News Roundup

The blue, sunny skies of July have given way, once again, to the grey, cool, sometimes foggy environment of December.  “Enthusiasm” is not a word I normally associate with this time of the year, but I don’t get as miserable as I used to.  These days we have a very laid-back Christmas season, and the lack of expectations to which I must live up is a great relief.  A few coloured lights adorn the house and the artificial Christmas tree in the living room, and a few Christmas cards give the dining room table a slightly festive look.  A will be home tomorrow, flying in late enough that P and I can take in a party with some friends before going to pick her up.  So, our small family will be together again for the first time in 6 months.  That is a Good Thing, but I have learned to feel the presence of my friends and loved ones even when I am alone.  It would be great to see all of you more often, but I know you’re out there.

My unusually philosophical frame of mind is partly the result of a one-week retreat I was at recently.  Some of you may be familiar with Shinzen Young.  I find his approach to enlightenment refreshing.  He is in the process (multi-year) of taking a hard-nosed, scientific look at what all this “mindfulness” stuff really does.  Working with neuro-types at Harvard, he gets people to try various meditation techniques while they make themselves comfortable in an fMRI machine.  Unlike many of the traditional Buddhist traditions, his practices and explanations draw heavily on psychology and neuroscience, and largely dispense with what I regard as the baggage – the more elaborate rituals and ceremonies, the mystical language, the religious overtones, and so on.  It is something of a chore to learn new mind-training techniques when the ones I have more or less work and feel comfortable, but it is probably a good thing to disrupt my habits.  Familiarity breeds contempt, so it is all too easy to fall into a self-devised formulaic ritual which may reduce the effectiveness of one’s practice.  Furthermore, it is actually quite interesting to pay attention to habits of mind that usually go unnoticed.

Life has been easier to take since I started meditating, and easier still since I started on the IL-2 injections 3 years ago.  Trekking into the city every two weeks is a pain especially in winter, but the treatments are now very routine.   P usually dumps me at the clinic so she can go shopping.

The waiting room has an inpiring  view (see photo), but I rarely get a chance to appreciate it for very long before being shunted off to an examination room.  I call P when the inaccupuncture (about 30 very small but still quite painful needles) is complete, generally in less than an hour.  Then it is home to snooze for the rest of the day and a couple of days of relative torpor thereafter.  There is a somewhat alarmingly large lump on the back of my leg, but the doctors are more curious than concerned, so I follow their lead.  Dr. G expects (“when, not if”) that I will start on some kind of cocktail or combo drug therapy this year, although the recipe is not yet finalized.

My “Life With Cancer” story is still unfolding.  Sadly, this is not the case for two people I know.  Adrienne Lotton, who I introduced to you about a year-and-a-half ago, died from her melanoma in August 2014.  It took me until very recently to work up the courage to check up on her.  Her blog has gone untended for some time, but her obituary is more recent.  In addition, our much-admired friend Bill Gilkerson died a few weeks ago after a long battle with a rare form of leukemia.   He greatly outlived the doctors’ prognostications and was receiving guests at his home until just a few months ago.

Both these people, as well as the brother of Mr. R.J of Calgary (last mentioned here 3 years ago and once more undergoing treatment), were treated with conventional, allopathic techniques and medicines.  In Adrienne’s case this did not produce the hoped-for cure or even much of a respite, but the other two have benefited greatly.  My next door neighbour, in complete contrast, swears by the use of hemp oil to treat cancer.  Other friends have found homeopathy to be very effective for what ails them.  What’s up with all that?

I am a great advocate of the scientific method as a way to discover how the universe works.  Conventional medicine makes use of this method to figure out what causes sickness, and to predict possible ways to alleviate it.  However, no one (in their right mind) claims to know everything about humans, how their biochemistry works, and how their psychology affects their health.  Most reasonably enlightened medical researchers will freely admit this and will be quite open to the idea that unconventional therapies may help.  There are several reasons why such therapies are not embraced by conventional medicine:

• to make use of treatments that lack scientific support is to give them the same level of credibility as those that have scientific support, so even if “it looks like this works for some people, sometimes” doctors will be very reluctant (at best) to condone them until the science catches up.
• to allow others to practice alternative medicine also gives it respectability and allow scientifically unsupportable claims to be made about it; many cases of fraud have resulted (dubious and expensive cancer treatments, for example) because there are no good criteria to separate what works from what doesn’t.
• in some cases attempts have been made to verify unconventional therapies by scientific means, and the attempts have failed (homeopathy, for example);  further scientific experimentation is hard to justify.
• without carefully controlled experiments, manufacturing processes, and so on, “natural remedies” (herbal extracts, naturopathic and health food products etc.) may contain almost anything which may do almost nothing or entirely too much (this food supplement, for example).

Obviously this list is not exhaustive.  Quackwatch is a great place to find out more.

All that said, any profession or discipline suffers from myopia or, indeed, outright prejudice.  Western medicine is largely driven by profit, and pharmaceutical companies are hardly beacons of unfettered knowledge.  It is the devil we know best, and there are several efforts (and here too) to improve it, but there will certainly be times when promising remedies are ignored because it is politically or financially convenient to do so.  So consider, for a moment, what the situation would be like if (say) “conventional” medicine was based on homeopathy:  how would we go about determining what works under what circumstances, what constitutes a therapeutic dosage and what the risks might be of getting it wrong, what might be the most effective lines of research into better treatments, and so on?

Science, or at least the application of the scientific method, is arguably the only reliable way humanity has devised to study our world and how it works.  It is the only “way of knowing” that has a built-in mechanism designed to weed out falsehoods.  Used properly it is a very effective tool and we disregard it at our peril.

I hope you enjoyed this Christmas Rant!  All rational discussion on the subject is welcome, and I promise that I will not censor any politely phrased comments you may have to offer.

Thank you to all who have contributed!  The continuous flow of hopeful news is a real morale booster.

