Marshall's Cancer Updates

A Chair with a View: Rooftop Cows at Northwestern Children's Hospital UPDATE (5/24/2024): I had the follow-up with the oncologist today. In discussing side effects with the palliative care specialist, I noted that I had much more energy last week while I was taking steroids in preparation for the transfusion. I asked if there were meds I could take to help combat the overall fatigue I've been feeling -- steroids, Adderall, cocaine . . . what do I have to lose at this point? She laughed and said that yes, it's become fairly common to prescribe Ritalin (Methylphenidate) to help with the fatigue during the day. She wrote me a prescription for 5 mg at 8 am and again at noon if I needed it. How many other helpful meds are out there that I don't know about unless I ask? I met with Dr. G, who said that the Northwestern tumor board recommended against surgery and radiation for the kidney mets, partially because of additional mets in my lungs that we had skimmed over when readin...

Papa's Chair May 23, 2024 The last 3 weeks between infusions have probably been the best for me in a long time in terms of dealing with side effects and being able to visit with family and friends. Lots of quality time -- eating, drinking, hanging out, pleasant naps in the afternoon, short walks, longer drives. A visit from Cornelia with lunch al fresco at the Hemingway Bistro in Oak Park, Illinois. A long, first class flight on Delta down to New Orleans to spend a week with my brother and his family. A lot of quality time with my granddaughter Otilia. It's all gone remarkably well, given a Stage IV diagnosis.  For this last appointment, it was time for a CT scan to check on disease progression. I had to drive an hour and a half, practically to Rockford, to climb into an available CT scanner last Wednesday. I still can't lift my right arm over my head, so that was a bit of a struggle. They finally let me leave it by my side. By Friday, I had seen the results in my online ch...

Needlepoint by Cornelia. Quote from The Sopranos It's been two months since my last post. Everything is pretty much humming along as best as can be expected.  After I was sent packing by the University of Michigan in February, we returned to Chicago to meet with Dr. G. at Northwestern on March 8th for a consultation. Instead of Gemcitibine, which Dr. Q had recommended at UofM, Dr. G. recommended Pemetrexed, a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help cancer cells multiply. The side effects are supposed to be milder than the other chemotherapies I've been on (First Line treatment with Carboplatin and Paclotaxel; Second Line treatment with Docetaxel and Ramucirumab). I'm hoping for a somewhat improved quality of life with this regimen. To help with the side effects that I do expect, they've prescribed a steroid (dexamethasone), folic acid, and B12.  There's a pretty st...

It's been over a year since my first diagnosis (1/24/2023) and just shy of a year since my first staging at Stage IV (3/3/2023). I'm still here. February 7th: Mojo Nixon died today. Or was that yesterday, I'm not sure. It was probably after midnight and this side of the International dateline, so I'll assume it's today. For those who don't know, Mojo Nixon was an iconoclastic rockabilly/psychobilly satirist who got his start in the mid-80s, taking aim at Reagan era corporate America with songs like "Burn Down the Malls," "I Hate Banks," "Destroy all Lawyers," "Debbie Gibson is Pregnant with my Two Headed Love Child," "Elvis is Everywhere," "Don Henley Must Die," and "Jesus at McDonalds." He was an imperfect encapsulation of the counter-cultural rage in that industrial wasteland, the musical equivalent of Texas Chainsaw Massacre .  Looking back through recordings of Mojo -- interviews and MTV ...

#WinterDriving #35ontheInterstate #LakeEffectSnow The night before my most recent infusion, we met with Cornelia and Jack at Sava's in Ann Arbor for dinner. There was some kind of sportsball game on the television that everyone seemed interested in, a post-Rose Bowl championship game happening. We left before the college-town fanatics streamed onto the streets of Ann Arbor and started setting everything on fire. Good thing they won. The session at the Rogel Cancer Center went without a hitch, though they were backed up in the infusion room and we had to wait a while for an open chair. We arrived at 11:30 am for lab work, then met with Dr. Q at 12:30 to go over the lab results -- all good reports in terms of kidney function, liver function, heart, and lungs. Dr. Q was upbeat about the response to Docetaxel and the mildness of the side effects which were much gentler than this past summer. We parked ourselves in the waiting room for the infusion bays by 1:00 or so for a 2:00 appointm...

Back in Chicago Erstwhile: after researching the University of Michigan's clinical trial for treating advanced Stage IV non-small cell lung cancer:  Ramucirumab Plus Pembrolizumab vs Usual Care for Treatment of Stage IV or Recurrent Non-Small Cell Lung Cancer Following Immunotherapy, Pragmatica-Lung Study, I finally decided to sign up for the study and start treatment in Ann Arbor. I  cleared all their protocols and scheduled the first session for December 19th. I'll still check in with Dr. H from time to time in Reed city to keep that link open. In mid-December, Dr. Q called me to tell me I've been randomized into the control group. This means that a computer has decided that I should be in the group that receives the standard care for 2nd line treatment for metastatic lung cancer after an unsuccessful first line treatment of chemotherapy (carboplatin) plus immunotherapy (atezolizumab). At least it's not a placebo. The experimental group, as opposed to the control grou...

The short version  For those whose impulse is "too long; didn't read" but still want to be in the loop, this section should get you caught up. I emailed a version of this to family members, so some of you may already be familiar with this information. I've joined the clinical trial at the University of Michigan's Rogel Cancer Center. Pre-trial scans (CT and MRI) over the last couple weeks all look good: no new brain metastases and little disease progression with bone mets and other lesions, which was surprising to me.  Over the next couple weeks, I will be sorted into Group A (control group/standard of care chemotherapy with Docetaxel) or Group B (experimental group/immunotherapy with Keytruda).  I should know right away which group I'm sorted into. I'll start infusions every 21 days beginning on December 19th for up to 2 years, or until the drugs become hypertoxic or stop being effective. -------------- The long version It's been one year since the fi...