Cancer Battle Update -- CEA Dives; Photos of my Oncology Team

Hawaii Therapy

Thanks to the many friends who have asked for blog updates. Sorry it has taken so long to post this one. The cancer battle news continues to be good – my oncologist Dr. Roger Shiffman is still very pleased with the progress. My CEA in mid-June was down to 380. In mid-July, it was 54.6! This measure of cancer presence was nearly 3000 when treatment began in April.

Pascale and I recently returned from some Roger-approved Hawaii therapy. We spent the first week honeymooning in our favorite place on the planet, the north shore of Kauai. I had been dosed up with chemo just before we left, so I was very tired and the facial rash limited my swimming in the ocean, but just breathing the air and experiencing the light and scent of that beautiful place was a treat.

Our second week of the trip was spent in Honolulu, and by then the chemo wore off. I attended the INFORMS Board Meeting and the IFORS international Operations Research conference. I had been feeling disconnected from my profession for the last three months. It was great to reconnect with friends from around the world, and to hear new research results. I had committed to giving a talk at the conference long before I got sick. Normally, I over-prepare for these talks, with numerous slides. This time, I lacked the energy to do that and just gave an old-fashioned talk – leaning on a lectern, telling a story. The audience seemed to like the retro style.

A great benefit of the conference being in Honolulu was that we got to see Pascale’s son Alec. Since getting out of the military, he has been living there. He is an entrepreneur, managing one coffee shop and owning another. It was fun to see him in his element and admire his focus on making his business a success. Alec came over to the OR conference and met a number of my friends. His reaction was wonderful – he said he never met a group of people before who enjoyed their work so much. He has a lot of math talent, and expressed an interest in learning more about OR.

Depression

It is hard to admit, but the truth is that being a cancer patient can get a bit depressing. Thankfully, the really scary times are behind me – I know I am going to beat this thing. But it gets old when you have been physically and mentally active all your life and now you have low energy day after day. It is especially hard in the summertime, missing out on the activities I love: hiking, biking, swimming, backpacking, kayaking, and so on. I lack the stamina even to read books or work hard on an OR problem.

I resisted at first but started taking an anti-depressant (Paxil) suggested by Roger. A conversation with Nancy Brown helped me make this decision. I said that the circumstances of my current situation could not be changed by a “happy pill.” She said that’s true but the pills can help improve the way you feel about the circumstances. This is an experiment still in progress. It takes time for the anti-depressant to have an effect.

The Next Step: Surgery in Philadelphia

Pascale and I are traveling soon to Philadelphia, where I will have the colon tumor and stint surgically removed. Why surgery now? Why Philly?

If my cancer had not spread from the colon to the liver, then there would have been a surgery at the outset to remove the colon tumor. But that would have been ill-advised because it would have left the liver tumors unattended and allowed them to grow. So we started with chemo to zap the tumors in both organs. (The body cannot take chemo while undergoing and recovering from surgery.) Now the liver tumors have receded enough so they can be ignored for a few weeks, while we concentrate on totally curing the colon.

The colon surgery is called a resection. They cut out the bad part and reattach the loose ends like a garden hose. Apparently, we have lots more colon than we need and it stretches easily, so this is not too tricky. The tricky part is that in the last few years, led by the Mayo Clinic, a few colon surgeons have learned how to do this surgery laproscopically. That means through the belly-button. The advantage is that the recovery period is much shorter than if the surgeon cuts through the abdominal muscles in the old-fashioned way. Quick recovery is important, not just for comfort’s sake, but so we can get back to killing cancer cells in the liver as soon as possible.

My brilliant niece, Dr. Jessica Rosenthal Berman, practices oncology in Abington, a suburb of Philadelphia. She has a surgical colleague and friend at Abington Hospital, Dr. Steve Fassler, whose practice is limited to colon surgeries and who has already done 500 of these surgeries through the navel. Jessica says he is a master, that when she sends her cancer patients to Steve, they are ready to resume chemo in about two weeks. Other than the Mayo Clinic, I don’t know where else to go for such an experienced and highly recommended surgeon. (My good friend Terry Cryan says that there has been a trend in the last ten years for top docs like Steve to move from the famous teaching hospitals to private hospitals in nice places to live.)

So Pascale and I will spend three weeks on the east coast. We will have a visit with my parents before the surgery. (I still have some hair on my head, so I think it will be possible to conceal the illness from them. My beard is quite full now, so that will create some distraction.) It will be great to see them, and my brothers and other family.

Steve says I will probably spend 2-4 days in the hospital and then will need about two weeks to recover before traveling back to California. Jessica has so kindly offered to put us up at her and her husband Jeff’s house for the recovery period. She also invites any of our east coast friends to drop by.

Despite the inconvenience of traveling so far for surgery, I am very pleased that I will be getting top quality care, and especially, having Jessica available to keep her eye on everything.

That’s the news for now. Thanks again to all the dear friends and family who have been supporting me in so many ways.



With my amigos, Wilson Price and Harlan Crowder in May.




Here is Roger, at work on designing my chemo cocktail.




He treats the whole patient: body, mind and spirit, not to mention caring about the family.


Here is what happens when I get fired up on Erbitux. Looks like a pretty bad sunburn, and it feels worse. Fact is I have been completely avoiding exposure to the sun. The good news is that when the chemo drugs cause a nasty reaction on the skin, it is very likely that they are also causing an especially nasty reaction on the cancer cells. I'll take that deal. Fortunately, the skin reaction wears off in a week or two.

Some of Roger's staff: Lindy, Jessica, James, Vivian and Beverla. Vivian is fondling the infusion machine that I spend a lot of time hooked up to. These people are very bright and caring. They do a great job for all the patients.