(takes deep breath and dives into teetering pile of URLs…)

Melanoma-specific

• Anti-PD-1 pembrolizumab approved as first-line treatment
• 3-drug nanotech delivery system shows promise
• BRAF-positive outcome improvement with SBI-756
• New class of inhibitory compounds
• Gut bacteria boost immunotherapy
• When melanoma turns deadly
• Counting your arm moles, and counting them again
• Surgery still has benefits
• Stuart McLean has melanoma 😦
• Adrienne Lotton draws short straw in drug trial
• Nivolumab + ipilimumab is a good combo
• Transplant recipients at increased risk
• Interleukin-2 + imiquimod – very similar to what I get
• Sunscreen myths debunked

Cancer in general

• Gene therapy kills prostate cancer
• Making radiotherapy more effective
• Turning off Ras inhibits glioblastoma and also melanoma
• Brazlian wasp venom kills cancer cells
• Nicotinamide (Vit. B3) cuts risk of skin cancer
• Cancer may accelerate with anti-oxidants
• CD4+ > CD8+ T-cells
• Implant ‘traps’ cancer cells
• Putting the brakes on cancer
• Soften up cancers before heavy-hitting
• Brain cancer study shocks scientists

 Other subjects

• Mindfulness helps those with inflammatory bowel diseases
• Keeping Canada Alive – CBC video stories from the health care field
• and just for giggles: this is Dr. G & his brother’s doing

That should keep you busy over Christmas – which I hope you all thoroughly enjoy!  Thank you for staying with me over the years:  I really appreciate it.  Talk to you again in 2016.

News Roundup

As the saying goes, “Time flies when you’re having fun” and I can attest to the truth of this.  Somehow seven months have flown since I last updated this blog.  Did you miss me?  Be honest, now.

What’s been happening to me (in blog order):

Tomorrow I get to see my oncologist (Dr. Mc) and my psychiatrist (Dr. C), both of which appointments I expect to be more or less non-events.  I still have active melanoma and I still have occasional mental struggles, but in general I seem to be staying relatively healthy.

Last week I had a PET scan and Dr. H was kind enough to call me with the results.  Although there are still active areas, she said that if anything the scan is a little better than last year’s.  By way of treatments, I still go for bi-weekly IL-2 shots which still knock the stuffing out of me for a couple of days, but that still leaves me with quite a bit of time to waste on other pursuits (exotic cars, boating, plotting the overthrow of the government etc.)

Speaking of exotic cars, we took a quick trip to Toronto recently so mine could get a tuneup.  This is not the craziest thing I’ve ever done by way of automobile maintenance, but it does come close.  Saw A for a few hours along the way.  She is working as a lab research assistant kind of thing at Queens U. this summer.

Hardcore party people

A few months back I passed another decade marker in my lifetime’s progress.  Back when melancholynoma started I really didn’t expect to see this birthday, so it was a very special occasion.  P rounded up all kinds of people (not sure where she found some of them) for a surprise party. The place was quite packed for a while but by the time the photo was taken many people had wimped out, leaving the hardcore to finish the food and booze.  This we did with relish.  And guacamole. And other stuff.

Too much snow to plough

Winter was only just over by the time the party happened. We were very nearly housebound a couple of times, and on one occasion needed a front loader tractor to dig enough snow off the drive so that it could be ploughed.  I was beginning to regret having ditched my X-skis a few years ago.

A short European cruise and visit to Ireland provided a most welcome break from the weather here.  The tulips near Rotterdam were colourful enough to keep us going for weeks afterwards.

Taking advantage of the miserable winter, P organized a weekend-long retreat at our local Meditation Centre.  Fifteen people came for a fairly solid 12 hours of meditation on a Saturday (including two mindfully-eaten meals) and a further 8 hours on Sunday.  We walked and sat a lot.  It is surprisingly hard to do this.  One uses all sorts of little muscles to maintain even a relaxed posture and, of course, once a muscle starts to get a bit tired and tense it spreads its displeasure to those around it.  I usually feel quite tired both physically and mentally by the end of that much meditation.

Throughout all of this I’ve been spending time on the Support Groups website.  My own problems seem much smaller when compared to what some of the people there go through.  It helps to keep my life in perspective, and practicing compassion is good for my non-soul.

And that pretty much brings us back to Christmas 2014.

I’m not even going to try to list all the stuff I’ve come across in the last six months.  Besides, some of it is probably out of date already.  So, here are the main points of the news:

• Activated T-cell therapy in clinical trial.  Some time ago I talked to Dr. Pamela Ohashi in Toronto about enrolling in some research along these lines.  I never managed to get involved, but they’re making progress without me.
• Herpes can cure melanoma – maybe; also noted here.
• Melanoma metastasis related to immune cell migration.
• Melanoma needs glutamine.  One more way to starve it out, perhaps?
• Better melanoma control with drugs + radiation.  All sorts of options.
• How wound healing influences cancer.  This may help explain why I have fewer lumps now the surgery has stopped.
• “Safe haven” for melanoma.  How some cells survive chemotherapy.
• New UV risk found.  Even worse than we thought.  I’m getting a lead-lined summer suit made up.
• Treatments for anxiety.  More research in how to cope with life.
• Thank you, cancer!  One man’s positive life-changing experience.
• Making peace with cancer, Buddhist-style.  Another man’s positive, life-changing experience.
• Meditation as therapy – research.
• HuffPo gratitude:  starting the conversation.  Nice to share a little good news, yes?

The abundance of research and the number of potential new treatments for all that ails me is very encouraging!

Wishing you all a very happy summer … and beyond.  Re-read the Sun & Skin Survival Special and abide by the sound advice therein.  Take care.

News Roundup

Unbelievable Maritime weather this Christmas!  It is 10C with sunshine,blue skies, and green grass here today.  I took a long-ish walk along a shore-hugging road, and watched someone out sailing.  What a wonderful feeling of vicarious freedom!  This was also the perfect excuse to use up the last James Bond movie title.  It was a pretty silly exercise, and I promise not to raise the spectre of its return in the future.

In the last episode P and I were about to depart on a cruise.  In this episode we have apparently returned, which is probably a Good Thing.  We had a wonderful time, but will have to cut back in the new year:  the deficit is getting too big.  Our lives seem to be full enough without too much travel, anyway.  In my case, I can spend a lot of time just sitting around doing crossword puzzles, listening to music, reading, dozing, taking the occasional walk.  It is wonderful that others explore new and interesting places, try new things, get active, and keep fit.  That’s just not me.  I have always found it hard to start new projects.  Even getting up in the morning is pretty tough.   Until a few years ago that caused me a certain amount of self-loathing, but I finally learned to accept that there is nothing wrong with living this way.  Since then I have been much more relaxed, happy, and content to celebrate and applaud the achievements of others.

