Good News So You Must Pay Up

Happy Agnostic Chanukah (much belated), Merry Agnostic Christmas, or the Agnostic Winter Solstice Holiday of Your Choice

I am not dying . . . quickly. Had my CT Scan on Tuesday and the news was good. Lots of shrinkage of tumors in the liver and on the Pancreas where it all started. The regimen for the time being is: I get a shot of Sandostatin, which has positive effects on my health, limiting the effects of my cancer on my digestive system and greatly remunerating a pharmaceutical company. It is also literally a pain in the ass.

I am also scheduled for a consult with a surgeon on December 30, so we will see what possibilities there are in cutting me open and removing these tumors. Again not a cure, but a strong possibility of positive outcomes. If enough tumors have shrunk or disappeared, than they can get the scalpel out. I’ll keep you updated.

Now in the holiday spirit, open your wallets and as you make your annual holiday charitable donations, I hope you will consider the most important one: ME! Please send your checks to: . . .
While I might not turn away your checks, I hope you will instead consider a small (or enormous, if you got it) donation to the Caring for Carcinoid Foundation. http://www.caringforcarcinoid.org/ Okay it is my most self-interested appeal, as it funds the research that could potentially save my life. Not only that, but for the holiday season there is the Goldhirsh-Yellin Foundation Awards Major Challenge Grant to the Caring For Carcinoid Foundation. That’s $1 million challenge in matching funds. It is really easy to meet the challenge, just donate and then you won’t feel guilty.

The interesting part of this appeal is that the only reason you even heard of this foundation or would donate is me. (Aren’t they lucky I got cancer?) And that the odds of any of their research helping me is not great, nonetheless there is a self-interested aspect to it. It would have been much simpler if Steve Jobs, who died of pancreatic neuroendocrine tumors had donated a few hundred millions before or after he died and we would have clinical trials galore by now. Unfortunately, Jobs was a strange man who was in denial about his cancer and sadly died prematurely because he did not take action quickly. For whatever reason, neither he nor his wife funded any research. But I digress . . .

The cancer community is quite fascinating in its own right. With modern media, even predating the internet, but especially since, whole communities develop around cancer and other diseases. All we have in common is the same variety of killer cells growing in our bodies, but they bring us together for advice on doctors, treatments, diets, coping, conferences, thankfully, not usually, prayers. I think this is due, in part, to the confusion as to how conduct prayers in such a diverse community. Yet I might be wrong, at least hatred of cancer is something we all agree on and doctrinal differences can be ignored. A proposal for our faith: the “Church of we all hate cancer and all the other shitty diseases that kill people prematurely” The name is a little long, but I can work on shortening it.

The notion of dying prematurely is an interesting one. I haven’t done much historical research on this, but our notion of a long life and fighting disease have changed so radically. In 1900 in the US, the average life expectancy for a man was 46.3, so I wouldn’t have much to complain about then. Nobody had a clue of what to do with cancer; you just died. Public health science had just figured out germ theory, teaching surgeons to wash their hands before cutting their patients open. That was a great advance!

Another aspect of dying is the issue of when to stop treatment or take extraordinary measures. I remember this clearly when my Grandma Ellie died at 90. Aside from her chronic depression, she was obese with type 2 diabetes. At the end, they amputated one of her legs, she was clearly dying and was ready to go. I don’t remember all the details clearly from nine years ago, although she did ask my mother to push her out the window of her hospital room in her last days. As the end neared my mother and her siblings made a decision, that was clearly attuned my grandmother’s wishes, to let her die as peacefully as one could and to stop extraordinary measures to keep her alive. I am sure if my grandmother isn’t anything more than ashes in an urn she would be pleased.
As for me, I’m not dying particularly quickly, but the idea of when one might want to stop treatment and pump me up with morphine is not ever present in my mind, yet it is something I think about. And on that upbeat note . . . happy Saturnalia!

Dreams of Prostate Cancer

My dream is to live long enough to be diagnosed with prostate cancer. So why do I want another cancer. It’s not for extra Sloan Kettering hot chocolate, however tasty it might be. Nor is it for the possibility of extra radiation or chemotherapy, despite their inherent appeal. No, it’s based on the statistical certainty that all men will eventually get prostate cancer, so if I live long enough to have prostate cancer than I will have beaten the odds on neuroendocrine tumors. Many of you may not be aware that when I first got the cancer diagnosis, the oncologist in Brooklyn added a PSA test. The results were so high that I got to have a full prostate exam followed by a prostate biopsy. While I would have preferred a vacation to North Korea, in part because I am not a relative of Kim Jong-Un, the tests came back negative. What we later discovered was that the PSA test was a marker for my cancer, since it went to normal when my tumors shrunk.

That brings us to the good news. My blood tests are all normal or very close to normal and my PSA test has dropped and is now in the normal range. My cancer antigen test is still in the stratosphere, but has been dropping, leading to the conclusion that my cancer cells are still crying in pain. The bicycle barometer also indicates that I am in good health. I’ve been doing 19 mile rides with laps in Prospect Park and my last two weekend rides I did 54 and 46 miles. After getting my folding bicycle fixed, I have been commuting to work by bicycle. While this may seem slightly crazy given the cold, but by dressing in layers, a ski helmet and a balaclava it is actually much fun and I do not get cold. Anyone want to join me?

The day of discovery is drawing near. Next Tuesday I have my CT Scan and will see what the tumors are up to. I am hopeful, since, except for some mild pains in my back, I am feeling quite well. I have now had no chemotherapy since June and after recovery from the radiation, this is the longest stretch I have had of almost feeling normal. That is if you ignore the neuropathy and the periodic diarrhea, which can thankfully mostly be ignored. In any event, let’s hope for good news next week.

My final thought is that your life is never the same after you are diagnosed with incurable cancer. It’s a little like a Bar Mitzvah. “Today you are a man.” “Today you are a cancer patient.” Both are very important milestones in a person’s life. At one you read from the Torah, have a party and get gifts; the other you get radiation, chemotherapy and the near certainty of a shortened life. Okay, maybe they aren’t alike, except if you eat too much at the Bar Mitzvah party, you’ll get sick and vomit. Vomiting, that’s the connection!