Know Thy Enemy

This week Lee and I had planned to be enjoying ourselves with friends in Maui. However a pesky lung tumor was muscling it’s way against my air way causing a rather irritating and persistent cough. A three week regimen of low dose radiation was prescribed to remedy this symptom. Although disappointed about the cancelled trip, it was an easy decision as the persistent coughing would be quite disruptive to umbrella drink imbibing.  

The fact that this lung tumor was growing is a much more disappointing reality. It signals that my third line chemo is losing its mojo. We can play “whack a mole” for a while addressing specific tumors, but it’s a “finger in the dike” solution. Pretty soon the dam will burst. It is most likely that soon it will be time to end chemotherapy. 

I am not depressed, I still plan to live my life to its fullest. In fact I feel a little more intensely about that than ever before.  We recently watched a film on Netflicks called Sing Street. A fun little movie, I recommend it. It has a great sound track of 80s-era pop music. One song really struck a chord with me,”Drive It Like You Stole It.” This verse particularly spoke to me: “This is your life. You can go anywhere. You gotta grab the wheel and own it. You gotta put the pedal down. And drive it like you stole it…”    To me that means living life with intense focus, exhilaration, freedom and a dose of fear.

But, could it be that what appears to be a sun setting, is in reality a sunrise?  Lee and I have been diligently looking for clinical trials on new therapies. You may recall that our strategy from the get-go with my “incurable” diagnosis was to tread water with conventional treatment, buying time until immunotherapy was a reality. It’s quite a task to find and identify these trials, almost an impossible task for even an oncologist, let alone a lay person. If you are able to locate one, hopefully one not thousands of miles away, you still may not be accepted.

Well last Friday my phone rang and a nice lady asked if I’d like a meeting with the medical director at University of Arizona Cancer Center to discuss trials and treatment options. Huh?!?!?!  When Lee and I first considered southern Arizona for retirement, the University of Arizona Cancer Center was a big plus. It is a designated National Cancer Institute center, the only one in the state of Arizona. With Lee’s cancer history, this was very important. We never thought that it would be so important for little Jimmy. We met with the medical director of the cancer center on Monday and it was decided that we should see the director of clinical trials today. WOW, just like that we were in to see the phase I clinical trials guru. We are so used to having to wait weeks to see a doctor that it was pleasantly shocking.  

Our meeting this morning with Dr. M was fantastically informative, inspiring and uplifting. I feel it is the dawn of a new day. Dr. M is the director of phase 1 trials and experimental therapies. He is both a research scientist and a physician. His name is on the patents of six drugs. There is still an enormous amount of uncertainty, wth no clear path. But  we have a amazing and powerful new ally in our battle with cancer. The first item on the agenda is identifying the DNA of the enemy (my tumors). In April of 2015 a biopsy was done of my primary tumor to test for genetic mutations and they ran a standard profile of 46 genes. This helps determine treatment, identifying agents to use or not to use. Dr. M will test 592 genes, nearly 13 times the test taken originally. The more information you know about the enemy, the more targeted the treatment, the higher likelihood of success. They drew blood today for a liquid biopsy and will compare that to the results of a tissue biopsy that will be taken from one of my lung tumors.  

Dr. M examines a smiling little Jimmy, it must tickle!

But the good news for today was not done. On the way home we dropped into the recently opened Barrio Bread Company. Previously available only at farmers markets, they just opened a shop. They make slow-fermented local native and heritage grain artisan bread. Perhaps the best bread I’ve ever had, sorry John O’Rourke. The owner was named one of the top ten bakers in America.

Barrio bread…..Oh My,,,

For those of you outside of Green Valley, below is my latest column that appeared in the Sunday Green Valley News.