As I enter my 4th week of not being able to train at the gym, I'm really starting to wonder about the potential permanence of some recent changes.
I am hopeful that the new chemo will work and reduce my tumor size. If that happens, I should be able to reduce my pain medication. That might allow me to train in the gym again. It might allow me to do more than go for an easy two mile walk as my "exercise". I did actually walk 5 miles yesterday, and I'm actually a bit sore from doing that.
How far will this extend? Right now, I'm guessing that I'm not going to be able to ski this winter. I can't ski with this much pain medicine in my system. I can't function at my job at the mountain. So, after 18 seasons, am I done being a ski instructor?
Will the nausea ever decrease? Or, am I in a battle just to get some calories into my system, and that's the new normal? Yesterday, after the aforementioned walk (in Stowe on the bike path), my wife and I went out to dinner with friends. I ordered a side salad and an appetizer, but to be honest, nothing on the menu looked palatable. I managed to eat most of the salad and I started on my scallop appetizer when my body quickly and violently rejected the food I was trying to force down. It feels as though my body simply won't eat any vegetables right now.
After the salad came back up, I was able to eat my scallops, but the beets and grapefruit that came with the scallops went untouched. Is this the new normal? Will I ever return to having a normal appetite?
Because of the pain meds, I'm not driving. As long as I'm on this level of medication, I don't think I'm going to be able to drive. Should I simply accept that I won't ever drive again?
It feels like my identity is being stripped away. For 20+ years, I've defined myself as an athlete of some sort. For years, I did triathlons. Then road racing. Then ultramarathons. I never imagined that I'd give up being a runner.
But then, at just the right time in my life, CrossFit came along. For the past 8 years, that has been my obsession. I know I'll never touch my lifetime PRs in the gym again, but will I ever be able to lift again?
If I lose the ability to train, to teach skiing, to do something as simple as driving, what is left? Fishing? I have to admit that I haven't been on the rivers since June right now. Part of that was due to stream conditions, but part of it was malaise from the cancer.
I've been thinking that maybe it's time to start selling my fly fishing gear. I know that I'll wait until next spring before I make a decision, but I've been thinking about it. I know what my fly fishing gear is worth, and I can get a lot of cash if I sell it myself. If my wife needs to sell it on her own in the future, she will never get fair value for the equipment that I've accumulated over the years.
I guess I'm dancing around the real issue here. This feels like the beginning of the end, to be honest.
Maybe the chemo will be wildly successful. Mathematically, the chance of significant shrinkage of my tumors is probably around 10%. Stabilization is a 1 in 4 bet. Not great odds, to be honest.
Median survival for people on the chemo that I'm on now is 16 months. It is only used after a number of other treatments have been tried, which is exactly where I am. It does increase survival even in cases where the tumors continue to grow, but the more they grow, the lower survival time is expected to be.
I hate to be so maudlin, but this disease is going to kill me at some point in time. And, it's starting to feel like I'm on final approach. I hope I'm over-reacting to a rough patch, but I also need to be honest with myself. Maybe I'll delete this post in a month because I'm feeling better, I'm back in the gym, and I'm ready to take on ski season. But, I honestly doubt that this will be the case.
For now, I feel empty. Like I've lost a huge amount of what makes me who I am. I'm at a loss.
Monday, October 15, 2018
Friday, October 12, 2018
Moving on
Since my last post, I think I managed to hit a nadir and I've gradually turned things around.
Let me catch you up.
So, insurance still has not approved, nor have they officially denied, my request for proton beam radiation. But, I simply can't wait anymore. Things have been getting worse and it was time for action.
Since I last posted, the pain issue really exploded. My pain levels were drastically increasing and my pain medications just weren't keeping up. It really peaked on a Monday and I had to call in sick. I couldn't get in to see my primary care provider, so she suggested that I visit the Emergency Department at our local hospital instead. So, I did that. I spent about 5 hours there, and at the end, they just threw a new prescription at me for a slightly stronger pain medication and they sent me home. I was supposed to follow up with my PCP on the pain medicine.
So, the next day, I called in sick again and used the new pain medicines. They didn't help. By now, my PCP had given me her cell phone number and she and I were texting back and forth. On Wednesday morning, when things weren't better, she suggested that I go to the ED at one of the two teaching hospitals in our region. Since my wife and I work in Burlington, I had my wife take me to the ED at the University of Vermont Medical Center. I ended up spending the entire day there.
The first thing they did was just try to get my pain levels under control. It took two injections of morphine to establish a baseline level of control. Four hours later, it took three more injections to keep things under control. But, the good thing about this hospital vs. the one I visited on Monday is that they wanted to figure out why my pain levels were so much higher. They did some imaging and found that my tumors had grown significantly since August. The larger tumors were creating pressure on nerves and that was causing the pain.
Late in the day, the doctor I'd been working with (Dr. Claus - the poor guy must have been tortured his whole life for that name) suggested two options. The first was that he could take a guess at a prescription that would work going forward and send me home. Or, I could be admitted and have a pain specialist from the oncology clinic work with me to establish control of the pain. He offered them to me as almost a 50-50 choice, assuming that I was averse to being admitted. But, to me it was a no-brainer and I chose to be admitted. That afternoon, before they could even admit me, I was interviewed by two pain specialists. They knew about the tumor growth.
By the time I'd been admitted, they had a plan they wanted to try - Oxycontin with oxycodone for breakthrough pain. I've found out since then that there is a lot of controversy about whether or not Oxycontin really works for the full 12 hours as advertised. In something like half of all patients, it works for less than 12 hours, and it needs to be supplemented with other pain medications. So, we started the Oxycontin on Wednesday night and I was able to sleep through the night for the first time in a while.
On Thursday, the doctors seemed quite happy with themselves, having found something that worked so quickly. I was discharged late Thursday afternoon with 2 new prescriptions. I was happy that we had a solution. Until, that is, we reached the pharmacy. It turned out that Oxycontin isn't covered by my insurance. I had two options - pay $541 out of pocket or pay for a lesser amount that I could choose. But, if I chose a lesser amount, the rest of the prescription would be invalid. I was torn. I knew that if I didn't fill the prescription, I'd end up back in the hospital. I felt like it would be justice for my insurance company to have to pay for the re-admission if they refused to pay for the medication. But, I'm not truly that petty, I didn't want to go back to the hospital, and I wanted the pain to be gone, so I paid the money.
