All posts by Jeffrey Poehlmann

Frying Pan, Meet Fire – Leaping from One Therapy to Another

I knew that I would not stay on chemotherapy forever. So getting to the point where I ended my “chemo journey” was not completely surprising. In fact, I had anticipated that a change would be good for some time — after over 2 1/2 years of the same routine, not only had it begun to gnaw at me each time I faced another infusion and ensuing side effects, but there was something of a “gut feeling” that the chemotherapy drug I had been on for so long had done about all it could do. I was probably influenced a lot by the promise of Immunotherapy drugs that had become the media darlings of the cancer world. When my oncologist said it was a good time to consider another approach, I was eager to do it.

Besides immunotherapy, for which I had hoped to join a clinical trial, there was the possibility that I might harbor an actionable gene mutation for my adenocarcinoma. My initial genetic analysis from a biopsy prior to starting chemo had shown none of the mutations that were being directly treated at that time. But a couple of years makes a big difference in the cancer world, especially with the increasing rate of progress science has been making over the past few decades. A re-analysis of that old biopsy showed nothing new, but a quick, painless liquid biopsy — two simple tubes of blood and fifteen minutes of my time — revealed that I harbor a fairly rare mutation, one that affects roughly two percent of  the adenocarcinoma subset of lung cancer patients: ErbB2, also known as HER2.

This shifted gears for me regarding the drive down my treatment path. It also made me shift perspective. There is the question, now, of whether finding myself in such a cancer minority is a sign of good fortune. On one hand, it means that my genetic demographic is not highly studied — the downside to minority group patients is simply that there are fewer of us to put into clinical trials. Flip that over, however, and it makes the trials that have been done highly specific — and it makes the case studies on patients with this mutation also highly specific. Which in turn suggests that this might be a very positive development after all. Continue reading Frying Pan, Meet Fire – Leaping from One Therapy to Another

Side-Effects I Won’t Miss: The Chemo Diaries, a Coda

My treatment is far from done, my “cancer journey” only partly traveled, but I am saying goodbye to chemotherapy — at least for now. Forty rounds of infusions came to an end last week and, though my brain is fatigued and my body is a bit of a mess, I’m taking a moment to appreciate the things I definitely will not be missing.

Topping my list, even above the malaise and nausea that sometimes follows my treatment, is:

#1, The Uncontrollable Gag Reflex.

It’s been a nasty thorn in my side, that gag reflex. Just brushing my teeth will set it off, causing me to wretch over the sink, even if it has been a long time since I ate. And scents of any kind have been known to cause gagging, too — and not just the smell of rot or the cat box or whatever was thrown in the garbage can the night before, but, yeah, all of those, too. Goodbye, gag reflex!

#2, Grimy, Oily-Feeling Skin

The days following my infusion are better with frequent showers. As I purge toxins, I always imagine that I smell horrible — and, in fact, I often cannot stand my own odor. But beyond that, my skin just feels gross. I’ve had the weirdest blemishes, well beyond any teenage acne I experienced in my wayward youth, and it wasn’t always easy finding soaps that I could tolerate in the enclosed space of a shower. Waking with a slick layer of grease on my face and a sticky sensation all over my body (worse on hot days, of course), mixing thick perspiration and whatever else is pushing through my pores, is an experience I am more than ready to be done with. Continue reading Side-Effects I Won’t Miss: The Chemo Diaries, a Coda

Common Sense, Clarity and Wellness Warrior Lies

As long-time readers know, I take issue with a number of high-profile “wellness warriors” and anti-science advocates who claim to offer “natural,” “holistic,” or simply “alternative” treatments that can cure cancer or prevent it entirely. Chief among these are Chris Wark and Ty Bollinger, two people with absolutely no scientific or medical training and tons of bad advice. They are part of a large network of disreputable and largely discredited hucksters, many of whom get by on their claims by offering just the tiniest shred of truth mixed in with their hyperbole and insidious messages. They thrive in our increasingly anti-intellectual culture, where headlines and sound bytes sway their customers and their “fan base” into believing that there is substance to their messages. This is why, more than ever, it is essential to take a critical approach to all the medical headlines that are presented, and especially those making extraordinary claims.

The well-established and professionally vetted website, Healthline, has a very good primer on the subject of spotting fake medical news. It could hardly be more topical. There is nary a day that goes by when some website or other isn’t making absurd claims about the latest health craze or danger. Whether it is bloating the risks of GMO foods or misrepresenting the cancer risk from eating red or processed meat, there are more sources out there in the ether intent upon cherry picking data or simply removing it from context in order to sell their point than there are serious outlets for the reporting of science news. Part of the problem with this is that science news isn’t usually considered very sexy or commercial, but a bigger problem is that it is generally difficult for most people to fully understand.

