CANCER / Eat your broccoli! … and what I told the Angel

CANCER / Eat your broccoli!

One year ago this week I returned home from Walter Reed after having part of my lung removed for cancer. Three more operations for more cancer elsewhere would follow through the end of September.

Have completed my one year checkup. No bad in sight. The Robin Williams suicide has made me reflect. In the middle of my chemo and radiation treatments I remember thinking that if an Angel appeared and said I could let go if I wish and move on: I would have. Cheerfully.
If the Angel were to visit me today: Kiss my ass. I ain’t going anywhere. Life is good. … but darkness can visit us all.

CANCER / HOPE / =^) … DNA technology provides new outlook

CANCER / HOPE / =^) … Met with Oncology today and my current health assessment: Am healthy in every way except for the effects of radiation and chemo … but am doing well in living with that. There are no detectable indicators of cancer (blood/chest xray/urine/physical exams for tumors, etc.). Comprehensive testing (MRA/PET Scan) will begin in February or March once my body settles down from radiation treatment — which creates false positives.

They had more good news … recently published research links specific DNA markers within my cancer with a potentially fatal weakness identified in the cancer … the tradeoff is that I must continue on with more chemo to get the possible payoff.

I want to see grandbabies and grandpuppies and see if social security gets fixed and to be a pain-in-the-ass factchecker for another 10-20 years.

Sign me up! I told the doctors — but I did have one question: Is it possible to get my chemo in chocolate flavor? … because the regular stuff sucks!!!

Chemo … my chemical romance with the future

My oncology doctor called and asked me to come in. She wants to discuss my future treatment.

Due to the characteristics of my cancer, my treatment plan has often see-sawed between: do this, cancel that, try this, let’s do next … just a week ago they told me that I could possibly skip the 12 weeks of chemo planned for January-March 2014. Today they say that is still the plan but they recommend continuing with my current chemo past December 13th and continue it into early January.

>>> The GOOD NEWS: Am doing well in all of my checkups. Just last week my internist raved how they ran every body fluid test imaginable and that I passed with flying colors. Some test results even improved from good to better. Not a single test result yielded concern.

Yet I must tell you that I feel like a shell of myself from just a few weeks ago. Yes, that is me just whining. I know that I am going to live and to have a good life to come … but … this has been a very tough week. Doing both daily radiation and chemo has taken its toll on me after six weeks. I am ‘alive’ and that is as good as I feel right now.

Docs says that I am doing ‘great’ … as expected … =^) … but they also want to extend my chemo past December 13th because of the theory: comeback could be a bitch. Since there is no intent of a ‘cure’, just the ability to overwhelm  the cancer now and to manage the cancer in the future, then let’s try to do this right the first time.

I can do the extra treatment … but I barely feel human at this point. Chemo makes the world taste, smell and feel like your body is full of ashes 24/7.

Please excuse my whining. I am an Optimist and  am doing my best to live up to that moniker … but …

CANCER, Kids and happy, happy smiles

I wake up each day smiling. Sometimes it takes me 30 seconds to get in full gear but I still smile … and usually I do so all day long.

This was today’s wakeup video, courtesy of my good friend Connie.

I loved seeing the faces of the kids in this video … and some of the nurses weren’t bad either.

Be brave. Stay strong. Life happens. Smile.

Cancer Coin Toss, Medical Ethics and Burning Bridges … et tu, Fate?

September 12th UPDATE to my original post.

The academic argument has been settled since I wrote the piece below several days back. A CT/PET scan of September 11th shows a metabolically greedy hotspot. That translates to a new cancer has appeared. Will be meeting with doctors on Friday the 13th to battle this and then it is on to the chemo, which I have nicknamed ‘Charlie Cool’. It will be up to Charlie Cool to beat Bad Bart’s ass so that I can wake up one day and take the grandkids to Disney … and since I don’t have any grandkids yet then Charlie Cool is going to need the help of my ever helpful and ever present guardian angels.


It is my week to be a guinea pig.

Met the most enthusiastic senior cancer researcher today. She came in to chat with my wife and I about the different views on where my treatment might be going. Today was the day for me to sign my consent form to begin chemo treatment … yet that will wait another day. It turned into a counseling session instead. Very informative. Very interesting. Bewildering.

She summed up my treatment plan as practicing the art of medical care rather than the science thereof.

The researcher said that my case is getting plenty of discussion among the cancer doctors. And they are involving more doctors to get their opinions, as well.

It seems that the doctors and researchers are uncertain as to what should happen next.