I continue to offer advice and comfort to those in need in the Support Groups family.  Some days it is frustrating or heartbreaking, but there are also times when I can get someone to laugh, or to look for different solutions to their problems.  That is very rewarding – for me, at least; I hope it does them some good too.  There is a Skin Cancer group which I monitor, but not a lot of activity there.  Occasionally I point someone to this blog in the hope that it will provide some inspiration or at least information.  Online support was not easy to find when I started down this path.

As far as my own melanoma is concerned, everything is going very well.  Earlier in the year I (and my doctors) were a little worried about the frequency with which new lumps were popping up.  There was talk about more drastic chemo, all of which was somewhat anxiety-provoking.  However, my last IL-2 treatment involved only 10 injections, down from about 35 at the peak of the panic.  This is much easier to take!   Quite apart from having my leg feeling like an abused pin cushion, that much IL-2 in my system thoroughly flattens me for about 3 days.  Now I can actually start making modest progress on stuff within 24 hours.  Furthermore, the decline in lumps to inject raises the prospect that the number may drop to zero, at least for short periods.  That’s closer to a cure than I ever expected to get.

Speaking of cures … they haven’t found one yet.  But the progress is promising, as evidenced in the next section.

I wish you all a healthy and happy 2015, and expect to be around to share it with you!

Melanoma

• Blocking TNF-alpha makes tumours smaller, but OTOH TNF inhibitors may increase risk of uveal melanoma.  Damned if you do, or not.
• Nivolumab (anti-PD-1) doing well in tests
• Combo of dabrafenib and trametinib also looking good
• More Skin, More Sun, More Tan, More Melanoma – I recently said something similar.  Not just a pretty leg 🙂
• Found:  chemical that helps melanoma to spread
• Sneaky sub-population of melanoma cells
• A nanoparticle that can deliver drugs directly to tumours
• TAK-733 (MEK inhibitor) excels in tests
• Why pembrolizumab works really well, or hardly at all
• Blocking chitinase 3-like-1 protein in mice

Cancer in general

• Anti-STAT3 therapy may be highly promising
• Arresting cancer as it spreads
• Personalized anti-cancer vaccines are coming
• Selenium helps prevent immune system burnout
• Researchers map paths to cancer drug resistance

Mind & Body

• Meditation and support groups are physically helpful – news from Calgary
• MORE program helps drug addicts

News Roundup

The summer has just flown by, and that’s what I will be doing later today.   A big, thundering bird will take me away from my first world 1% life and deposit me (indirectly) on a squalid Princess cruise ship which will in due course  return me to my very own squalor.  Sounds like hell, doesn’t it?  But, please: I don’t need your sympathy.  Really.  I’ll get through this somehow.

It has been a few weeks since my visit to the oncologist.  At that time we decided that I will stick with the status quo:  IL-2 injections every couple of weeks until the universe winds down.  That is a nuisance, but a fairly mild one.  It writes off a few days each month during which I am good for very little, and it hurts a Whole Lot when they give me the 30-ish injections, but that soon fades away and life resumes.  So, I continue to be well and mostly happy with my existence.  Spare a thought for those less fortunate than I.

Recently a couple of long-time friends made it out here for 10 days.  Fortunately they are fairly self-sufficient, since relying on us (me, in particular) for entertainment is a bit of a dead loss.    It was great to see them, though, and we did manage to go to a few places, see a few things, and eat a few good meals with them before they returned home.

That’s about all I have to report, which is probably just as well.  Do stay in touch, all of you,  and I wish you a gentle slide into the Fall.

Once more, my thanks for all the pointers to news articles.  Keep ’em coming.

Cancer

• The IMPACT program
• Making cancer vulnerable to treatment
• Cat poop for cancer?  Anyone?
• Bromodomain inhibitors look promising
• A better tumour-targeting agent
• More evidence in favour of immnotherapy
• The inspiration of Stephen Sutton
• Killing cancer with fever

Melanoma

• Leukemia drug for melanoma
• Harnessing natural kill cells.  I wonder what the unnatural ones are like?
• Reflections in UV – video showing how your skin responds to UV light
• Understanding MCR1
• Sunscreen < 100% effective (also noted by the BBC),  but use during childhood is definitely a good idea
• Indoor tanning considered harmful.  Just say no.
• Liver surgery improves survival odds
• Adoptive T-cell therapy improvements
• Selumetinib treats uveal melanoma which was previously almost untreatable
• Pembrolizumab wonder drug.  More on this from the Beeb
• Good results from combo immunotherapy
• New ways to combat BRAF inhibitor drug resistance
• Melanoma rates are rising fast in Canada; we’re so vain…
• Rare palm/sole melanoma prone to recurrence; more common in those with darker skins
• Pine bark for melanoma?  Better than cat poop?

Mind

• All you need is 25 minutes of meditation
• Good for more than just your mind – diabetes, heart, etc..

 Miscellaneous

• Gut feelings: how your gut influences your mood
• A nasty mole for the chemists among us

Sun and Skin Survival Special

‘Tis the sunshine season, although much of the Northern hemisphere may be in some doubt about this.  The summer solstice is upon us.  For many this is a time to frolic in the great outdoors in as near an au naturel state as the law permits.  For me it is a time to cover up and slap on the sunscreen.  For those of you with fair complexions, Nordic skin and especially red hair, mine might be a good example to follow.

Melanoma rates have been rising steadily for at least a decade  in the US, Canada, the UK,  and especially in Australia.  There appear to be two primary reasons for this.  The first is that the time we spend outdoors we wear fewer clothes than we used to.  If you look at pictures of people on holiday 100 years ago, almost all are wearing hats, the bathing suits leave everything to the imagination, parasols are not uncommon, and pale, white skin was considered a mark of high social standing.   The kids on the beach are wearing (more or less) street clothes and hats.

By 50 years ago a lot had changed.  Bathing suits were much more common and a good deal more revealing.  Hats and parasols were much less common, although the middle-aged and elderly still kept a lot of their skin under wraps.  In Europe, as post- World War II austerity wore off, a lot more people could afford to take vacations in France, Italy, or Spain where the summer sun beats down much more strongly than in Northern Europe.  In Canada the destinations tended to be The Caribbean, Florida, California, Mexico, Hawaii.

