Marshall's Cancer Updates

Giving Thanks, November 2023 In my last update a couple weeks ago, I wrote about needing to make a decision about next steps for second line therapy -- whether to go with the Pragmatica-Lung Clinical Trial, a prospective randomized study of Ramucirumab plus Pembrolizumab (Keytruda) in a 3 hour IV infusion every 3 weeks for 2 years (or until it stops working or becomes hypertoxic) or to go with standard of care, which is Ramucirumab plus Docetaxel chemotherapy for two years or until hypertoxic. In messaging with our primary oncologist, Dr. H., we learned that if I start another round of chemotherapy, I will be disqualified from joining the clinical trial. In that case, it would make more sense to start with the Pembrolizumab trial first and then switch to Docetaxel later if that's not working. Of.course, if I end up in the control group, I'll be prescribed Docetaxel anyway. When pressed about whether to join the clinical trial at UM in Ann Arbor or one of the same trials at ...

MRI: Not quite sure what I'm looking at here, but I thought the eyeballs looked cool.  Teaching   There are only a few active weeks left in the semester, and my students in creative nonfiction have been incredible. They're a small group of very talented and self-motivated writers and have been gracious about my lapses. I've nearly caught up on scoring and commenting on their work, but there's also a lot of peer feedback and they are all quite skilled at that. Nearly all of the students are writing consultants in either the writing center or the embedded writing specialist program. We had a fantastic face-to-face session this last week with Curtis Chin , author of the new memoir Everything I Learned, I Learned in a Chinese Restaurant .  Curtis Chin. That's me in the (back left) corner. I'm thinking that this might be my last semester of teaching, and what a good class to go out on. I'm looking into extending my paid medical leave through May, taking summer of...

From the New York Times : "One of the great joys of the Jazz Fest is the odd parade that occasionally takes over the pedestrian paths, bursting through the center of the fairgrounds with an explosion of color, sun-brellas, horns, feathers, and fancy footwork. This apparently chaotic event is called a second line. "The second line is a type of parade historically associated with jazz funerals; the term "second line" is often thought originally to have referred to the secondary group of participants in such a parade, behind the band and the family . "Second line" is also used to refer to the distinctive dance moves that can be glimpsed during New Orleans street parades of all sorts." It’s clear that my treatment team is transitioning me from curative treatment to palliative care that attempts to arrest disease progression and provide a measure of comfort. I've reconnected with the palliative care team for pain management and to alleviate side effect...

An existentialist gazes into the abyss; the abyss gazes back.  Existential Comics: The Elflord and the Mayfly In " Hour of the Mayfly: Life and Death the Existentialist Way ," Tim Raynor writes, "The Existentialist philosophers . . . were so impressed with the transformative power of death that they made confronting death central to their philosophical way of living. Death, Existentialists argue, brings life and its possibilities into focus. In the process, it reveals what we are ultimately capable of being. Heidegger argues that confronting death brings to light ‘the totality of our potentiality-for-Being.’ In a moment of vision, we grasp our full sphere of potential – a realm of potential that is ours and ours alone, that we may or may not take advantage of. We catch a glimpse of our whole person, our total capacity to exist. "     “There is no Stage 5.”  John "Johnny Sack" Sacrimoni,  The Sopranos ,  Season 6, Episode 14 .   I talked to Dr...

This is my first update in about 6 weeks, since the past month and a half has essentially been about flushing the chemo out of my system and getting in a few rounds of immunotherapy. I’ve now surpassed the 6 month median survival rate or life expectancy ( outdated statistics , perhaps) for Stage IV adenocarcinoma non-small cell lung cancer , counting from the initial staging on February 28. That’s certainly reason to celebrate. Physical Therapy is going well and I’m developing much more mobility in my right shoulder with the humerus implant as well as gaining a bit of strength. I still can’t lift a coffee cup to my mouth with my right arm, but it’s getting there. I’m largely alcohol free, but if I could stomach a martini or Manhattan, I’d probably spill quite a bit of it trying to get it to my mouth, whether with my bum right arm or my non-dominant left hand. My PET scan was a week ago in a trailer connected to the Reed City Hospital -- I guess a semi-mobile lab for the area similar t...

Greg and I escorting Betty to the clinic. Photobomb by NASA. It's been a while since I last posted because it feels like there's no real news yet. My fourth and hopefully final chemo session, according to the initial treatment plan, was on July 24th. I didn't ring the bell ( IYKYK ) because it didn't really feel like a major milestone yet. The CT scan, as I said in the last post, was promising -- the tumor in my lung has shrunk and has cavities, which the oncologist says is evidence that the cancer cells inside have died. He described it as a house without people in it -- it eventually deteriorates and collapses in on itself. There was no evidence of spread to lymph nodes or other organs. I still have to wait 3-4 weeks for the PET scan to make sure and the next appointment with the oncologist to go over the results on September 8, but all indications are that we are beating Stage IV cancer into remission. Pretty amazing, really. My oncologist admitted that I'm likel...

Homemade Pierogi by Corrine July 16, 2023 Yesterday was day 11 after chemo session 3. On schedule the same as the first two sessions, the side effects from the  Neulasta Onpro  patch kicked in full force. Fortunately, I knew to be prepared to spend the day in bed under sedation.  I'm feeling better today and have stopped taking the Oxy. One more week until the final chemo session. Last week, I had a CT scan to check on the progress of the treatment, and the results were promising. The tumor has shrunk by a full centimeter and shows evidence of cavitation, which means that it's dying. All my lymph nodes are clear and there's no evidence of metastasis in my liver or kidneys or any other organs. The oncologist got in touch the next day to say that he is very happy with the results. I'll have a PET scan after the next/final round to make sure, but it looks like the treatments are working as hoped. I feel like oncologists, in general, are optimistic about treatment, if fo...