Oddly Enough

Today...  is my birthday...  73 years young or old?  I guess it depends upon one's perspective.  What it means to me is that I am not young physically even though I go to the gym 3-5 days a week...  and that is also strange because I have a treadmill and stationary bike downstairs, just collecting dusk as they wait to be used by someone in this house.

Around my birthday 13 years ago, I was diagnosed with non-Hodgkin's lymphocetic Lymphoma and about 8 years ago on or around my birthday, I was diagnosed with Melanoma and in 4 days from today I will have a biopsy to determine if I have prostate cancer or not.  It seems that my birthday is not just full of Halloween surprises.  I never have liked my birthday actually.

On the other side of the coin, each birthday now is a blessing because I have lived another year longer than I could have lived...  and, there is nothing wrong with that.  My health is pretty good considering what I have been through and I have always been told that if you have your health, you have everything.

Full Body PET Scan With Radioactive Tracer

Yesterday, I had a PET-CT scan with a tracer and while this type of scan is not unusual for me have every 6 months, it is unusual for me to a PET that is full body.  Usually, I am checked from groin to neck and the procedure is completed in 2-3 minutes; whereas,  a full body scan sends me through the machine very slowly and instead of 2-3 minutes, it is completed in 12-15 minutes.  I will have to ask the Oncologist at our next visit why I was give a full body.

A PET-CT scan is an imaging procedure that’s used to:

• See how the tissues and organs in your body are working.
• Find and diagnose many disorders, such as cancer.
• Plan radiation therapy.
• See how treatment is working.

Most PET scans are done to study your body’s use of glucose (a type of sugar). This is because cancer cells take in glucose faster than normal tissue. Because you get glucose from food and drinks, it’s important that you follow the dietary guidelines listed in the “The Day of Your PET-CT” section.

You’ll have a low dose CT scan done at the same time as your PET. CT scans take a fast series of x-ray pictures. The x-ray pictures are combined with your PET scan to create pictures of the soft tissues and bones in the area that was scanned.

You may also be scheduled for a diagnostic CT at the same time as your PET-CT. If you’re also having a diagnostic CT scan, ask your nurse for the resource Computed Tomography (CT) Scan.

Before this PET-CT, I was given an injection of  radioactive medication with glucose called a tracer. This was done to show differences between healthy tissue and diseased tissue. My PET-CT used fluorodeoxyglucose (FDG) as the tracer. FDG is taken up by your cells and I am told that it doesn’t stay in the body long.

My Life Previously

Some days when I wake up, I feel refreshed and full of life and other days I feel like I have not gotten enough sleep with a less than positive outlook but not necessarily depression.  I cannot predict how each morning will be nor can I predict how each day will unfold in the sense will these sensations continue or will my feelings change...  and, I try not to recall what the earlier days of my treatments were like because my constant vomiting was the worst experience of my life.  I would be lying on the cold tile floor because I felt like I was going to pass out, and my entire upper body would be covered in dripping sweat; my entire upper body would convulse and arch and I could feel myself pulling up through my throat and stomach something hidden deep inside my body.  Only nothing would come out.  

I would continue to do this until a tiny amount of liquid would emerge from my mouth and all my symptoms would suddenly disappear and the sweat made me shiver uncontrollably for several minutes.  It would be several more minutes before I had the strength to pull myself up from the floor, put on a bathrobe and stumble back into bed.  I would rest but not sleep for a couple of hours and the process would happen all over again.

After a half dozen times, I would go the the ER and as soon as they infused ZOFRAN into my body, I would immediately feel there had been nothing wrong with me at all and I could not understand why I had wanted to go there, other than my memories.

It was a horrible experience every months for 6 months that I wish on nobody.

Staying at Home

Before the COVID-19 Pandemic, I spent a lot of time at home except for doctor's appointments but I knew that if I needed or wanted to go somewhere I could.  I knew that if I wanted to visit the Mall, any restaurant, Walmart, movie theaters, parks, or gyms I could.  My wife and I usually went out to dinner once a week, got movie tickets once a month, and went on vacation 5-6 times a years either on a cruise, staying in a condo at Myrtle Beach, Gulf Coast, or used our frequent flyer points for a trip to the other side of the country like Las Vegas, Los Angeles, or Vancouver...

And, while is basically the same issues that most everybody else in America is facing, my condition is a TAD different because of the following:

1. I am 73 years old
2. Have had a heart attack
3. Have low to none immunity
4. Have Anemia
5. Have Lymphoma
6. Have Melanoma
7. Have Hypothyroidism

I am more at RISK than most other Americans because of my illnesses and previous health conditions; therefore, I am forced to stay at home more than others and because of that restriction, my home confinement seems to be, at least to me, that it might be more emotional than other people.  There is just so much one can do at home, even if one has hobbies, likes to clean, likes to work outside in the yard, likes to watch 10 year old movies on CABLE

What Is Non Hodgkin's Lymphoma?

Why is it called non Hodkin's?
Hodgkin lymphoma was named after the doctor who first recognised it. It used to be called Hodgkin's disease. Hodgkin lymphoma has a particular appearance under the microscope and contains cells called Reed-Sternberg cells.
                                                                        

What are Reed-Sternberg cells?
Reed-Sternberg cells are large, abnormal lymphocytes that may contain more than one nucleus.

Non Hodgkin's Lymphoma

Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas. To learn more about how cancers start and spread, see What Is Cancer?

Non-Hodgkin lymphoma (also known as non-Hodgkin’s lymphoma, NHL, or sometimes just lymphoma) is a cancer that starts in white blood cells called lymphocytes, which are part of the body’s immune system.