My specific case has three medical ethical challenges:

  • Clinically my body is free of cancer. Taking chemo will hurt my body in some way. To take chemo will be to do some harm with a range of possible side effects. Today I asked the researcher what I have asked the other doctors: whether she believed that my cancer was truly gone. She said that the DNA of the cancer indicated metastasis. Multiple metastases is common.  General consensus is that there is cancer somewhere in my body and it is only a matter of time before it makes an appearance.  Medical “dogma” is however that I should be sent upon my way and that further treatment is unnecessary. “Dogma” was the researcher’s word, not mine … and she used it several times. Appearance of being cancer-free may be an illusion, or it may be real.
  • The second ethical challenge is that even if there is cancer, there is no evidence that the chemo that they recommend for me will work. It is NOT that this treatment has given poor results in the past — it is that the doctors are treating me in the blind because there is almost no data or protocol history to judge how this cancer will react to treatment using chemo. There are well under 50 cases of ENT BSCC, and fewer with metastasis.
    Note: Taking the chemo will probably cause a mutation in any existing cancer, whether it works or not. Radiation is not currently appropriate because there is no cancer to radiate.  If cancer exists microscopically then chemo needs to be a comprehensive first strike. Yet taking chemo now or later will be the equivalent of “burning bridges” (the researcher’s words), because what they have in their arsenal is as good as it gets .. so if an existing cancer mutates, which it should, there are no chemo alternatives for a counterattack.
    Option: Only take two of the three recommended kinds of chemo and save the third type for a later counterattack. Using only two kinds would however remove the ‘comprehensive’ attack approach.
  • Thirdly, to wait for the cancer to return is not such a good plan either … not when it could return in several places that you want to avoid cancer at all costs (bladder, liver, kidneys … almost anywhere actually). Waiting could itself render the chemo of little value if used then instead of now. So saving the bridges from burning now may mean that the cancer burns them later instead, before symptoms present themselves and the cavalry can render assistance.

I do not mean in any way to imply that the doctors are ethically challenged, only that there are challenges which pose ethical dilemma for medical treatment.

Where is it all going? My choice will be either a partial (maybe full) salvation by preemptively weakening the cancer’s ability to return, or a cup of unpredictable hemlock.

The doctors will go with my choice — they are very much refraining from making any specific recommendations … although they are obviously making recommendations just by assisting me so closely in my adventure via tests and an overwhelming collaborative search for options.

The good news is that I am otherwise very healthy, have a great team of curious, motivated doctors that promise to be there for me every step of the way, and I am in the hierarchy of most likely to do well in any treatment … assuming treatment works, whether now or later.

There is no reality check in this situation per se — I may outlive everyone offering me treatment. I am continually impressed by the quality of my care and the willingness of the doctors to brainstorm what it all means.

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Treatment: My consent form will have to wait a week or so later before we get back to it. The docs are giving me tests galore to create a baseline of my body before we do anything. Today I contributed more blood for more tests (but got no cookies for my effort) and on Wednesday I will take another CT/PET scan that can supposedly find cancer down to 5mm in size. Being a good American I have no clue how small that is … except supposedly really, really small … which in this case is a good thing.

Note: My assumption is that they are turning the machine up to its highest setting because previously we were told on several occasions that the standard CT/PET scan was only effective at finding bad stuff at 1cm in size.

Early next week I will do more tests and get a chemo port inserted into my chest and throat.

Then we will all meet again and rediscuss the challenges of what to do next.

 

 

 

Kids and Cancer – September is Awareness Month + SCAMS

Kids – gotta love the kids. Cancer and illness can be hard when you really have not a clue what is happening in your life … except that it hurts, the hurt returns, and bad days are too many.

Also, please be wary of ALL charities. A great many are not worth giving even a penny. Ignore that ‘we are a non-profit’ bogus sell job. A great many charities do very little for whomever they supposedly claim to be helping.

Learn more about Kids, Cancer and Charities.

Cancer - September is children cancer awareness month

UPDATE 8/27: Chemo for life … a lifelong battle begins

Yesterday was a long day. Met with doctors from the John P. Murtha Cancer Center at Walter Reed Hospital.They presented me with the Cancer Board’s findings and recommendations.

It was good news and bad news, but overall not new news. BSCC cancer always comes back.

Back in 2011 they felt positive that they had removed all of my cancer. There was no treatment other than surgery. This time around I am advised that I will need to take chemotherapy for life in what will be a lifelong battle for my life. Murtha doctors recommended that I replace the word ‘cure’ with ‘fun’ — as in I should focus on enjoying life and being with family.

So what will chemo for life get me? They do not know. It is a gamble. Two or 20 or 30 years are possible.

The ugly chemo will last about 12 weeks, starting in early September. There are major side effects, or as noted in my counseling: there are some less common but possible side effects. Just under ten percent of chemo patients taking this cocktail have heart attacks and experience strokes.

