Tag Archives: Education

Dropping the Cancer Bomb

Dropping a bomb or sabotage — what does it feel like when you get the news of someone’s cancer second hand or by accident? That is what I have been pondering this afternoon since offhandedly mentioning my blog address in conversation earlier, without pausing to put its content in context. Since I don’t look like I am sick, a non-subtle reveal that I have lung cancer can be like a slap across the face. It’s a shock. One I deliver, I expect, far more often than I intend to.

I’ve been told on more than one occasion that it should not be my problem, that I should not feel obligated to hold somebody’s hand when I tell them about my “health condition,” and that I cannot be responsible for another person’s reaction to my disease. But I also consider the reality that most people know someone, quite often family or a close friend, who has struggled with a form of cancer. Depending on where you get your statistics the numbers vary slightly, but no matter which source you use the bottom line is that over a third of us develop some form of cancer. That means out of every ten people you know, three or four of them are likely to have cancer at some point in their life. It is no surprise, therefore, that on my street alone I know of seven patients — and I should stress that those are only the ones I know of within less than two blocks, not necessarily the absolute total for the street. Also, I’m not particularly social or friendly, in case that is relevant to knowing what neighbors are up to. In other words, there are probably more of us on this stretch already.  Continue reading Dropping the Cancer Bomb

Some Thoughts on Death and Dying

The past few days have been interesting, in the way that might make a person both sad and angry, and hopefully also touch into a compassionate spot. After a lot of attention had been given to the hurricanes that battered our nation last month, highlighting both the devastation of nature and human resilience, it seemed that we were due a period of celebration. Instead, music icon, Tom Petty, died (prematurely reported, retracted, and ultimately, with some finality, reported again). And just before that, on the last night of a big music festival in Las Vegas, a so-called “lone wolf” gunman managed to use a stash of roughly 20 weapons (at least some of which were modified to be more deadly) to kill in the neighborhood of 60 innocent people, wounding hundreds of others. He did this from a hotel room in a very fancy casino across the street, using long-range rifles. It’s enough to get a person ruminating on mortality. As if living with stage 4 lung cancer wasn’t enough.

Before I get too self-indulgent, however, I should put my thoughts into perspective. Death doesn’t bother me so much; I do not hold onto a fear of dying and I cannot recall a time when I did. But I do have a deep and consistent anger about enabled murder, preventable deaths and injuries (both physical and psychological), and the lack of public will to address the underlying issues that allow such things to continue happening. And in that regard, I suppose, I do have a fear of getting shot. In almost 50 years, I’ve been lucky enough to have been directly threatened with a gun only once — but I’ve still been threatened with a gun. It is hard not to think about these things when a mass shooting happens just a few blocks away from where you had been lying poolside about a month earlier. Continue reading Some Thoughts on Death and Dying

Spoiler Alert: Side-Effects Show Up

It has been over two weeks since I began taking my new drug, afatinib. Over two weeks of feeling good, feeling like the chemo has been thoroughly flushed from my system even as I have diligently taken these new pills, feeling the best that I have in three years. I have been keeping a journal this time, chronicling how my body is responding each day, trying to pave the way for a better understanding of how to live with this new treatment. For the first week, anyway, it almost seemed like it was going to be too easy.

There are two weeks of video updates on my Patreon feed, talking about how great I feel and wondering how bad the side effects will be once they really kick in. I had been prepped by my oncologist that it was very likely that I would experience worse side effects than I had with the chemo I had been taking. This was based on how well I tolerated pemetrexed, the chemotherapy drug that had kept my cancer at bay for so long, but not so much on patients in general having a particularly tough time on afatinib. Which is not to suggest that I expected a walk in the proverbial park with this new drug.

Still, the first week was amazing. It was almost like I was taking nothing at all. Sure, there was some digestive stuff going on, but nothing outside of the realm of what I would have been used to in a previous life if I decided to live off of bean burritos for a few weeks. And I love a good burrito, so it would be worth it. But by day eight, I realized that the side-effects of the drug were presenting themselves quite visibly. Continue reading Spoiler Alert: Side-Effects Show Up

Interview With Radiation Therapist Turned Stage IV Lung Cancer Patient

I meet a lot of interesting people through my lung cancer support group. Most of them are on some form of chemotherapy. A few have tried immunotherapy. Some targeted drugs have been in the mix, along with surgery and radiation. The one commonality between them is their optimistic perseverance. But it isn’t rooted in blind optimism or faith — the whole point of the group is to share perspectives and experiences, gathering useful knowledge in the process. We all come with our own perspectives that inform our decisions and influence how we share, most of us having begun as (more or less surprised) patients that have evolved into advocates. Once in a while, a patient arrives with multiple perspectives built-in, hardwired to see her situation from both sides of the exam table.

And if I’m really lucky, she lets me interview her for my podcast:


 

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Radon Gas, The Invisible Cause of Lung Cancer

I recently received a kind email about my blog from Jessica Morgan, who works with a radon testing and mitigation company based in the United Kingdom. Outside of smoking, radon gas exposure is one of the more common known factors for increasing the risk of lung cancer. In the message, she asked if I would be interested in an infographic her company had created called The Dangers of Radon and its Health Effects. According to their website, radon gas exposure is responsible for approximately 1,100 to 2,000 lung cancer deaths each year in the UK. Estimates for the US suggest between 15,000 and 22,000 deaths occur annually due to lung cancers related to radon gas exposure. Clearly, this is a serious and persistent issue.

 

Admittedly, I don’t know a whole lot about radon gas outside of having researched to see if it was a probable cause for my cancer diagnosis. The types of structures I have lived in and the locations of my previous homes indicated that there was no likely connection between my personal lung cancer and radon gas exposure. However, it is a subject that  I think is highly relevant to the greater lung cancer discussion and is an essential part of understanding that lung cancer is not simply a smoker’s disease.

 

Because radon gas is not one of the areas of my own specialty, I asked Jessica for some information that I could share. The following information comes directly from PropertEco Ltd, and was supplied to me by request as educational material based on their expertise in the field.

Continue reading Radon Gas, The Invisible Cause of Lung Cancer

Inside a Chemo Clinic Phamacy

Where the concoctions are prepared.

Before I concluded my chemotherapy, I sat down with the pharmacist who had mixed my drugs for nearly three years and recorded our conversation for my erstwhile podcast, The Deep Breath. It offered a revealing look inside the process of administering chemo, as well as other drugs used to treat cancer patients.

Meet Evan, the pharmacist. Click his image to hear his insight into the treatment of cancer through pharmacology.

I did not realize that I was one of the longest consistent patients currently receiving treatment at this facility. Although I was preparing to call chemo quits after slightly more than 2.5 years, I knew of at least one patient who had been on the same basic regimen as me for around seven years. But that had been before my time. As I settled in to interview my pharmacist, he revealed that he was not aware of any patient at the clinic who had been receiving chemotherapy as long as I had been since he started the job. I appreciated the special distinction, even though I had mixed feelings about it. Continue reading Inside a Chemo Clinic Phamacy

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

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