Reveling in the  outdoors with the sun on your skin was supposed to be good you.  Indeed, it is, up to a point (don’t get me started about the bugs, though) but there is a reason that those with a genetic history of living in the tropics tend to have darker skin than others.  Us gwai lo people have evolved to produce more vitamin D from less ultra-violet light, but this ability comes at a cost: our skin can be overwhelmed easily by the more intense sunshine at lower latitudes, and the damage can be very serious.

The second reason skin cancer is on the rise is that having a tan is now considered desirable, or even beautiful. The more of your skin you can bronze and the quicker you can do it, the better.  Not everyone can afford to spend all the time in sunny places to obtain a natural tan, which has led to the proliferation of tanning beds.  It turns out getting a tan this way is even worse than too much solar exposure and may even be addictive.  Figuring this out involved quite a lot of research, and there are clearly many people who dispute the results, or simply ignore them.

There is also a great deal of confusion over the use of sunscreen.  SPF values don’t apply to UVA, so they are not a very reliable guide to what products work best, and some people feel that the sunscreen ingredients are toxic (or at least highly suspicious) to the extent that one is better off not using them.  Sunscreen is quite safe and may be  a very good thing to do for your skin.

Our children are, in many ways, the most vulnerable when it comes to melanoma risk.  Not that they are likely to get it when they are young (although it does happen) but the skin damage lasts a lifetime and greatly increases the risk of melanoma later in life, which is why we are seeing so much more now.  They need to be  dressed appropriately, slathered in sunscreen, and when they are old enough taught how to take appropriate precautions.  Such precautions include not using tanning beds.  Many jurisdictions now forbid their use by minors, but this is a recent development.  Quite a lot of damage has already been done.

Having said all of that, getting outside is good for health – trees and flowers and chirping birds all promote healthy states of mind.  I love being outdoors (except for the bugs).  Avoiding excess sun does not mean cowering in a basement until the autumn equinox.  I wear a hat, long sleeves, long pants and (horror of horrors!) socks with my sandals, and I use sunscreen on the bits of me that still see the sun:  my nose, forehead, ears, and hands.  This is probably overkill for most people.  Please pardon my paranoia:  UV can  encourage melanoma to spread.

 The US Centers for Disease Control (CDC) has a good summary of how to take care of your skin for the summer.

Melanoma can strike anyone, young or old, sun worshiper or not.  It is worth knowing how to spot the bad spots. To find out how much you know, try this quiz. I really hope none of you ever have occasion to worry, but prevention is easy.  A cure may prove quite elusive.

Legnotes

• My recent PET scan reveals no unexpected melanoma activity.  It ain’t gone, but it is under control for now.
• My recent tissue pathology report on the suspicious lump on my right breastbone indicates that it is benign.
• Adrienne has run up a lot of travel bills for her treatment.  If you are feeling flush with cash, please consider helping her out.

News Roundup

Ah, the hell with it!  I’m going boating 🙂  Have a great summer, all of you!

News Roundup

Another birthday has just gone by.  The next one will be one of the big 0’s which, a few years back, I really did not expect to see.  So, perhaps this is a good time to look back on who I was, and who I am now.

Depression, anxiety, and the feeling that “I ought to be able to do better” were my constant companions for many years.  Coping with them was something I just did:  it’s just who I was.  The past looked pretty good, the present tolerable, and the future positively frightening.  Was I good enough to get a job?  To keep it?  Would I spend my life lonely?  Were we all going to die in some horrible catastrophe – war, plague, famine,  or whatever?  What would happen if I had a debilitating accident or contracted some nasty disease?   I spent many hours with counselors and friends looking for ways to help myself.  Perhaps more exercise would help: jogging, biking, hiking, dancing, sailing; or maybe a dose of self-confidence and focus a la Tony Robbins; a more solid relationship, or a new girlfriend;  a more rational working environment.  I tried all of these and none brought  more than temporary relief.  Eventually the lead-booted feeling of depression and inadequacy and the fear of total failure would return.  Medication eventually prevented the worst of the lows, but life was always an effort.   There were times when I felt really happy where I was, but it always seemed as though something beyond my control would happen to spoil it.  Needless to say, this fed back into the feelings of depression, anxiety, and inadequacy.

When P first suggested that we could afford to retire early I felt euphoric.  I would be able to get away from all the crazy work stress and devote my time to my own agenda:  putting effort into something really worthwhile, relaxing, catching up on my reading list, spending time with the family.  Just what I needed!  Everything would be OK when I could get away from all the things that were bugging me.  This idea sustained my last few working years while we socked away our  salaries and planned The Big Move to a quiet, semi-rural area by the sea.

The year of The Big Move was probably the most stressful of my life.  We disposed of huge amounts of possessions (although not nearly enough, as it turned out), bought a small, temporary home near where we hoped to build, packed up, and moved several thousand kilometres away from our friends and family.   Settling ourselves in was a major task.  Settling P‘s mum and my dad in was pretty much impossible.  The arrangements we made for them were always an awkward compromise for all concerned.  Tempers frayed and happiness was, once more, elusive.  It was with very mixed feelings that I watched my father die about 8 months later.

There followed a very tiring year as we got the new (bigger) house built.  With the help of a wonderful contractor and a lot of very competent trades people, the edifice gradually rose from the ground.  It felt wonderful to climb the ladder to an upper storey and bask in  the beautiful view.  Such basking was rare, however.  Most days were filled with all the minutiae of house construction and finishing.  We constantly seemed to be driving into the city to buy materials or fittings, or run after our parents.  Of course, A was in school and  had her own requirements for living.  Soon, I promised myself, things would improve.  Everything would come together into some sort of idyllic existence.

Just about the time we were getting ready for our second move in two years (from the small house to the newly built one) I got the diagnosis of melanoma.  This, of course, scored 11/10 on my personal catastrophe meter.  I was just about to be supremely happy in my new existence when events beyond my control screwed me over – again.  I had a very possibly fatal disease that might be quite uncomfortable and might require a lot of support from friends (absent) and family  (overwhelmed).   I had absolutely no idea how I was going to cope and on several occasions seriously looked into the possibility of assisted death or suicide as being the least bad option.  My life and my state of mind hit an all-time low.

In spite of all that, here I sit, six years later, feeling as fulfilled and content with my life as I ever have:  a whole new person, you might almost say.  Wassup with that?