What comes next will then be a new form of chemo that has relatively mild side effects — and since I am otherwise in very good health then that is when I should be able to resume life. The stipulation is that we must assume that there is no defeating this cancer. My treatment plan will focus on constantly seeking out cancer cells and trying to keep them under control either through majority eradication or slowing their growth.

If all goes well … life is what it is. I am an optimist. I am giving myself no other choice.

 

UPDATE 8/24: Cancer, Coffee and Cookies

Life is good.

I find it bothersome that I cannot drive when I want. It makes me feel like a 15 year old teen: life is awaiting me if only there was a ride to where life is.

On the other hand, riding in cars currently unhinges me. The left side of my chest and left shoulder blade remain scratched up from the surgery. Basic healing of that should take another few weeks. So far I have left home twice, once to go to church at the Reverend Al’s place and once to the movies … and to go to the doctor’s office for followup health checks.

This coming week starts consultation with the hematology-oncology folks. Will start chemo in September. There is no known effective chemo therapy for BSCC cancer — but since the cancer has shown that it will return, and is mobile in where it returns, then chemo will be one approach to battling or slowing my next battle with it.

Perhaps the more significant fight against cancer’s return will be to eat a some strict anti-cancer diet. I started such a diet in mid-2011 but admit to having strayed. I did eat all the things that I should … but I also ate (often after the first year of recovery) many of the things that I should not: beef, dairy, bread and simple carbs — all of the blessed tasty stuff in life. There will be the occasional chili dog and beer in my life but only on holidays; have considered moving to Germany where they have 22 official holidays annually.

Life is good. I have no complaints. With diligence and proactive advocation for appropriate health care with the doctors then I expect to have decades of good quality life ahead.

Stay curious. Ask questions. Not all answers to your questions are correct. Be your own advocate. Eat chili dogs if the chance presents itself … just not too often.

Cancer, Coffee and Cookies

Luckily I am an optimist.

Gotten a checkup lately?

This has been a challenging summer for both my business and for my health.

I can fix my business but will have to trust Lady Luck and some professional advice when it comes to my health.

In late July I received a call from my doctors that I needed to come in immediately.  My scans indicated that I probably had cancer in my left lung. When I met with the consulting thoracic surgeon he was polite, calm and very businesslike. My wife was with me as he kept it simple: “Mr. Golden, you have cancer in the lung. We do not know what kind it is and it doesn’t really matter. We will take it out next week and come up with a treatment plan afterwards.”

Luckily I am an optimist.

My lung surgery was on August 7th and I really do not remember much about it other than being prepared for surgery and then waking up in the intensive care unit. For four days I lived life with a hose stuck in my stomach running up to my chest to keep things in order. The surgery did not hurt but that damned chest hose certainly did.

A long story made short: In May 2011 I underwent surgery for BSCC cancer, which is a very, very rare cancer. Doctors told me that I was incredibly lucky after the surgery.  They had removed it all with clean margins to make sure that they got it all, said my doctor who was and is a very caring surgeon. Two years of almost monthly check ups said that the cancer was indeed gone.

Research says different. The BSCC cancer always, always returns. It has almost no symptoms and there is not really a treatment protocol known to work. Eventually it comes again for you … and your only defense is to stay constantly aware of possible symptoms for almost any kind of cancer and to get constant checkups. I was just completing my two year checkup for the 2011 cancer when they found a new recurrence in my lung. It is a migratory cancer. You never know where it will appear next.

Luckily I am an optimist.

Doctors felt good about having gotten all of my cancer removed in 2011 and did not recommend chemo. Radiation treatment is out of the question as it is believed that the cancer was caused by overexposure to radiation to begin with. Radiation aggravates and just increases the recurrence rate. Chemo is on the menu this time.

This time we are taking no chances. I will begin chemo in early September. Doctors are still debating what kind might work best for me. None are known to work effectively. The idea with taking chemo this time:  it may not help but what can it hurt when combating a cancer that is relentless. Maybe we can slow its return or slow its growth when it does return.

As for cookies and caffeine: cancer loves sugar. I had altered my eating habits before but this time around I am doubling down on the cancer prevention diet. As for coffee, it is important for cancer survivors to keep their Ph in balance. Coffee can alter your Ph — for now I have these cool little Ph strips that keep me aware of my body’s chemical balance, or imbalance. I can give up cookies but coffee is staying on the menu. It is a way of life for me.

Luckily I am an optimist. For a second time I have overcome cancer in the shortterm and should be able to return to a full and active life … with a cup of coffee in one hand and a checkup scheduler in the other.

Smile. Life happens. I have no complaints. It has been good to me so far. I only see good yet to come.

Gotten a checkup lately?