email sent May 10, 2016

Subject: A Tasty Recipe…
… or, It’s Not What You Think

When I left you last, not so long ago, Vicki and I were faced with a treatment decision. One option entailed radiofrequency ablation (RFA), which involves inserting a probe or two into the center of the tumor then burning it from within. The small size of my tumor and its location near the surface of the lung made it an ideal candidate. Pneumothorax is the most common complication of RFA. I was told to expect both it and a collapsed lung. Those events come with the added excruciating pain of the later removal of a dreaded chest tube (think, yanking on a wound without pains meds). Been there twice. They were among my worst experiences… ever. I didn’t wish to risk an encore, thank you. We passed on this option. Another option consisted of the combination of an immunotherapy drug and a chemotherapy drug. The chemo drug is more benign than the two I had previously received, but still offered many similar potential side effects: hair loss, nausea, vomiting, diarrhea or constipation (huh?), etc. It also is administered with the steroid that robs me of sleep. No thanks. And Dr. Spierer ruled out radiation, I had already reached my glow limit. So, thankfully, the choice of treatment ultimately became an easy one, re-enter the infusion phase of my current study. It’s back to treatment every two weeks, for up to a year.

I hope to weather the current storm with this wonder drug (and its absence of side effects and untoward consequences) until the next, improved wonder drug is available.

And if the recurrence of lung cancer weren’t enough, I learned the following day that a growth on my thigh was squamous cell cancer. Oh great, more cancer stuff to investigate. Surgery had to be performed before I could resume immunotherapy treatment. During my consult, after viewing the growth, the surgeon called it a “pretty straightforward” procedure, a “slam dunk.” It’s always nice to hear such confidence, especially from the national director of surgical oncology. And he’s very tall – perhaps he really can dunk.

On the positive side, wow, I did make it to five years post-diagnosis, and therefore reached the 3% (or 1% depending on the data base) survival milestone. (Five years is the longest follow-up for which I have found survival data.)

Later that day, on the drive from Cottonwood to Flagstaff, I stopped in Sedona for lunch. I chose that stunning route through the luscious Oak Creek Canyon to become imbued with the scents of spring with windows down and moon roof open, to process the events of the previous 24 hours. In Sedona I saw the perfect bumper sticker, for me at that moment and for that of the land of harmonic convergence…
REALITY
IT’S NOT WHAT YOU THINK

The surgery went well today. A 2.5-inch battle scar. Not too bad. In 2-3 days, I’ll hear about the pathology results on the margins to ensure the doc got all of the malignant tissue. (At least I won’t need to wear a bag over my head to hide the stitches and incision, as I long ago recommended to a good friend after her skin cancer surgery. She often reminds me of that well-intended suggestion. I wonder why. Last week, she even went so far as to tell me that I should wear a bag!)

I received many wonderful responses to my last email. I’m always gratified to learn that they are being passed on, especially when at least portions are shared with children. I also enjoy that I can in a small way remind all of us to live in the present and appreciate all that surrounds and infuses us. One great friend wrote of our symbiotic relationships, that the email recipients and I give each other strength. Nice.

It’s time again for some quotes…
“Perfection is not attainable, but if we chase perfection we can catch excellence.” Vince Lombardi
“Hope is a waking dream.” Aristotle
“I find hope in the darkest of days, and focus in the brightest. I do not judge the universe.” Dalai Lama
“Life is really simple, but we insist on making it complicated.” Confucius
“Life is a series of natural and spontaneous changes. Don’t resist them – that only creates sorrow. Let reality be reality. Let things flow naturally forward in whatever way they like.” Lao Tzu
“Faith is taking the first step even when you don’t see the whole staircase.“ Martin Luther King, Jr.

Hope, faith, excellence, simplicity and flow… they comprise pretty good ingredients for cooking up a fine life. But let’s not forget what Mr. Lennon told us, “All you need is love.” Without this icing, the cake is dry and not quite sweet enough.

With immense gratitude and lots of icing,

Jim

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