In the end, it turned out that, with prior approval, my insurance company will pay for the brand name Oxycontin, but not the generic. I've now gotten that prior approval, and my local pharmacy is carrying the brand name just for my needs. That's one advantage of living in a small town, where the pharmacists know me and my condition well. They are willing to change their stock just to help my needs. And, UVMMC turned over my co-pay issue to a social worker. Through a grant, I got back about 60% of the cost of the prescription.
So, I now had my pain under control. But, these new pain meds mean that I can't really drive anymore, which has created a new burden for my wife. She had always been the driver on our commute, but I usually dropped her off in the morning and took the car for the day. She is now dropping me off, and she needs to come with me on every medical appointment. I feel bad for the burden on her, but I'm not going to risk driving with pain meds in my system.
So, with the pain under control, I still had two issues to fight. First, I needed to get treatment re-started. It's been two months since I found out that the last treatment failed - two months of allowing my tumors to grow without fighting back. At this point in time, I have to assume that the proton beam therapy is not going to happen, and we need to start a systemic treatment as an alternative. And, I had to work on my nausea, which had been getting worse by the day.
First, let's talk about treatments. When I was last at Sloan Kettering, the medical oncologist that I see there had suggested a drug called Eribulin. It is an older drug that's been around for a while and I think it's often used in breast cancer treatment. My local medical oncologist had suggested Trabectidin, which is a newer drug that is specific to sarcomas, if not just liposarcoma.
As the prospects for the proton beam therapy dropped, and my symptoms began to increase, I started to rely more and more on my local medical oncologist. She scheduled me for a CT scan on Wednesday of this week. That was followed by an appointment yesterday - Thursday. In the appointment, she said she was fine using either of the drugs, but that she'd gone along with the Sloan Kettering recommendation and scheduled me to start Eribulin immediately.
I had no qualms with that. I am concerned that Eribulin tends to have more side effects than Trabecticin, but that isn't the most important thing right now. Getting started with a treatment was the most important thing. So, I did have a treatment yesterday and I'm now on Eribulin. It's given in a 21 day cycle, with infusions on days 1 and 8 and a Neulasta injection on day 9. I will probably end up doing the Neulasta with their OnPro technology - a high-tech patch that goes on your arm at the end of chemo and does the injection automatically 24 hours later.
So, treatment is taken care of for now.
The nausea problem peaked last weekend. It got to the point where I vomited from the nausea 3 days in a row, and I was barely eating anything. I was resorting to milk shakes made with Ensure just to get some calories into my system. Most days, I was able to eat fewer than 1000 calories. At my appointment yesterday, I found out that my weight has dropped almost 20 pounds since August.
Early this week, the doctor had me greatly increase my dosage of Compazine, an anti-nausea drug that I have a prescription for during chemo. I was taking it once a day at 5mg. They had me start taking 10mg every six hours and the nausea now seems to be at bay. I had a bit of nausea this morning, the day after chemo, but not so bad that I vomited.
Hopefully, the chemo won't increase the nausea beyond manageable levels.
So, that's it. Pain is under control. Nausea is under control. And, I've started a new treatment. Now, we wait and hope the treatment works.
Let me catch you up.
So, insurance still has not approved, nor have they officially denied, my request for proton beam radiation. But, I simply can't wait anymore. Things have been getting worse and it was time for action.
Since I last posted, the pain issue really exploded. My pain levels were drastically increasing and my pain medications just weren't keeping up. It really peaked on a Monday and I had to call in sick. I couldn't get in to see my primary care provider, so she suggested that I visit the Emergency Department at our local hospital instead. So, I did that. I spent about 5 hours there, and at the end, they just threw a new prescription at me for a slightly stronger pain medication and they sent me home. I was supposed to follow up with my PCP on the pain medicine.
So, the next day, I called in sick again and used the new pain medicines. They didn't help. By now, my PCP had given me her cell phone number and she and I were texting back and forth. On Wednesday morning, when things weren't better, she suggested that I go to the ED at one of the two teaching hospitals in our region. Since my wife and I work in Burlington, I had my wife take me to the ED at the University of Vermont Medical Center. I ended up spending the entire day there.
The first thing they did was just try to get my pain levels under control. It took two injections of morphine to establish a baseline level of control. Four hours later, it took three more injections to keep things under control. But, the good thing about this hospital vs. the one I visited on Monday is that they wanted to figure out why my pain levels were so much higher. They did some imaging and found that my tumors had grown significantly since August. The larger tumors were creating pressure on nerves and that was causing the pain.
Late in the day, the doctor I'd been working with (Dr. Claus - the poor guy must have been tortured his whole life for that name) suggested two options. The first was that he could take a guess at a prescription that would work going forward and send me home. Or, I could be admitted and have a pain specialist from the oncology clinic work with me to establish control of the pain. He offered them to me as almost a 50-50 choice, assuming that I was averse to being admitted. But, to me it was a no-brainer and I chose to be admitted. That afternoon, before they could even admit me, I was interviewed by two pain specialists. They knew about the tumor growth.
By the time I'd been admitted, they had a plan they wanted to try - Oxycontin with oxycodone for breakthrough pain. I've found out since then that there is a lot of controversy about whether or not Oxycontin really works for the full 12 hours as advertised. In something like half of all patients, it works for less than 12 hours, and it needs to be supplemented with other pain medications. So, we started the Oxycontin on Wednesday night and I was able to sleep through the night for the first time in a while.
On Thursday, the doctors seemed quite happy with themselves, having found something that worked so quickly. I was discharged late Thursday afternoon with 2 new prescriptions. I was happy that we had a solution. Until, that is, we reached the pharmacy. It turned out that Oxycontin isn't covered by my insurance. I had two options - pay $541 out of pocket or pay for a lesser amount that I could choose. But, if I chose a lesser amount, the rest of the prescription would be invalid. I was torn. I knew that if I didn't fill the prescription, I'd end up back in the hospital. I felt like it would be justice for my insurance company to have to pay for the re-admission if they refused to pay for the medication. But, I'm not truly that petty, I didn't want to go back to the hospital, and I wanted the pain to be gone, so I paid the money.
In the end, it turned out that, with prior approval, my insurance company will pay for the brand name Oxycontin, but not the generic. I've now gotten that prior approval, and my local pharmacy is carrying the brand name just for my needs. That's one advantage of living in a small town, where the pharmacists know me and my condition well. They are willing to change their stock just to help my needs. And, UVMMC turned over my co-pay issue to a social worker. Through a grant, I got back about 60% of the cost of the prescription.
