test and was a barrier to early detection (which would have saved countless lives).

“The fact is 99 percent survive prostate cancer when it’s caught early,” according to Jamie Bearse, CEO of ZERO – The End of Prostate Cancer. “Left unchecked, survival rates plummet to 30 percent if prostate cancer is found in an advanced stage. Unfortunately, the C rating is still insufficient and dangerous for high-risk men or men who – without testing – will develop unchecked aggressive or advanced disease.”

The new rating from the USPSTF stipulates that with regard to the prostate-specific antigen blood test (PSA), there is “at least a moderate certainty that the net benefit is small”. The previous D rating – which remains in place for men 70 and over – labeled the PSA test as doing “more harm than good,” and strongly discourages physicians from using the test for men at risk for the disease. At ZERO, we meet active and vibrant men 70 and older leading amazingly impactful lives. We believe these men deserve to know their PSA levels and make an informed, personal decision about options should they develop the disease.

“We need to make sure men know that PSA testing leads to a life-saving diagnosis,” Bearse said. “We’re hearing about advancements in screening and diagnostic tools every time a medical journal publishes a new issue. The technology exists to put men with aggressive disease on the right treatment pathway while not harming those with indolent tumors.”

See the following link and short video for more information.


----------------------------------------

Waiting, Submitting and Trusting – an Often-Needed Message

bjgabrielsen : May 5, 2018 5:31 am : 2018, Encouragement

Seven Sisters Waterfall, Geiranger Fjord, Western Norway

We who struggle with various medical conditions are often either seeking guidance from God about specific decisions or awaiting results and answers to our prayers. In Psalm 130, the author writes about being in deep distress facing a situation that feels like the blackest of nights. He writes in verse one “out of the depths I cry to You Lord; Lord, hear my voice. Let Your ears be attentive to my cry for mercy.” But in the midst of his troubles, he chooses to trust God and stay alert like a guard on duty charged with announcing daybreak. “I wait for the Lord, my whole being waits and in His word I put my hope. I wait for the Lord more than watchmen wait for the morning (v.5-6).” The anticipation of God’s faithfulness breaking through the darkness gives the Psalmist hope to endure even in the midst of suffering. Based on the promises of God found throughout Scripture, this hope allows him to keep waiting even though he has not yet seen the first rays of light.

In Psalm 130:5-6, the word “wait” appears five times. In God’s development of our personal faith, He often delays an answer to prayer to deepen our trust in Him. At times this can be perpexing. Asking for His intervention often carries a sense of urgency. We pray, “Lord, I need Your help now!” But “waiting on the Lord” takes discipline and develops a perseverance in our faith that only steadfastness can yield. Remember Abram waited years for Isaac, the child God had promised to him. This came about only through his wife Sarah’s unlikely conception when she was advanced in years and well beyond the age of childbearing. Abram waited on God in prayer and eventually God granted him generations of offspring too numerous to count. (Genesis 12, 16 and 17).

What prayers are you waiting for God to answer?  In what ways might your heavenly Father be developing your faith as you wait? Be encouraged if you are in the midst of a dark night. The dawn is coming. In the meantime, don’t give up hope but keep watching for the deliverance of the Lord in one way or another. He will be faithful. A good prayer would be “please bring light to my darkness. Open my eyes to see You at work and to trust You. Father, I am grateful that You are faithful”. If you are unsure of your own personal relationship with God as your heavenly Father, see the following link.

The above was an excerpt from the May 1st, 2018 devotional written by Lisa Samra appearing in Our Daily Bread, published by RBC Ministries.


----------------------------------------

« Page 1, 2 »