Firstly, of course, the six years  did not turn out anywhere near as badly as I thought they would.  I did not die (in case you were wondering), and apart from the ongoing melanoma treatments I live a fairly normal, retired life.  P assures me that we are pretty secure financially, and A is all grown up and at university 2000Km away.  Our parents are now both dead.  All these factors have removed quite a load from the minus side of the scales.  On the plus side, we are well-established in our new (well, “nearly new” by now) home, we have good friends nearby, toys to play with, and fulfilling activities to make up for the lack of work.

Mostly, though, I think my outlook on life is radically different.  My sense of “self” is much more flexible now.  I no longer feel the need for some kind of future guarantee of happiness, or the need to make that guarantee for anyone else.  Everything I really wanted to prove in life has been proved or abandoned.  I still have quite strong opinions on various topics, but I am not as emotionally invested as I would have been in olden days, and (this is a biggie) I have learned not to spend as much time judging the opinions and actions of others.  This allows life to be a lot calmer, more mellow.  The really big single breakthrough was when I understood my fear of fear, and accepted that there will be times when I will be afraid or outright terrified.  Now I can wait, calmly, for the anvil to fall on me.  When it does I will perform my best Wiley Coyote impression and try to bounce back.  As I have stated many times, the mindfulness meditation has helped enormously by giving me many of the tools I need to watch my own craziness in action, and to devise strategies to keep it down to a dull roar.   Life is good.  I would like everyone to have this experience.

One person who is almost certainly not having a good time right now is Adrienne, whose blog I have just added to the blogroll.  She left a comment on my previous posting describing her ongoing two year  fight against  stage IV melanoma.  Hers seems to be much more aggressive than mine, and less amenable to the treatments they have tried.  I encourage you to read her blog, watch her video updates, and to send any  positive vibes you can generate in her direction.

My every-few-week injection routine continues, although there have been rather more lumps popping up in recent months.  A punch-biopsy of a suspicious lump on my right breastbone is still awaiting the pathologist’s verdict, which is mildly alarming; two years ago it would have been petrifying.  I am scheduled for another CT scan, and there is talk of starting me on a systemic treatment using yervoy (aka ipilimumab).  I was a little nervous when this was first mooted but I now feel almost excited to try something new.  About 25% of recipients have a “durable response”, which basically means that they are cured.  Wouldn’t that be nice?  One way or another it looks as though I have a good shot at the next big birthday.  I’m looking forward to it.

It may be laid back where I am, but the rest of the world seems to be churning along fast and furious.  Without much commentary, here are the main points of the news.

Skin Stuff

• Sentinel node treatment does improve melanoma outcomes.
• Sunburn packs double whammy.
• BRAF drug resistance reduced using malaria drug.
• Modified tumour cells which produce IL-15 and IL-15Rα used in melanoma vaccine.
• Nivolumab (immunotherapy drug) produces lasting melanoma remissions.
• UV light accelerates extravascular metastatic migration of melanoma – sounds like once you’ve got it, cover up!
• Broad spectrum sunscreen (TPF 50) is better.
• Young skin cancer survivors have higher risk for other cancers.
• Mutated POT1 gene flags high melanoma risk.
• Genetic screening helps in melanoma fight.
• Tumours with BRAF mutation can be starved of copper.
• UK incidence of skin cancer now 5 times what it was in 1970’s.
• 76% of melanomas in women between 18-29 are associated with tanning beds.
• Learn to spot skin cancer.
• A story from a tanning bed.

Other Cancer Stuff

• Nanofibres lure cancer cells to their death.
• Taking the brakes off Natural Killer cells.
• Magnetic nano particles help train immune system.
• Immune system training by cooking the tumours from within.
• Group backs coverage for oral cancer drugs – in Canada.
• Slowing cancer by inhibiting TGF-β protein.
• Survivor of “terminal” breast cancer has “a lot of living to do” – bravo!
• Inhibiting MTH1 enzyme may treat cancer in general – now that’s what I call a breakthrough!
• New immunotherapy drug trial: ID-G305.
• Terminal teenager raises 3 million pounds – sadly he has since died.
• A cancer mis-diagnosis story.
• Immunotherapy boost from the thymus gland.

Head Stuff

• Dealing with a lifetime of extreme anxiety – sounds awful.
• Scientists inhibit formation of fearful memories – in mice.
• Mindfulness-Based Stress Reduction helps nurses.
• Meditation helps teens with cancer – a clinical trial.
• Ketamine is an exciting new treatment for depression – party on!
• Work out in a garden gym, for best results.

TTFN.

Greetings all! Happy 2014! Gung Hay Fat Choi! Etc. etc..

As I’ve commented before, my state of being index is inversely proportional to the frequency of updates on this blog.  This is also true for my own, hand-written journal which last saw an update in November.  So, you see, meta-data analysis can, in fact, tell you more than you might think.   Whether or not the various nefarious agents out there on the internet have managed to piece together all my alter egos I’m not sure.  Why would they want to?  Perhaps because they can.  For now I have no particular reason to think my identity has been compromised, so I continue to sleep well.  The melatonin helps, too.

One of my recently created internet identities is as a participant in online support groups for anxiety, depression, and skin cancer.  Right now I’m in a pretty good state to provide some support to others, and by doing so I bank up some credit for when I don’t feel so strong.  This seems to be working out pretty well, although there are very few people active in the skin cancer group.  Lots of people with various anxiety & depression disorders, though.  I get a warm and fuzzy feeling every time one of them says “thank you” for one of my postings.  Of course, for all I know I’m offering advice and consolation to an army of bots, or to a whole bunch of people who are just having me on:  the whole thing is entirely anonymous.  However, I choose to believe that at least some of them are real people with real problems.  BTW, if anyone figures out my disguise there please don’t blow my cover!  I’d like to keep all the pieces of my online existence separate.

Reading the postings on the support groups site brings back memories of the bad times, not so very long ago.  By now I can think about them without anxiety, but when someone writes “I can’t do this anymore” it still produces a momentary cold, sinking feeling in my gut.  People are not very good at handling uncertainty, especially when the signs are inauspicious.  I like to think I’ve got a bit better at that.  The real test will come when the bottom drops out of my world again, which it surely will someday.  For this reason alone I keep up my meditation practice, and although I doubt if I will ever become a buddha I feel as though I am taking sensible, proactive steps to improve my long-term prospects.