So, I now had my pain under control. But, these new pain meds mean that I can't really drive anymore, which has created a new burden for my wife. She had always been the driver on our commute, but I usually dropped her off in the morning and took the car for the day. She is now dropping me off, and she needs to come with me on every medical appointment. I feel bad for the burden on her, but I'm not going to risk driving with pain meds in my system.
So, with the pain under control, I still had two issues to fight. First, I needed to get treatment re-started. It's been two months since I found out that the last treatment failed - two months of allowing my tumors to grow without fighting back. At this point in time, I have to assume that the proton beam therapy is not going to happen, and we need to start a systemic treatment as an alternative. And, I had to work on my nausea, which had been getting worse by the day.
First, let's talk about treatments. When I was last at Sloan Kettering, the medical oncologist that I see there had suggested a drug called Eribulin. It is an older drug that's been around for a while and I think it's often used in breast cancer treatment. My local medical oncologist had suggested Trabectidin, which is a newer drug that is specific to sarcomas, if not just liposarcoma.
As the prospects for the proton beam therapy dropped, and my symptoms began to increase, I started to rely more and more on my local medical oncologist. She scheduled me for a CT scan on Wednesday of this week. That was followed by an appointment yesterday - Thursday. In the appointment, she said she was fine using either of the drugs, but that she'd gone along with the Sloan Kettering recommendation and scheduled me to start Eribulin immediately.
I had no qualms with that. I am concerned that Eribulin tends to have more side effects than Trabecticin, but that isn't the most important thing right now. Getting started with a treatment was the most important thing. So, I did have a treatment yesterday and I'm now on Eribulin. It's given in a 21 day cycle, with infusions on days 1 and 8 and a Neulasta injection on day 9. I will probably end up doing the Neulasta with their OnPro technology - a high-tech patch that goes on your arm at the end of chemo and does the injection automatically 24 hours later.
So, treatment is taken care of for now.
The nausea problem peaked last weekend. It got to the point where I vomited from the nausea 3 days in a row, and I was barely eating anything. I was resorting to milk shakes made with Ensure just to get some calories into my system. Most days, I was able to eat fewer than 1000 calories. At my appointment yesterday, I found out that my weight has dropped almost 20 pounds since August.
Early this week, the doctor had me greatly increase my dosage of Compazine, an anti-nausea drug that I have a prescription for during chemo. I was taking it once a day at 5mg. They had me start taking 10mg every six hours and the nausea now seems to be at bay. I had a bit of nausea this morning, the day after chemo, but not so bad that I vomited.
Hopefully, the chemo won't increase the nausea beyond manageable levels.
So, that's it. Pain is under control. Nausea is under control. And, I've started a new treatment. Now, we wait and hope the treatment works.
Tuesday, September 18, 2018
Next steps - the Kobayashi Maru
Since my last post, I've made one more trip to Sloan Kettering in NYC. To be honest, I don't like how things are going right now.
The surgeon that I saw in early August doesn't really want to operate, and he's one of the more aggressive surgeons out there for liposarcoma. He will operate when others don't want to operate. He's the guy that people go to see when their local surgeon doesn't want to do any more surgery.
He sent me to a radiation oncologist instead. I was mostly disappointed in that visit, because it seemed that the radiation oncologist wasn't really prepared when I got there. It seemed like he was making stuff up while I was sitting there.
Essentially, he didn't want to do conventional radiation, because the beam of radiation would pass though a spot where my bowel has been re-constructed. He is worried that the radiation could burn a hole in the bowel, and because of prior radiation, it could be very difficult to get in there and do the surgery to repair the hole in the bowel if it occurred. It would be an emergency surgery, full of risks.
But, he did have an alternative idea - proton beam radiation. Proton beam radiation, unlike normal photon beams, can he halted at a particular depth. So, it was his reasoning that we could make the beam go far enough to reach two tumors, but not go so far that it would damage my bowel. Of course, he said there were still risks, but he thought that this was the way to go.
He also warned me that proton beam radiation is very expensive and insurance companies tend to fight it as a treatment option. While I was still at the hospital, he talked briefly to the surgeon and they agreed to take my case to their tumor board to discuss options. This was on 8/22. Then, for weeks, I heard nothing. I thought that perhaps they were fighting my insurance company. I finally heard from my surgeon on 9/14. They had finally agreed to a plan.
I have four total tumors right now. One of them could easily be operated on. The other 3 are not great candidates for surgery. So, the plan is to attack those 3 tumors with proton beam radiation and then enroll me in a clinical trial to try an immunotherapy drug to target the 4th tumor after radiation.
They are allegedly working on the insurance approval right now.
I checked my insurance company's web site yesterday, and found nothing about the pre-approval for the radiation. Perhaps they don't list items until a decision has been made, but it just seems to be taking forever.
While this process drags on, three things have been occurring. First, the pain I'm dealing with is getting worse. We increased my oxycodone prescription a couple months ago, and the next time I need to increase the dose, I need to see a pain specialist rather than my primary care doc. I'm at the limit that VT law allows my PCP to prescribe. The next step is likely to be something like a morphine pump, something I've been hoping to avoid.
I'm also dealing with increasing fatigue. I am napping all of the time. I fall asleep in the car on the way to work. I fall asleep on the way home. I fall asleep on the couch as soon as I get home.
Yesterday was all of those things. I slept on the way to work and on the way home. We skipped the gym on squat day, a day that I hate to miss, because I was so tired. As soon as I got home, I fell asleep on the couch. I woke up about 8:00 and ate a sandwich for dinner. And then, I fell asleep again. At 10:00, my wife woke me up to go to bed. And, at 6:45 this morning, having seemingly slept for most of the past 24 hours, I could barely drag myself out of bed.
Lastly, I have zero appetite. I never eat breakfast. I rarely eat lunch, or I eat something very small for lunch. On the weekends, I never bother to eat breakfast or lunch. And then at dinner, even with the medical marijuana, I still don't feel hungry. My weight is gradually decreasing. I think it's been my fairly regular attendance at the gym that's been stopping it from dropping faster, but if the fatigue starts to mess with my gym attendance, I'm afraid that my weight will plummet. I'm certainly not skinny. But, to be honest, I don't want to lose any weight right now. I need to keep as much muscle mass on my body as possible, to be ready to handle the rigors of radiation and immunotherapy.
For the first time since this ordeal started about 3.5 years ago, I feel like I'm starting to fall behind. Previously, it felt like we always had answers, another treatment option, I had the gym and my training to focus on, and I had a focus for taking on this disease. Right now, it feels like I'm starting to lose some of that.