And capitalizing on that, we have opportunists like Chris Wark, a self-proclaimed guru on defeating cancer without chemotherapy. Duly note, of course, that Mr. Wark was cured through surgical intervention and, while chemotherapy was recommended as an adjunctive treatment to lower the risk of future metastasis, there was no indication that he had any actual, existing metastases that needed treatment. To put it bluntly, he was one of the lucky colon cancer patients who had it all taken out without any recurrence. This had nothing to do with whether or not he received chemotherapy, and there is no way of knowing how he would have responded to such treatment or whether his “lifestyle” choices have had any bearing whatsoever on his post-surgical health. Continue reading Common Sense, Clarity and Wellness Warrior Lies

A Conversation About Critical Thinking

Why is Critical Thinking important?

Arguably, we live in a time when it has become increasingly important to carefully parse data, even, as it turns out, in casual conversation and friendly communication. The rampant spread of misinformation in the Age of Social Media is nothing new. Conspiracy Theorists and intentional hoaxsters have been an ever-more-apparent online presence since the rise of newsgroups. Even in those near-forgotten days of Lost History prior to our every moment getting logged for “posterity” in the cloud, we had plenty of access to active (and more easily identifiable) paper sources of deliberate misdirection ranging in credulity from The Weekly World News to The National Inquirer — publications finding a non-ironic insurgency in recent years as their online brethren like NaturalNews, InfoWars, and WorldNewsDaily have added to the fodder for the less-Luddite paranoid contingent.

For the sake of reason, it is essential for all of us to adhere to certain standards of Critical Thinking. Just for purposes of general, civil communication, we should all want a basic, coherent understanding of the facts of our world. Philosophical differences aside, it should be a simple task to understand the foundations of science and recognize pseudo-scientific rhetoric as what it is; it should be easy enough to discount rigorously anti-intellectual arguments and logical fallacies

Lately, I have written a few posts on critical thinking and promised an interview on the topic. Although I recorded this some weeks back, I have finally delivered on the promise to upload it.

Click here to listen to The Deep Breath podcast.

Logical Fallacies, the Enemy of Critical Thought

Following are a few fun pages that list logical fallacies. They present them differently, so it is worth visiting a few of the sites to get a feel for how they lay them out or categorize them, but generally speaking, they cover a lot of the same ground. Enjoy the journey!

Logical Fallacies Handlist

YourLogicalFallacyIs

Common Fallacies in Reasoning

Master List of Logical Fallacies

Drake’s List of the Most Common Logical Fallacies

Wikipedia List of Logical Fallacies

Fallacies: Alphabetical List

Logical Fallacies


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Chemo and I Had a Pretty Good Run

My recent post on dealing with change and adversity was inspired in no small part by a change I am facing in my own life, one rife with uncertainty and heavy with anticipation. The last CT scan I had showed that my primary tumor, the one by which we gauge progression or lack thereof, was still within the technical boundaries of business as usual. That is to say, its lateral dimensions had not changed significantly since the previous scan, and overall had not grown enough over the similar measurements from a year or two years ago to precipitate anxiety. But CT scans are, for lack of a better term, a bit fuzzy. The images are fairly clear, but the data is difficult to measure with absolute precision.

My first CT scan machine from October 12, 2014, and still one of the more peaceful places I know. I have taken about a dozen rides through that hole by now.

Because CT scans are essentially three-dimensional, but are viewed on two-dimensional screens, comparisons between scans are inherently imprecise. The angle of a subject’s body, how inflated the lungs were, the position of the subject within the imagining chamber, all figure into subtle differences between the final scans. On top of that, because the images are basically multitudes of cross-sectional snapshots, a comparison must be made by selecting the closest approximation to the “same” image between scans from different times. I’ve looked at lots of these — in fact, I keep digital copies of all my scans for reference or posterity — and I’ve used the tools to line up and measure my tumor as best I can.

And in two dimensions, at the standard viewing cross-sectional approximation, my mass looks very similar from scan to scan, every three or so months since this process began. My chemotherapy was clearly doing what it was intended to do, which was to prevent progression of the disease. Progression is generally defined in terms of the length of the tumor, but we all know that tumors are bundles of cells that grow and change along more than just one axis.

I was never under any illusion that the chemo would cure me — there is no official cure for Stage 4 Lung Cancer. Any time that the chemotherapy could afford me by maintaining stasis has been considered a luxury and at over two and a half years on this particular regimen, I have been the longest continuous success case that many on my medical team have known. So the next time I see most of them will be a special, bitter-sweet occasion.

Because the time for change has come. Continue reading Chemo and I Had a Pretty Good Run

Beyond the Shame of Change, Adversity, and Grief

Nothing is forever, as the saying goes. And it seems true in terms of human experience. Change is inevitable. You can’t please all the people all the time. Time will tell. What doesn’t kill you makes you stronger. But, of course, you can’t judge a book by its cover because the grass is always greener on the other side. Also, that thing about picking your friend’s nose.

