Cancer Journey of a Secular Buddhist

 This week I had my first adverse effects from the immunotherapy and went back to the hospital for the 4th time. On Monday 8/24 I woke up from nap in the morning and Yas though my voice was slurred. Our oncologists told us to report every suspected symptom, so we called and they advised us to go to the Emergency Department, so Yas drove me down and they ran a CT scan of my head and torso and did blood tests. The good news is that the CT scan of my torso showed that all of the big tumors in my chest had shrunk by about 25% since the last scan (4 weeks ago).   Yay!  The immunotherapy is working. They checked me in to the 8th floor of the Feldberg building. The staff had all recently moved from Reisman 11 where I spent the last 3 hospital visits so there were lots of familiar faces. On the intake exam they noticed some rashes on my forehead and back, so I needed a dermatology consult. After 2 days they discharged me from the hospital on Wed 11/26, the day before Thanksg...

Dealing with cancer over the past 6 months has encouraged me to think about the big questions; what is my purpose in living, how have I impacted the world and the people I love. I think we are born into this world with some instinctual drives - to eat and drink and sleep and to be safe. We are also social animals and need to feel part of a community and to give and share love. Finally, if all of these other needs are mostly fulfilled then we are drawn to seek and create beauty, to learn how the world works so we can predict the near future, and to seek to make the world more just. One way to think about living is that we are creating our life; actually, we are cocreating it because the actions we take impact the people and the world around us, and so the result of living is the total impact we have had on the world and the ones we have the most impact on are our loved ones. Our impacts on the world continue even when we are gone as people remember our ideas and thoughts and caring, and...

 A recent article in the highly regarded journal Nature reports on a study of 884 lung cancer patients being treated with immunotherapy (e.g. Pembrolizumab/Keytruda) between Jan 2015 and Sep 2022 of which 180 had been vaccinated with an MRNA Covid vaccine (e.g. Moderna) within 100 days of starting their immunotherapy.  The patients who had been vaccinated had almost twice the overall 3 year survival rate (55.7%) compared to those who were not vaccinated (30.8%). So more than half of those who were vaccinated lived at least 3 years, while less than a third of those without an mRNA vaccine survived 3 years. Here is a link to the article https://www.nature.com/articles/s41586-025-09655-y and here is a figure which shows the number of patients still alive as a function of time. The blue line is for patients who had the Covid mRNA vaccine, the red line for those who didn't. We see that over half of vaccinated patients were alive after 3 years (blue line) but less than a third ...

 I had my last CyberKnife X-ray session on Thursday 11/13 to kill the 20 tumors that they discovered in my brain on the last CT scan.   I have also tapered down to 1mg/day of the steroid Dexamethasone and have experienced no side effects. In fact, I'm getting more mobile and the swallowing issues I had (inability to swallow moderate to large pills, choking on food with different consistencies) is gone, and my voice has returned to normal (it was hoarse and slow). These are signs that my brain inflammation is decreasing! This week is a big one for me and could represent a big positive change. On Tuesday I have two infusions  my 2nd dose of Keytruda (Pembrolizumab) which is an immunotherapy drug that can allow my immune system to directly attack and kill the lung cancer cells anywhere in my body, including my brain as it passes the Blood Brain Barrier my 1st dose of Avastin (Bevacizumab) which is another anti-cancer drug that cuts off the blood supply to tumors. It is ...

 The Cyber Knife facility took a week to get fixed and my treatments have been rescheduled for Sun-Thu (11/9-11/13).  I had a CT planning scan 10 days ago and they needed to mark each of the regions that is to receive a toxic dose of radiation. Dr. Hertan said she marked out 20 mets, ranging in size from 1/4 inch (the smallest they can reliably spot on a CT scan to about an inch! They had to divide them into two groups (one with 8 lesions and another with 12) and design a plan for the Cyber knife (40 minutes for the 12 lesions and 20 for the 8). I've had three sessions already (Sun, Mon, Tue) and have two to go (Wed, Thu). We met with my oncologists, Drs. Costa and Carradonna, and decided to start my infusions next Tuesday 11/18. I'll have my second dose of Keytruda (Pembrolizumab) and my first dose of Avastin (Bevacizumab). I've lowered my daily steroid dose to 2mg of Dexamethasone, and will phase it out over the next two weeks. My mobility keeps getting better and my appe...

This week (11/2/2025-11/8/2025) has been exciting and on the whole a very good week. I was discharged from the hospital on Sunday (11/2) and have been living at home. Yas has taken a leave of absence, and Shaye and her partner Kyndra came up from New Orleans.  Caitlin and Ryan stop by when they can and Fezco our dog and Allie our cat give us their unconditional love. Living at home is so much better than being in the hospital. Caitlin gave up her childhood room for me to use as a hospital room, so we have a hospital bed where the back and knees can be automatically raised and lowered. We also moved another bed into that room so Yas can sleep in the same room with me, but for the past few days she's been sleeping with me in the twin bed. I love cuddling with my wife all night!  We created a daily schedule where I do PT exercises 3 times each day, eat 3 good meals a day, nap between meals, and we take one outing a day where I walk down the 25 stairs from our 2nd floor apartment ...

Last week,we met with the fellow, Dr. Tim Caradonna, leading my oncology team and decided at each new setback we need to  discuss Quality of Life issues and decide if the treatment plan is worth it (Palliative care) or if we should stop treatment and focus on Quality of Life issues only (Hospice care).   The challenge is I keep having brain mets that prevent me from using immunotherapy until the swelling goes down.  Our current plan is to do the Cyber Knife X-ray treatment to kill the current  brain mets and then use Avastin to reduce inflammation while tapering down on steroids so I can use the  Keytruda to kill any new mets. Avastin can be used with steroids (dexamethasone) and with Keytruda. The issue is whether the Avastin with a steroid taper will allow me to reduce the brain inflammation enough to maintain enough mobility to make the outpatient appointments We're currently going to try following the plan.  For me that means eating well every day ...