I'm also somewhat depressed by something my employer did to me recently. I will admit that during my last chemo, I was far from 100%. I tried hard to keep up, to do a good job, and I was even working up to 60 hours per week during chemo. But, it wasn't good enough for my employer.
The Friday before Labor Day, my employer presented me with an "offer". Basically, they were planning to demote me for poor performance, to decrease my salary by 35%, and they asked me to sign a form that admitted I was incompetent at my job.
I spent the weekend trying to chase down an attorney to see what my options were. What I discovered is that despite my cancer, at-will employment seems to trump the ADA and EEOC laws, and I really had no means to avoid the situation. Two attorneys suggested that I not sign the form, but I was told that they could impose the job and salary on me at will. So, I did refuse to sign the form, and the company imposed the new job and new salary on me. So, now my wife and I are staring at bankruptcy on top of everything else that is going on.
If they had fired me, I would have been eligible for unemployment, I would have filed for bankruptcy immediately, and I would have started the waiting period to collect social security disability insurance. Instead, they left me with some income, but not enough. So now, we will struggle for 3-12 months (it's hard to predict how long we can hold out) and then we will have to file for bankruptcy.
Another hope that I was holding onto was that I'd be able to go onto disability insurance when I'd reached the one year mark at work. That insurance basically pays 2/3 of your salary. At my old salary, again, we could have gotten by for a while on that level of income. But, 2/3 of my new salary is now less than half of my old salary, and while we may still take that option, it would again mean bankruptcy.
All in all, I think we've held up pretty well for the past 3.5 years. If you count my prostate cancer before that and the rare form of melanoma that my wife had, it's been five years of dealing with cancer. But, we are now approaching the point where we are not going to be able to make it on our own any more.
My daughter is currently doing a semester in Spain. She sent me a WhatsApp message last night, asking if my wife and I might be interested in meeting her in Spain for a long weekend in Bilbao. We would love to do that, but it's simply not possible given this turn of events. I was almost in tears as I read her invitation and thought about how impossible it was.
Oh yeah, two different attorneys have looked at what my employer has done to me. Both of them described it as the most unethical thing that they've ever seen an employer do. At the same time, they said that it appeared to be completely legal.
What kind of system do we have in this country where someone's life can just be destroyed because you were unlucky enough to contract a rare cancer? I know I'm not alone in this situation, but for a while, it seemed like we'd be OK.
Now, I'm left wondering if we are going to be able to afford to eat, or to even feed our pets.
Please don't feel sorry for me. I've had a great life. I have an amazing family and support system. I'll get through this somehow. I'm sure that many others have been put in worse situations than mine.
But, it's certainly not how I expected that the final years of my life would go down.
The surgeon that I saw in early August doesn't really want to operate, and he's one of the more aggressive surgeons out there for liposarcoma. He will operate when others don't want to operate. He's the guy that people go to see when their local surgeon doesn't want to do any more surgery.
He sent me to a radiation oncologist instead. I was mostly disappointed in that visit, because it seemed that the radiation oncologist wasn't really prepared when I got there. It seemed like he was making stuff up while I was sitting there.
Essentially, he didn't want to do conventional radiation, because the beam of radiation would pass though a spot where my bowel has been re-constructed. He is worried that the radiation could burn a hole in the bowel, and because of prior radiation, it could be very difficult to get in there and do the surgery to repair the hole in the bowel if it occurred. It would be an emergency surgery, full of risks.
But, he did have an alternative idea - proton beam radiation. Proton beam radiation, unlike normal photon beams, can he halted at a particular depth. So, it was his reasoning that we could make the beam go far enough to reach two tumors, but not go so far that it would damage my bowel. Of course, he said there were still risks, but he thought that this was the way to go.
He also warned me that proton beam radiation is very expensive and insurance companies tend to fight it as a treatment option. While I was still at the hospital, he talked briefly to the surgeon and they agreed to take my case to their tumor board to discuss options. This was on 8/22. Then, for weeks, I heard nothing. I thought that perhaps they were fighting my insurance company. I finally heard from my surgeon on 9/14. They had finally agreed to a plan.
I have four total tumors right now. One of them could easily be operated on. The other 3 are not great candidates for surgery. So, the plan is to attack those 3 tumors with proton beam radiation and then enroll me in a clinical trial to try an immunotherapy drug to target the 4th tumor after radiation.
They are allegedly working on the insurance approval right now.
I checked my insurance company's web site yesterday, and found nothing about the pre-approval for the radiation. Perhaps they don't list items until a decision has been made, but it just seems to be taking forever.
While this process drags on, three things have been occurring. First, the pain I'm dealing with is getting worse. We increased my oxycodone prescription a couple months ago, and the next time I need to increase the dose, I need to see a pain specialist rather than my primary care doc. I'm at the limit that VT law allows my PCP to prescribe. The next step is likely to be something like a morphine pump, something I've been hoping to avoid.
I'm also dealing with increasing fatigue. I am napping all of the time. I fall asleep in the car on the way to work. I fall asleep on the way home. I fall asleep on the couch as soon as I get home.
Yesterday was all of those things. I slept on the way to work and on the way home. We skipped the gym on squat day, a day that I hate to miss, because I was so tired. As soon as I got home, I fell asleep on the couch. I woke up about 8:00 and ate a sandwich for dinner. And then, I fell asleep again. At 10:00, my wife woke me up to go to bed. And, at 6:45 this morning, having seemingly slept for most of the past 24 hours, I could barely drag myself out of bed.
Lastly, I have zero appetite. I never eat breakfast. I rarely eat lunch, or I eat something very small for lunch. On the weekends, I never bother to eat breakfast or lunch. And then at dinner, even with the medical marijuana, I still don't feel hungry. My weight is gradually decreasing. I think it's been my fairly regular attendance at the gym that's been stopping it from dropping faster, but if the fatigue starts to mess with my gym attendance, I'm afraid that my weight will plummet. I'm certainly not skinny. But, to be honest, I don't want to lose any weight right now. I need to keep as much muscle mass on my body as possible, to be ready to handle the rigors of radiation and immunotherapy.
For the first time since this ordeal started about 3.5 years ago, I feel like I'm starting to fall behind. Previously, it felt like we always had answers, another treatment option, I had the gym and my training to focus on, and I had a focus for taking on this disease. Right now, it feels like I'm starting to lose some of that.
I'm also somewhat depressed by something my employer did to me recently. I will admit that during my last chemo, I was far from 100%. I tried hard to keep up, to do a good job, and I was even working up to 60 hours per week during chemo. But, it wasn't good enough for my employer.