Two pieces of news inspired today’s James Bond / Beatles -based posting title.  The first was a personal experience just before Christmas.  One of the things I do with my copious free time is to help seniors with their computer problems.  A while back, one of the participants was a comparatively young man, probably in his late 40s.  He had had a hard time of life, suffering from alcohol abuse, working as a shrimp fisherman, and eventually losing a certain amount of cognitive function to a work-related accident.  More recently his house had burned down and his wife and daughter had left him to take care of his mother who is dying of cancer.  He was soft-spoken and very accepting of his fate, battling through his short-term memory problems to try to stay in email contact with his extended family in Iceland.  We managed to get some of his computer-related problems under control, but in late December I hadn’t seen him for some time.  I made a point of dropping by his mother’s house to deliver a Christmas card with a note suggesting we get together again in the new year.  When I asked if he was home, his mother said, “He’s dead.”  Apparently he had a heart attack in his sleep sometime in November.  I was completely dumbfounded.  Tomorrow never knows, indeed.

The second piece of news came courtesy of the BBC, and describes almost exactly the opposite situation.  This young lad was diagnosed with several forms of cancer.  During treatment he acquired other infections and his doctors despaired.  They predicted that he would die within days.  He didn’t.  In fact, he fought of his infections and now seems to be responding well to his cancer treatments.  My brief synopsis really does not do justice to this story:  you should watch the video.  This is a wonderful example of survival snatched from the jaws of death.  It is good to be reminded that uncertainty can have an up-side.  Tomorrow never knows….

In terms of my own health, my biggest complaint right now is the lump in a very inconvenient place on top of my foot.  It is right on top of that very prominent bone, ideally placed to be rubbed up the wrong way by my shoes.  What is truly surprising about this is that it is the only example (so far!) of a melanoma tumour farther down my leg from the primary site.  It took me a while to realise what it was.  Fortunately it seems to be responding well to the IL-2 injections.  As you can see in the (TMI) picture, it shows signs of inflammation and there is a scab on top.  These symptoms result from my immune system killing off the cancer cells, leaving me with what amounts to a non-healing wound.  Eventually the lump will shrink to nothing and the scab will drop off, leaving just a small scar.  In the meantime, I’m looking forward to weather that will allow me to wear sandals, which will avoid rubbing on the damn thing.  I also had a couple more lumps removed from my calf (you really don’t want to see those pictures) so I’ll have to get some more stitches out next week.  Life goes on and winter can’t last forever.

News Roundup

Another bulging bag of bumph.  I’m just going to dump it on the floor here and let you sort through it.  Thanks, as usual, to Dr. DL and Mr. JP of Calgary, and others for contributing pointers.

Melanoma Stuff

• Dramatic rise in skin cancer among middle-aged adults.
• Sniffing out melanoma; better detection.
• More anti-melanoma T-cell research; sounds promising.
• The David Cornfield Memorial Fund; these are the people who produce the more-or-less famous “Dear 16-year-old Me” video.
• Another couple of studies on BRAF inhibitor resistance.
• Sunscreen is even more effective than we thought; good for everyday use.
• Out of Africa migration caused melanoma vulnerability.
• Another couple of celebrities with melanoma.

News about Cancer in General

• There is diversity in a single tumour; oh, goody.
• T-cell activation marker found.
• T-cell gene therapy shows good results.
• Prostate cancer shape-changer stem cells:  adding complications to complications.
• Vitamin D supplements not-so anti-cancer? And again. Probably true, but the jury is still out.
• Many lung cancer tumours are harmless; says so, right here.
• Anti-fungal drugs for brain shrink tumours; old drugs for new uses.
• Identification of key genes may simplify cancer research; let’s hope so.
• How two interacting genes can kill cancer cells.
• Nano-particle “sticky balls” to help slow cancer progress.
• There are two types of breast cancer stem cells.
• More success with combo cancer treatments.
• Mekinist (trametinib) + Tafinlar (dabrafenib) combo gets FDA nod.

Thoughts and Other Mind Fillers

• Meditation may help slow Alzheimer’s progression – another good reason to start.
• David Cain on Acceptance.
• Dr. C on Chemotherapy is Like War and Thinking About Death; he wrote a whole series of articles for CBC on his fight with cancer, which he seems to be winning.
• Spirituality thickens brain cortex – which may help prevent depression.  The upside of thick-headedness?
• Why everyone seems to have cancer.
• Grass and trees are good for you – it’s official.
• Meditation changes your chemistry.
• More evidence that exercise is medicine for what ails you.
• Why poor people make poor decisions – MUST read!

And this just in:

A cure for basically everything (video).  Dr. Mercola, Dr. Burzinsky et. al. please take note:  you have a competitor.

’nuff said.  BFN.

News Roundup

Three months later.  Unbelievable, except that the skies now produce cloud, cold, and damp rather than sunshine, warmth, and dessication.  I hope you have all had a great summer.   What little I can remember of my own was very pleasant.  I did quite a lot of messing about in the boat, and we managed a short family vacation to Cape Breton which was fun for all of us.  P was away in Italy for 10 days, 4 of which I spent in a state of radical seclusion at a Buddhist retreat centre.  Ms. Z.J of Calgary spent a week here recently giving us the excuse to ditch the routine and play tourist.  A few of you have called or emailed generally with favourable life reports which we are always glad to receive.

The rune is gradually fading (common with magical markings, so I understand) leaving me with four or five lumps by way of an ongoing situation.  My doctors all seems amazed at my continuing good health which is a source of some concern to me.  I mean, if they’re happy, I’m happy but it would be comforting to feel that my current good health owes more to their understanding and expertise than it does to luck and divine intervention.  Anyway, the pathology report regarding  the lump removed during the marking of the rune confirms that it was (as expected) melanoma and that we did not manage to remove all of it.  So, I expect to continue the IL-2 injections until some other miracle cure is found, or the issue becomes moot for some reason.  Dr. H described my condition as “chronic”  which doesn’t sound so good until you contrast it with, for example, “terminal”.  I now go for shots once a month.  We use one (small) syringe of drug each time, half what was required a year ago.  As a result I feel less groggy and bounce back more quickly after each treatment.