I am clearly not above the occasional inspirational bracelet.

Just not that one about everything happening for a reason. I’ll concede that there are certainly arguments for cause and effect — in fact, very much so, which is essential understanding when it comes to actually dealing with the issues that are thrust upon us in spite of our best efforts and desires. To suggest that everything happens for a reason is immensely wrongheaded and, even with the best of intentions, is ultimately unhelpful.

This does raise the issue — when suffering or change of any sort occurs — of how one is to cope if there is no purpose behind the suffering or change. Continue reading Beyond the Shame of Change, Adversity, and Grief

Flying on Chemo — Latest Post for LungCancer.net

July is devoted to issues surrounding travel over at LungCancer.net, and I’ve added this small contribution to the discussion. The story centers around the one-year anniversary of my diagnosis — and a good reason to get on a plane.

 

Flying On Chemo and Other Fun Ideas - LungCancer.net

Jeffrey Poehlmann- My wife, who cares about me deeply, is inclined to encourage me to rest. This is especially true for the week following my chemo infusion, though any time she sees me on my feet for an extended period, carrying “too much” around or otherwise pushing my body forward with some task, I’m likely to get the suggestion to “take it easy” or, more bluntly, “go lie down.” It isn’t that I don’t understand why — especially if I’m wearing shorts. My legs have taken to swelling up like I have elephantiasis some days, though thankfully it is just water retention… READ MORE

©2010-17 Health Union


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The Meaning of Normal

I have been fascinated by the suggestion that life with cancer somehow equates to “a new normal” in my families existence. I don’t know what that is supposed to mean, exactly; isn’t “normal” supposed to be an objective center, a median experience, the fulcrum of an ever-swinging scale? But nowhere does the relative nature of normality present itself so clearly as with the slide into a chronic, managed illness.

Read the full post here.

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Time to End the Anti-GMO Fearmongering

Here’s a thought that needs to be considered. Since the United States is not doing its part to fight global climate change, nature will not be able to keep up. This REQUIRES us to be open-minded about the advantages science offers to help our species adapt. Science-denial is one of the biggest reasons we are in this mess, but science can help mitigate the damage if it is embraced and supported in a reasonable, methodical and pro-active manner. One of the areas that must be re-evaluated by many is the use of GMO crops.

GMO vs Non-GMO corn crops.
Sometimes a little modification goes a long way.

There is overwhelming evidence from unbiased sources that show the safety of these crops, many of which are modified explicitly to be able to grow under hotter and drier conditions, or in soil that would not otherwise support proper plant development. Already, without the use of GMO crops, it would be difficult to keep up with the food production needs of the planet. Within the next decade, there is little doubt left that human food will be largely reliant upon GMO crops for minimum sustainability. I propose that it is time to look at the science objectively and stop reacting to fear-based marketing that mostly just serves alternative health websites and their advertisers or overpriced processed food manufacturers.

Continue reading Time to End the Anti-GMO Fearmongering

Critical Thinking and the Rush to Organics

From the Forbes.com article by Steven Savage, “Why I Don’t Buy Organic, And Why You Might Not Want To Either”

In the spirit of an interview I will be conducting tomorrow on Critical Thinking, I invite you to check your confirmation bias before reading the link below. Now, more than ever, this is becoming an essential skill, especially in the age of social media and 10,000 clicks per second “information” sharing.

Also essential is the ability to differentiate legitimate viewpoints from pure nonsense. (“Nonsense” would be any argument for the existence of chemtrails, for example.) A “legitimate” viewpoint always requires two things: clear logic and reliable sources. This is an incredibly low bar, but people, it seems, are often inclined to stoop much lower.

As a disclaimer, I buy a lot of organic food. But not because I think it is safer or healthier. I am much more inclined to buy LOCAL, which has a greater positive impact than organic and often tastes better, too, though I am fortunate enough to live in an area where much of the local is organic, if that is what I am looking for. But I have also talked with people who source organic for their products about why sometimes they specifically choose non-organic, not the least reason being that it is often ethically superior and more environmentally friendly NOT to be organic. Organizations like the EWG (Environmental Working Group) tend to only tell a distorted part of the story, and they certainly present data from a heavily skewed perspective (we expect this from corporate mouthpieces for Big Agriculture, and the EWG is no different — it is just a corporate propaganda arm for the organic foods industry).

But, like I said, if you can, let go of your confirmation bias. Assume that what you “feel” isn’t necessarily true. Assume that you are wrong, or at least only partially right, and that maybe you will find something to fill in the blanks and help you arrive at a reasonable conclusion. It’s good practice. We all need it. Only an exercised skill stays sharp and critical thinking is no different.

Read this article by Steven Savage and feel free to come back here and comment.

Then go get something fresh to eat.