The Friday before Labor Day, my employer presented me with an "offer". Basically, they were planning to demote me for poor performance, to decrease my salary by 35%, and they asked me to sign a form that admitted I was incompetent at my job.
I spent the weekend trying to chase down an attorney to see what my options were. What I discovered is that despite my cancer, at-will employment seems to trump the ADA and EEOC laws, and I really had no means to avoid the situation. Two attorneys suggested that I not sign the form, but I was told that they could impose the job and salary on me at will. So, I did refuse to sign the form, and the company imposed the new job and new salary on me. So, now my wife and I are staring at bankruptcy on top of everything else that is going on.
If they had fired me, I would have been eligible for unemployment, I would have filed for bankruptcy immediately, and I would have started the waiting period to collect social security disability insurance. Instead, they left me with some income, but not enough. So now, we will struggle for 3-12 months (it's hard to predict how long we can hold out) and then we will have to file for bankruptcy.
Another hope that I was holding onto was that I'd be able to go onto disability insurance when I'd reached the one year mark at work. That insurance basically pays 2/3 of your salary. At my old salary, again, we could have gotten by for a while on that level of income. But, 2/3 of my new salary is now less than half of my old salary, and while we may still take that option, it would again mean bankruptcy.
All in all, I think we've held up pretty well for the past 3.5 years. If you count my prostate cancer before that and the rare form of melanoma that my wife had, it's been five years of dealing with cancer. But, we are now approaching the point where we are not going to be able to make it on our own any more.
My daughter is currently doing a semester in Spain. She sent me a WhatsApp message last night, asking if my wife and I might be interested in meeting her in Spain for a long weekend in Bilbao. We would love to do that, but it's simply not possible given this turn of events. I was almost in tears as I read her invitation and thought about how impossible it was.
Oh yeah, two different attorneys have looked at what my employer has done to me. Both of them described it as the most unethical thing that they've ever seen an employer do. At the same time, they said that it appeared to be completely legal.
What kind of system do we have in this country where someone's life can just be destroyed because you were unlucky enough to contract a rare cancer? I know I'm not alone in this situation, but for a while, it seemed like we'd be OK.
Now, I'm left wondering if we are going to be able to afford to eat, or to even feed our pets.
Please don't feel sorry for me. I've had a great life. I have an amazing family and support system. I'll get through this somehow. I'm sure that many others have been put in worse situations than mine.
But, it's certainly not how I expected that the final years of my life would go down.
Monday, August 13, 2018
What a waste of time and resources
I was at Sloan Kettering last week, getting a CT scan after 3 months of chemotherapy. This was a rough round of chemo and I dropped 17 pounds in 3 months despite exercising very little. To be honest, a lot of the lost weight was probably muscle mass. I am really struggling in the gym these days, from both a strength and an aerobic perspective. I honestly think my fitness right now might be the worst it's been since 1998.
So, after all of those side effects, at least I knew I'd been taking a chemo that has worked for me in the past and I was optimistic that I'd get good news. Regretfully, my optimism was unfounded, and the tumors continued to grow right through the chemo.
I have four tumors right now, and three of them grew. Two of them are in a spot that is tough to operate, because it would require an extensive resection of my liver, and it would require a liver specialist as a second surgeon. My surgeon was not crazy about that option.
The chemo that I could try next doesn't have a great success rate. Clinical trials would require me to be in NYC one day every other week - something I can't pull off right now.
But, my surgeon, remembering the good success I had with high dose Image Guided Radiation Therapy (IGRT), suggested we try that again for the two tumors near my liver. The radiation oncologist agreed that this makes sense, so that is the next treatment for me.
The bad thing is that only 2 of my 4 tumors will be targeted, although one of the tumors that won't be targeted is well differentiated, small and growing very slowly. But, the radiation will not go after one of the other major tumors, meaning I might need surgery after radiation.
The bosses here at work are being supportive, but I know they aren't really happy. They would prefer to have me in the office full time rather than being out getting treatments. For this next treatment, I have a consult with the radiation oncologist next week in NYC, then a day to fit a mold around my body to hold me in place during radiation, and then finally, five straight days of treatment. I'll need to be out of the office for all of those days, although I hope to work from NYC during the radiation itself.
I'm afraid of what my travel costs are going to be as well. Finances are pretty tight right now and the cost of a week in NYC, plus the train for 3 trips to the city will be expensive. I'll do my best to figure it out, but things are going to be tight for a while.
So, after three months of a rough chemo, the news wasn't good. But, the doctors have a plan and I'm going to listen to them and continue with the treatment. The side effects from the radiation aren't great, but they are less intense than chemo. It's mostly nausea and fatigue that I'll have to deal with.
I was looking forward to the arrival of fall and hopefully some rain so I could get out fly fishing again. I've hardly fished at all this year due to the high temperatures and the drought we've been dealing with, and now, by the time conditions improve, I'll be dealing with the side effects from radiation.
My next scan will be in late November, and that will determine whether or not I can teach skiing this coming winter.
So, after all of those side effects, at least I knew I'd been taking a chemo that has worked for me in the past and I was optimistic that I'd get good news. Regretfully, my optimism was unfounded, and the tumors continued to grow right through the chemo.
I have four tumors right now, and three of them grew. Two of them are in a spot that is tough to operate, because it would require an extensive resection of my liver, and it would require a liver specialist as a second surgeon. My surgeon was not crazy about that option.
The chemo that I could try next doesn't have a great success rate. Clinical trials would require me to be in NYC one day every other week - something I can't pull off right now.
But, my surgeon, remembering the good success I had with high dose Image Guided Radiation Therapy (IGRT), suggested we try that again for the two tumors near my liver. The radiation oncologist agreed that this makes sense, so that is the next treatment for me.
The bad thing is that only 2 of my 4 tumors will be targeted, although one of the tumors that won't be targeted is well differentiated, small and growing very slowly. But, the radiation will not go after one of the other major tumors, meaning I might need surgery after radiation.
The bosses here at work are being supportive, but I know they aren't really happy. They would prefer to have me in the office full time rather than being out getting treatments. For this next treatment, I have a consult with the radiation oncologist next week in NYC, then a day to fit a mold around my body to hold me in place during radiation, and then finally, five straight days of treatment. I'll need to be out of the office for all of those days, although I hope to work from NYC during the radiation itself.