The only tiny fly in the ointment is an unanticipated punch biopsy taken by Dr. L (the dermatologist) a few days ago.  I have a fairly innocuous lump on my belly which Drs. H and M have more or less dismissed.  It isn’t growing, but neither has it shrunk since I noticed it a couple of months back.  Dr. L thought we ought to check it out so I have a single stitch holding together a tiny incision near my rib cage.  It was the only thing he could find to criticize so … better safe than sorry. The results should be in by the time I next get my IL-2 shots.

Speaking of groggy, my experiments with melatonin reveal that a single half-3mg pill gets me a pretty good night’s sleep and a clear head the following morning.  Yes, I said morning!  For the first time I can remember, getting out of bed  is verging on pleasurable.  Doubtless all that psycho-work I’ve done contributes to this happy state of mind, as does the absence of monthly surgery.   Once my back recovers from the abuse it took getting the boat packed up for winter I may try skipping for joy – just to see what falls off.

And speaking of exercise, we have taken the completely unprecedented step of acquiring an exercise bicycle.  It must have been quite high-end at one stage but by the time we got it (for $15 in a garage sale) it was fairly beat-up.  An energetic day (requiring no further exercise) of cleaning, rewiring, and gluing together the display/meter thingy has rendered it once more suitable for use.  I have, in fact, used it once or twice and expect to do more during the winter.  Perhaps you, dear readers, would be good enough to remind me of that commitment.

I may start cutting back on this section.  A three month backlog is no joke, and the weight of even the URLs involved is enough to kink up my back again.  Oh well, let’s dive in:

Melanoma Stuff

• Rose Bengal (PV-10) injection looks very promising.
• Redheads are at greater risk of melanoma.
• Laproscopic removal of inguinal lymph nodes.  No more 5-day hospital stay!
• Phase 1 trial of implantable vaccine.  Not much detail here.
• STAT1 protein & natural killer cells.  Promising research.
• Sleep apnoea predicts aggressive melanoma.  Quite apart from aggressive bunkmates 🙂
• Airport security scanning booth tech helps spot melanoma.  Finally, a good use for this tech.!
• GM2/KLH-QS-21 vaccine not very effective.
• ATG5 protein helps cancer digest itself.  Yum.
• 7 new potential melanoma immunotherapy targets.
• Inhibit PDK1 gene to slow melanoma.
• Inhibit BRAF, MEK and PI3K/mTOR genes to slow melanoma.
• Ipilimumab (yervoy) effective up to 10 years.
• Caveat emptor: dermatology apps.  Not the first time this has been reported.
• Sunscreen IS effective against skin cancer!  The benefits outweigh the risks.
• LEE011 inhibitor reduces e.g. BRAF resistance.
• Melanoma ‘phenotype switching’ research.  Too hard to summarize this.
• Blood test for TFP12 gene detects melanoma.  Even if you can’t see it.

More general cancer news

• Fiddling with Treg cells to boost immune system.
• Rapid evolution of tumours may be their Achilles’ heel.
• Six stubborn cancer myths.  Mythinformation and conthpirathies abound.
• Chinese medicine slows cancer spread.
• Another documentary on Burzinsky.  (Short video) Judge for yourself.
• Reservatrol softens up cancer cells.  Found in grapes & red wine.  Please booze responsibly.

More general health stuff

• Migraine brains are different.  That doesn’t necessarily mean damaged.
• Mindfulness reduces teacher stress.  Nice to know something does.
• A new understanding of depression.
• Genetic underpinning for depression?
• How about a bacterial underpinning?  Might explain a lot in my case.
• Exercise as good as medication in some cases…
• … such as breast cancer – also noted here.
• Pain management is not a priority for many doctors.  Give me a pencil and just 1 minute with them…
• Legalization of assisted suicide inching closer?  I hope so.  At least we’re talking about it now.

In summary:  progress on many fronts, and hope for the future.  I’m off to do some skipping.  Be well, peeps.

News Roundup

Everything seems to be going reasonably well.  The stitches came out about a week ago and, although there are a couple of “soft” spots and one little section that isn’t holding together too well, the situation is improving. This pic was snapped just before removal of the stitches (I count 50), and there were about that many holding together the deeper layers of tissue so the rune is starting to fade into the background, as magic symbols tend to do.

The surgery itself was a little more involved than usual.  Dr. M. himself did the honours with a couple of assistants and a nurse.  As usual they used local anaesthetic injected at various places along the proposed incision lines.  It is pretty effective but if they are cutting close to a nerve there is a kind of deep, achy feeling; it is as if my body knows it is suffering damage even if it can’t feel the pain.  In spite of all my meditation practice it is still difficult to remain completely undisturbed and a few minutes in I started to feel light-headed and nauseous with profuse perspiration, a bit like having really low blood pressure.  No one accused me of being a wimp, however.  The nurse helped to lower my head and got me some cold cloths.  She said that very few people had actually succeeded in throwing up on her, a tribute to her fleetness of foot I suspect.  After a few more minutes of revolting nausea and wooziness I began to feel better again and we made it to the end of the surgery without further incident.

With my leg swathed in layers of gauze and compression bandages I was placed in a wheelchair and P helped decant me into the car.  Once home I hopped (literally) from the car to the elevator and thence to bed where I remained more or less continuously for the next 48 hours or so with my leg propped up on a pile of pillows to help it drain.  After that, with the aid of a walking stick and a shower chair (not simultaneously, I hasten to add) I was able to resume a semi-normal existence.  It remained painful to put weight on the leg for another few days, but in general I required little by way of analgesics.  Since then it has been slow but mostly steady progress.

Today (as I write) is a drab, dreary, rain-soaked day after a week or so of quite fine weather.  It is tempting to feel bummed out because I still can’t do much leg exercise:  walking, stairs, boating, ballet, tight-rope walking  etc..  Feeling sorry for myself is something I’ve had lots of practice at.  The summer is waning (as well as raining) and my boat sits neglected at the dock.  My bike is gathering dust in the garage and even I feel motivated to get out and get some exercise.  We have A home for three weeks and I would love to be able to go places with her rather than sitting around like the proverbial bump on a log. Thursday will see another round of IL-2 injections which will render me a smaller bump on a bigger log.  But instead of allowing the heaviness of disgruntlement settle upon me I am catching up on my back reading, listening to dharma talks, learning Python (a programming language) and going through most days feeling quietly contented with life.  It is so much easier now to focus on the positive side of life that it used to be, and a lot more fun.