I'm afraid of what my travel costs are going to be as well. Finances are pretty tight right now and the cost of a week in NYC, plus the train for 3 trips to the city will be expensive. I'll do my best to figure it out, but things are going to be tight for a while.
So, after three months of a rough chemo, the news wasn't good. But, the doctors have a plan and I'm going to listen to them and continue with the treatment. The side effects from the radiation aren't great, but they are less intense than chemo. It's mostly nausea and fatigue that I'll have to deal with.
I was looking forward to the arrival of fall and hopefully some rain so I could get out fly fishing again. I've hardly fished at all this year due to the high temperatures and the drought we've been dealing with, and now, by the time conditions improve, I'll be dealing with the side effects from radiation.
My next scan will be in late November, and that will determine whether or not I can teach skiing this coming winter.
Wednesday, July 4, 2018
On to round 3
It seemed to take forever, but my white blood cell counts finally rebounded enough that we could finish round 2 of the chemo. It's supposed to be a 21 day cycle, with treatments on days 1 and 8, but my day 8 treatment didn't happen until day 20 in the second round.
Even then, my white blood cell counts, although high enough to give me the treatment, were still less than 10% of normal. So, the third cycle was delayed by an additional week and it's scheduled to start on Friday.
The second round ended up taking a lot out of me. I'm going to see if there's any way to use Neulasta or Neupogen to speed along my immune system recovery in this next round. I don't want all of the rounds stretching out to 4 weeks.
By adding a week to the process, it now means that all of the concerts I have tickets for in July happen on the same weekend as Day 1 of the chemo cycle. This is when I feel the worst from the chemo, although the "down period" from the Day 1 treatment lasted a full 10 days in this past round. I also went 22 days without going to the gym - something I really hate. In July, I'm hopeful that I'll feel OK at all the concerts (4 total) that I'm going to see. My biggest concern is three straight days of shows at the end of the month - a Thursday night (we will likely do chemo that day), and then Friday and Saturday in Camden, NJ.
So, on Friday, I will talk to the doctor about options to keep my immune system functioning at its best as we start this next round.
I have to admit that work has really been a challenge, and I'm guessing it showed to some extent. I met with my boss yesterday, and she is going to temporarily take a few projects off my plate. She warned me that she still had high expectations for my work, but she wanted to reduce my stress level a little bit as I go through the rest of chemo.
In some ways, I'm thrilled. I have felt like I'm drowning at work and I can never catch up. I'm still going to have a lot to do, but it's going to be more of what I was hired to do and less of the project work that was outside my core skill set.
On the other hand, I worry a bit that the work was removed from my plate because I wasn't doing it well enough. Anyone who knows me knows that I'm a perfectionist about the work I do, and I'm my own harshest critic. Although, and I say this with no ill will at all, my current boss is also a tough critic and she has high expectations. I'm hopeful that the work that was removed from my plate was removed for the reasons stated, and not because I was doing a poor job at some of it. But I'll probably never know for sure.
My primary goal now is to excel at the core work I was hired to do, and then, in a few months, I'll hopefully be feeling better and I'll ask to be re-assigned some of the project work that was taken away earlier this week.
In the interim, life is simple. Work hard and do a good job at work. Reduce my stress levels a bit and get my treatments done. Try to have fun with my concerts, the gym, and some fly fishing. And, hope that the chemo is doing its job so that I can enter a period of no treatments later this summer. Or, at the very least, hope that I'll continue with just one of the current chemo agents - the one with very few side effects.
And, I have to hope that my immune system can handle the treatments. Apparently, every time I have had a cytotoxic chemo in the past, it has done a little bit of damage to my bone marrow. Over time, the bone marrow simply doesn't work as well after the beatings it's taken, and the risk of neutropenia goes up with repeated treatments. Hopefully, we can find a way to avoid that issue in this next round and in the future. The last thing I need is to be hospitalized with some sort of opportunistic infection. I trust that my docs are doing everything that they can for me, but I'd prefer to see them a little bit less often, if possible. Being hospitalized for an infection would mean seeing them more, not less.
Even then, my white blood cell counts, although high enough to give me the treatment, were still less than 10% of normal. So, the third cycle was delayed by an additional week and it's scheduled to start on Friday.
The second round ended up taking a lot out of me. I'm going to see if there's any way to use Neulasta or Neupogen to speed along my immune system recovery in this next round. I don't want all of the rounds stretching out to 4 weeks.
By adding a week to the process, it now means that all of the concerts I have tickets for in July happen on the same weekend as Day 1 of the chemo cycle. This is when I feel the worst from the chemo, although the "down period" from the Day 1 treatment lasted a full 10 days in this past round. I also went 22 days without going to the gym - something I really hate. In July, I'm hopeful that I'll feel OK at all the concerts (4 total) that I'm going to see. My biggest concern is three straight days of shows at the end of the month - a Thursday night (we will likely do chemo that day), and then Friday and Saturday in Camden, NJ.
So, on Friday, I will talk to the doctor about options to keep my immune system functioning at its best as we start this next round.
I have to admit that work has really been a challenge, and I'm guessing it showed to some extent. I met with my boss yesterday, and she is going to temporarily take a few projects off my plate. She warned me that she still had high expectations for my work, but she wanted to reduce my stress level a little bit as I go through the rest of chemo.
In some ways, I'm thrilled. I have felt like I'm drowning at work and I can never catch up. I'm still going to have a lot to do, but it's going to be more of what I was hired to do and less of the project work that was outside my core skill set.
On the other hand, I worry a bit that the work was removed from my plate because I wasn't doing it well enough. Anyone who knows me knows that I'm a perfectionist about the work I do, and I'm my own harshest critic. Although, and I say this with no ill will at all, my current boss is also a tough critic and she has high expectations. I'm hopeful that the work that was removed from my plate was removed for the reasons stated, and not because I was doing a poor job at some of it. But I'll probably never know for sure.
My primary goal now is to excel at the core work I was hired to do, and then, in a few months, I'll hopefully be feeling better and I'll ask to be re-assigned some of the project work that was taken away earlier this week.
In the interim, life is simple. Work hard and do a good job at work. Reduce my stress levels a bit and get my treatments done. Try to have fun with my concerts, the gym, and some fly fishing. And, hope that the chemo is doing its job so that I can enter a period of no treatments later this summer. Or, at the very least, hope that I'll continue with just one of the current chemo agents - the one with very few side effects.
And, I have to hope that my immune system can handle the treatments. Apparently, every time I have had a cytotoxic chemo in the past, it has done a little bit of damage to my bone marrow. Over time, the bone marrow simply doesn't work as well after the beatings it's taken, and the risk of neutropenia goes up with repeated treatments. Hopefully, we can find a way to avoid that issue in this next round and in the future. The last thing I need is to be hospitalized with some sort of opportunistic infection. I trust that my docs are doing everything that they can for me, but I'd prefer to see them a little bit less often, if possible. Being hospitalized for an infection would mean seeing them more, not less.
Friday, June 15, 2018
Climbing out of the abyss
I started my second cycle of chemo last Friday. Regretfully, this round hit me harder than the first time through, and it's been a tough week. Part of the problem was that I had concert tickets for this past Monday night, and on a night where I should have been resting, I was at SPAC in Saratoga, NY seeing Dead and Company.
Ever since then, I've been playing catch-up on my sleep, and struggling to get by at work. But, day by day, things have been getting better. Today is the first day I've even considered going to the gym in the past week, although I'm guessing I'm going to opt for rest instead.
I was due for another infusion today - the less toxic drug only. But, somehow the hospital screwed up and didn't get the drug in stock, so they had to delay things until Monday. That means I don't get the weekend to rest and recover right after the chemo. But, because it's the less toxic drug, I'm hoping I'll feel pretty decent next week, even with the infusion on Monday rather than Friday.
I did talk to the hospital a few times this week. I've honestly felt so bad that I barely made it to work a few days this week. I was hoping there was something that could be done to alleviate the fatigue and nausea. They couldn't really help for this round, but they have some ideas going forward.
Today, the hospital finally got back to me on those issues, and they want me to really focus on taking more of a steroid next round, plus more medical marijuana. I've been nauseated, unable to eat, and not sleeping well despite being tired. My doctor is convinced that the medical MJ will make a big difference if I can just get that down the next time around. So, we have a plan for the next round. This is the first time ever that my doctor has actively advised using marijuana. She never flinches when it's time to sign for my medical MJ card, but she's never really advocated for its use either. This time, she is actively suggesting that I use it more. So, I will.
Hopefully, by not having chemo today, I'll feel better this weekend. It's supposed to be a beautiful weekend, and I'm hoping my wife and I will get out and do some fishing. Plus, we have our normal weekend trip to the farmers' market and some lawn work to do.
Other than that, life moves on. I'm just trying to have as much fun as possible, take care of my body, and make sure I can handle the demands of work. It's been a tough week, but I made it through. Hopefully the next two weeks will be much better.
Here's a link to an interesting article that I read this week. While the author has a completely different illness than I have, I really identified with the article.
Ever since then, I've been playing catch-up on my sleep, and struggling to get by at work. But, day by day, things have been getting better. Today is the first day I've even considered going to the gym in the past week, although I'm guessing I'm going to opt for rest instead.
I was due for another infusion today - the less toxic drug only. But, somehow the hospital screwed up and didn't get the drug in stock, so they had to delay things until Monday. That means I don't get the weekend to rest and recover right after the chemo. But, because it's the less toxic drug, I'm hoping I'll feel pretty decent next week, even with the infusion on Monday rather than Friday.
I did talk to the hospital a few times this week. I've honestly felt so bad that I barely made it to work a few days this week. I was hoping there was something that could be done to alleviate the fatigue and nausea. They couldn't really help for this round, but they have some ideas going forward.
Today, the hospital finally got back to me on those issues, and they want me to really focus on taking more of a steroid next round, plus more medical marijuana. I've been nauseated, unable to eat, and not sleeping well despite being tired. My doctor is convinced that the medical MJ will make a big difference if I can just get that down the next time around. So, we have a plan for the next round. This is the first time ever that my doctor has actively advised using marijuana. She never flinches when it's time to sign for my medical MJ card, but she's never really advocated for its use either. This time, she is actively suggesting that I use it more. So, I will.
Hopefully, by not having chemo today, I'll feel better this weekend. It's supposed to be a beautiful weekend, and I'm hoping my wife and I will get out and do some fishing. Plus, we have our normal weekend trip to the farmers' market and some lawn work to do.
Other than that, life moves on. I'm just trying to have as much fun as possible, take care of my body, and make sure I can handle the demands of work. It's been a tough week, but I made it through. Hopefully the next two weeks will be much better.
Here's a link to an interesting article that I read this week. While the author has a completely different illness than I have, I really identified with the article.
Thursday, June 7, 2018
First chemo cycle done
Each of my four scheduled chemo cycles lasts 21 days. Today is day number 21 of the first cycle, which means that I start the next cycle tomorrow.
Just as with all the other chemo I've done in the past, it seems that just as you start to feel almost human again, it's time to start all over again.
On Monday and Tuesday of this week, I had the best workouts I've had since the chemo started. For the most part, my strength, while reduced, hasn't been too bad. It's been my aerobic capacity that's taken a big hit. I'm not anemic, but I just seem to have no aerobic capacity. On Monday and Tuesday, I finally felt like I could push a bit.
On Monday night, I ate what I would consider my first truly normal dinner since the chemo started. My appetite is finally returning. Yesterday was my wife's birthday (last year, we had dinner at db Bistro Moderne in NYC on her birthday, so this year's local restaurant was a bit of a letdown), and I felt good enough to take her out for dinner to celebrate. I even had a martini - my first alcoholic beverage since the chemo started. But, again, I didn't eat very much and I was in bed by 9:15. Not my best effort for my wife's birthday, but in her infinite patience for my medical situation, she said she was just happy to have the whole family together for dinner.
So, tonight I'll get in one more CrossFit workout before the next round begins.
And then tomorrow morning, it all starts again. I am hopeful that everything goes better at the hospital this time. Last time around, they seemed a bit confused by all of the drugs, any potential drug-drug interactions, my sensitivity to dexamethasone (I need to have it infused over an hour instead of the normal 10-15 minutes), etc. I think that my cancer is so rare that the nurses had never even given one of the meds before. It is a fairly new drug, only given to liposarcoma patients at a particular stage in the disease, and usually in conjunction with another particular drug. They were very concerned about the possibility of allergic reactions with that drug, hence the need for the dexamethasone and also Benadryl. All in all, I didn't get out of the infusion clinic until after 7:00 p.m. last time around.
Tomorrow, we are starting earlier and hoping to finish much earlier. I'm sure that none of the nurses wanted to be in the clinic with me that late on a Friday last time around. I'm sure they had better things to be doing on a Friday evening.