I have been experimenting with sleep recently.  This one of my other chronic difficulties, frequently exacerbated by my irritable bowel.  It is difficult for me to sleep through even mild disturbances:  conditions have to be almost perfect for me to get a good night.  For the last few years I have been taking a small dose (one-quarter of a .5mg tablet) of clonazepam before bed.  However, it seems to be losing its effectiveness and I don’t want to become habituated to it in case I really need it to do its job as an anti-anxiety medication.  My current substitute is melatonin, a choice I ran by Dr. C who seems to think it is a worthy experiment.  I’m popping two 3mg pills at bedtime which seem to help me fall asleep and to sleep more soundly, although I wake up a bit foggy.  For some reason I also have a tendency to wake for about an hour after 2-3 hours of sleep.  I don’t know what that’s all about but I try to use the time to meditate which is, at least, restful.

Speaking of meditation (that almost never happens here) I came across some articles on adverse effects.  This is a total surprise to me, although I suppose that anything that affects your mind could cause problems.  This Livestrong article briefly exposes some of the potential problems and Wikipedia also deals with this topic.  What it comes down to is that having an experienced teacher is a good idea.  Failing that, I’d say it is a good idea to take a course or at least find some other meditators (an online forum is better than nothing) with whom you can compare notes and ask questions.  It has done wonders for me but, as always, YMMV.

A refreshingly short list this time around.  My thanks, as always, to those of you who have pointed out items of interest.

• We seem to be winning the melanoma battle. Take Scotland, for example.
• High-dose IL-2 used to treat melanoma metastases in the brain.
• How skin maintains itself.  New research on skin cell models.
• Omega-3 fatty acids seem to help prevent cancer.  Sounds fishy to me.
• A new approach to an immune system attack on cancer.
• Breakthrough research: Just 21 DNA mutations are found in 97% of cancers.
• Using forensic techniques to analyze cancer spread.
• Here is a better cancer surgery tool (video).
• Good vibrations: altering your mood with ultrasound.
• Gardening helps alleviate depression (video); as I said, YMMV 🙂

And that’s all for now.  Hope you’re all having a wonderful summer!

News Roundup

I wonder if that should be parsed: Never say “never” again, or: Never say “never again”?  In my case the latter interpretation provides a friendly reminder that my first surgery for over a year is coming up on July 23rd.There is a sizable lump in an area that has seen a lot of activity over the last few years.  It doesn’t seem to be growing, which is good.  We have been giving it IL-2 injections but it doesn’t seem to be shrinking either, which is not so good.  It may simply be a build-up of scar tissue, but the general consensus is that we should cut first and ask questions later.  Yesterday Dr. M spent some time drawing occult symbols on my leg, perhaps to cast out any malevolent influences before the surgery.  There was some talk of doing it while I waited (just bite down on this leather strap while we…).  However, the doctors decided that they needed a better-equipped torture chamber with more sharp-shiny-tool-equipped assistants.  This is a slightly bigger job than usual so they’re going to do a yin-yang flap surgery which is likely to heal faster than my normal evil-eye variety.  It may also require a small skin graft.  Ah well:  been there, done that, got the T-shirt stained.

An appointment with Dr. D revealed that there is little else to worry about.  A recent CT scan reveals nothing sinister north of my right thigh, and a slightly less recent prostate exam reveals that prostate exams are still uncomfortable but (in my case, anyway) innocuous.  There are good reasons for me to be optimistic.  The hot topic in cancer research at present seems to be the various mechanisms by which one’s immune system can be coaxed into a more effective response.  Anti-PD-1 drugs are showing a lot of promise and Yervoy/ipilimumab has been proving quite effective for lots of people.  I foresee a whole different death awaiting me, when the time comes.So far the summer seems to be going really well.  All the major weather events, train derailments, airline crashes, regime changes, intelligence leaks, senate scandals, and questionable beatifications have been a long way away.  Now we’re looking forward to September which is peak hurricane month and may provide a little more entertainment.  In the meantime, perhaps some of you would like to visit?  We got the leak in the boat fixed and we can take you tubing.

That is all I have to reveal about my life right now.  Check WikiLeaks for more information, doubtless coming soon from someone at the NSA.

Have a great summer!

(come hell or high water)

Well, the level of dammed-up news articles has reached a barely manageable mass.  I’m bailing frantically.  Meanwhile, open wide and take a sip from this fire hose.

Save Our Skins

• Exposure to sunlight brings blood pressure benefits.  I wonder if this still works with sunscreen?
• UVA vs. UVB: do you know what your sunscreen is doing for you?
• Or you can try some of these tips.
• Make sure you get the right sunscreen for your kids.
• Whether it is sunny or not, sunscreen may slow skin aging.
• If you’re going to get melanoma, you may be better off to get it twice.  Weird.
• Small proteins reveal melanoma in new screening test.  So can skin odours, apparently.

Drugs, Therapies, & Screening

Anti- PD-1 drugs seem to be really hot right now:

• Antibody wakes up T-cells
• Two new Yale U. studies
• UCLA gives us lambrolizumab
• Could be useful for more than just melanoma

There are many other really cool potential treatments:

• Smart drug targets metastasis
• Selumetinib for uveal melanoma
• Diabetes drug may help treat melanoma
• Dual-Action compound for melanoma
• Herding melanoma to its demise
• Targeted viral therapy for breast cancer
• Radioactive bacteria nuke pancreatic cancer in mice

And a couple of improved screening developments:

• Urine odour test for bladder cancer
• Better prostate cancer screening

Do you mind?

• Meditation boosts genes that promote good health
• Cultivating relaxation is good too.
• Can we make ourselves happier? Spoiler alert: yes.  It helps to have social connections.
• Activate your Anterior Cingulate Cortex – read on to find out why, and how.
• The religious experience of science.

And would you believe it?

• Skin cancer or Alzheimer’s:  pick one.
• Lucky 6% can get melanoma recurrence after 10 years.  Previously thought to be very rare.
• White blood cells help spread cancer in mice
• Cancers don’t sleep – thanks to Dr. DL of Calgary for this one.
• The irony of Popeye’s diet
• The Burzynski Cure – this came up once before,  a while ago

And finally, The Cancer Villages of Turkey:  it turns out much of the local geology is erionite which is a form of asbestos.  Needless to say, mesothelioma is a rather common problem.

BFN.