This weekend, I'm scheduled to fish in a fly fishing tournament. I'm a bit skeptical that I'll feel up to it, but as long as I'm taking dexamethasone, which helps with my energy levels in the days after the infusion, I have a chance that I'll make it out.
I have to admit that I've been sleeping in most weekends, and if I'm going to fish the tournament, I would want to be on water close to 5:00 a.m. on Saturday morning. So, we will see if I can do it or not. I can always start (if I can get out of bed) and then bail if necessary.
I'm going to load up on Ensure and ice cream this weekend. In the first chemo round, my weight dropped almost 10 pounds in the first week after the infusion, although it has stabilized in the last two weeks. I always seem be carrying some extra pounds, but I really want to limit how much weight I lose. I certainly don't want to be losing muscle mass, which I think is important for me to remain active through the treatments.
So, no exciting updates. The first round was tough - tougher than I expected, to be honest. Last time I had doxorubicin, each round got worse than the one before it. I'm hoping that doesn't happen this time around. I've been able to work every scheduled work day since treatment started. I had one day where I was really exhausted, but I managed to make it to work. I've already lost my hair, so that won't change this next time around.
One round down, and three to go.
Thanks to all of you who read this blog and send me words of encouragement. It's very much appreciated. When I started this blog about a decade ago, it was all about ultra-running and skiing. i certainly never imagined that it would end up being a cancer blog. But, I imagine that most cancer patients never really expected their diagnosis right up until the moment it happened. None of us are immune. Eventually, whether through a friend or a family member or even yourself, cancer will touch your life. Let's all hope that science eventually finds a cure for the plethora of diseases that we collectively call cancer. Nobody should have to go through the process of being poisoned right up to the limits of what the body can handle, or radiated so extensively that secondary cancers are spawned.
I sometimes think of the movie Star Trek IV: The Voyage Home. The crew of the Enterprise finds itself in a Bay are hospital in the 1980s. Dr. McCoy encounters a patient on dialysis. His response is "What is this, the Dark Ages?" He gives the woman a pill, and if I recall correctly, her body generates a new kidney. The interns are shocked at what they find.
Yes, we are a long way from those kind of medical solutions. But, in many ways, we are living in the Dark Ages, and I'd rather be a patient in an era where medicine guesses less and actually knows how to solve problems. Who knows how many years/decades/centuries might pass before we reach that point?
Just as with all the other chemo I've done in the past, it seems that just as you start to feel almost human again, it's time to start all over again.
On Monday and Tuesday of this week, I had the best workouts I've had since the chemo started. For the most part, my strength, while reduced, hasn't been too bad. It's been my aerobic capacity that's taken a big hit. I'm not anemic, but I just seem to have no aerobic capacity. On Monday and Tuesday, I finally felt like I could push a bit.
On Monday night, I ate what I would consider my first truly normal dinner since the chemo started. My appetite is finally returning. Yesterday was my wife's birthday (last year, we had dinner at db Bistro Moderne in NYC on her birthday, so this year's local restaurant was a bit of a letdown), and I felt good enough to take her out for dinner to celebrate. I even had a martini - my first alcoholic beverage since the chemo started. But, again, I didn't eat very much and I was in bed by 9:15. Not my best effort for my wife's birthday, but in her infinite patience for my medical situation, she said she was just happy to have the whole family together for dinner.
So, tonight I'll get in one more CrossFit workout before the next round begins.
And then tomorrow morning, it all starts again. I am hopeful that everything goes better at the hospital this time. Last time around, they seemed a bit confused by all of the drugs, any potential drug-drug interactions, my sensitivity to dexamethasone (I need to have it infused over an hour instead of the normal 10-15 minutes), etc. I think that my cancer is so rare that the nurses had never even given one of the meds before. It is a fairly new drug, only given to liposarcoma patients at a particular stage in the disease, and usually in conjunction with another particular drug. They were very concerned about the possibility of allergic reactions with that drug, hence the need for the dexamethasone and also Benadryl. All in all, I didn't get out of the infusion clinic until after 7:00 p.m. last time around.
Tomorrow, we are starting earlier and hoping to finish much earlier. I'm sure that none of the nurses wanted to be in the clinic with me that late on a Friday last time around. I'm sure they had better things to be doing on a Friday evening.
This weekend, I'm scheduled to fish in a fly fishing tournament. I'm a bit skeptical that I'll feel up to it, but as long as I'm taking dexamethasone, which helps with my energy levels in the days after the infusion, I have a chance that I'll make it out.
I have to admit that I've been sleeping in most weekends, and if I'm going to fish the tournament, I would want to be on water close to 5:00 a.m. on Saturday morning. So, we will see if I can do it or not. I can always start (if I can get out of bed) and then bail if necessary.
I'm going to load up on Ensure and ice cream this weekend. In the first chemo round, my weight dropped almost 10 pounds in the first week after the infusion, although it has stabilized in the last two weeks. I always seem be carrying some extra pounds, but I really want to limit how much weight I lose. I certainly don't want to be losing muscle mass, which I think is important for me to remain active through the treatments.
So, no exciting updates. The first round was tough - tougher than I expected, to be honest. Last time I had doxorubicin, each round got worse than the one before it. I'm hoping that doesn't happen this time around. I've been able to work every scheduled work day since treatment started. I had one day where I was really exhausted, but I managed to make it to work. I've already lost my hair, so that won't change this next time around.
One round down, and three to go.
Thanks to all of you who read this blog and send me words of encouragement. It's very much appreciated. When I started this blog about a decade ago, it was all about ultra-running and skiing. i certainly never imagined that it would end up being a cancer blog. But, I imagine that most cancer patients never really expected their diagnosis right up until the moment it happened. None of us are immune. Eventually, whether through a friend or a family member or even yourself, cancer will touch your life. Let's all hope that science eventually finds a cure for the plethora of diseases that we collectively call cancer. Nobody should have to go through the process of being poisoned right up to the limits of what the body can handle, or radiated so extensively that secondary cancers are spawned.
I sometimes think of the movie Star Trek IV: The Voyage Home. The crew of the Enterprise finds itself in a Bay are hospital in the 1980s. Dr. McCoy encounters a patient on dialysis. His response is "What is this, the Dark Ages?" He gives the woman a pill, and if I recall correctly, her body generates a new kidney. The interns are shocked at what they find.
Yes, we are a long way from those kind of medical solutions. But, in many ways, we are living in the Dark Ages, and I'd rather be a patient in an era where medicine guesses less and actually knows how to solve problems. Who knows how many years/decades/centuries might pass before we reach that point?
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