NHL is a term that's used for many different types of lymphoma that all share some of the same characteristics. There is another main type of lymphoma, called Hodgkin lymphoma, which is treated differently. See Hodgkin Lymphoma.

NHL most often affects adults, but children can get it too. See Non-Hodgkin Lymphoma in Children.
NHL usually starts in lymph nodes or other lymph tissue, but it can sometimes affect the skin. See Lymphoma of the Skin.

Non Hodgkin's Lymphoma (NHL) DISCRIMINATES

In the United States, whites are more likely than African Americans and Asian Americans to develop NHL. Worldwide, NHL is more common in developed countries, with the United States and Europe having some of the highest rates.

Knowing this is still not a reason to protest and demand a better treatment from our government...  it is simply a fact of life and a fact with which only the white race in America has to contend...

Personally,

I don't care one way or the other because I only must concern myself with what I have and not with what others do not have...

What concerns me now is the simple fact that I have lived with this cancer for over 12 years and have plans to live with it for at least another 12 years maybe more if I can continue to make myself, do the following:

• First and foremost, I suppose, is exercising at least 3 days each week
• Second and equally as important is to eat all sorts of fruits and vegetables
• Third, is to continue to eat lots of fish and chicken and beans
• Fourth, is to maintain a positive attitude

The Thyroid and One's Heart

 

Conflicting Oncological Opinions

ONLY TWICE in my Cancer Pilgrimage have there been conflicting opinions as to how my cancer treatments should proceed.  The first conflict, was not really a conflict I suppose as much as it was different approaches.  I had temporarily relocated (for work) to KY from TN and the Oncologist in KY decided to give me a cocktail of 3 drugs instead of the 1 drug my TN Oncologist had been ordering.  This new cocktail was:  Rituxan, Fludara, and Cytoxin that I was given two days in a row, every month.  I experienced severe nausea and vomiting and had to be taken to the ER two day after my last day of treatment to get my vomiting under control.

When I returned to TN, my former Oncologist was rather annoyed at what had taken place in KY but since he could do nothing about it, simply proceeded with giving me monthly infusions of Rituxan only.  A couple of years after returning to TN, we discovered Melanoma on the bottom of my left foot which seemed like an odd place.  At first, we thought it was simply a wart.

From the research that my wife and I conducted, there was a possibility but it was not conclusive that the infusions of Fludara or Cytoxin that I had been given in KY could have caused my body to become more susceptible to Melanoma.

Our first thoughts were these:  Would you not have thought that Oncologist would have know about this risk and if so, why did the Oncologist in KY bring it to my attention?

This brings me to my SECOND CONFLICT OF OPINIONS when after my Melanoma had moved from my foot to my groin (four years later) and that it was inoperable because of its location and extensiveness, it was decided to have Opdivo/Radiation treatments simultaneously AND CONTINUE taking my IMBRUVICA pills daily for my Lymphoma.

The opposition's opinion was that the two treatments would conflict with one another.  At the time that this was being discussed, I did not know that my Lymphoma had turned aggressive and that my Oncologist really had no other choice but to treat both cancers at the same time and HOPE FOR THE BEST.

Fortunately for me, the best happened as the two treatments worked in harmony and did not conflict with each other and both my cancers were halted from their continued growth.  Today, I can feel the dead cancer cells in my groin with my fingers and sometimes if I drive for long periods of time or just sit, I can feel them pressing against something even though the pressing is in way hurting.

Metastatic Melanoma BRAF Negative

Approximately half of patients with metastatic melanoma have tumors with mutations in a gene called BRAF. These patients are often treated with one of several targeted therapies approved by the Food and Drug Administration (FDA), including vemurafenib (Zelboraf®), dabrafenib (Tafinlar®), and trametinib (Mekinist®).

These treatments, however, are not effective in patients whose tumors do not have BRAF mutations. Patients whose tumors lack BRAF mutations are often treated with an immune-based therapy, ipilimumab (Yervoy®). Ipilimumab, which inhibits a protein on T cells called CTLA-4, was the first agent from a class of drugs known as immune checkpoint inhibitors to be approved by the FDA.  SOURCE:  Cancer.gov

As far as my particular situation goes, I am BRAF negative which my Oncologist thought was very positive as far as my treatment options were concerned and I was prescribed infusions of Yervoy and Opdivo monthly.  This treatment regime/protocol lasted about 6-9 months as I recall as my Oncologist suggested that I be turned over to a Radiologist for radiation treatments while I continued to receive monthly infusions of only Opdivo.

The latest news from the leading Cancer Institute in the US, MD Anderson, indicated that the best treatment for patients with my particular Melanoma situation was Opdivo enhanced Radiation.  So, I was set up for 6 treatments of concentrated radiation over a period of two weeks.  Fortunately, I experienced no side effects other than fatigue.

However, the radiation did in fact enhance or SUPER CHARGE the Opdivo and my next scan showed that there was a SUBSTANTIAL DECREASE in my melanoma tumors.  Surgery on my neck later to remove a bulge and suspected Melanoma movement revealed DEAD MELANOMA cells when removed and analyzed.

Slowing Down Atrophy

Last week, I went to the gym on Monday and Tuesday, stayed home on Wednesday, and returned to the gym on Thursday and Friday and on Saturday rode our stationary bike downstairs for 50 minutes and did nothing on Sunday...  my exercise routine at the gym is 20-30 on the bike, 10-30 reps on 5-6 strength machines using no resistance to 40 pounds that target my back and shoulders and conclude with 20 minutes on treadmill at a speed of 2.5 which is relatively slow...  I want to get it up to 3.5 eventually or even 4.0.

Depending upon how fast I peddle and my time of 20-30 minutes, I burn about 150-180 calories...  My calorie intake now is 1500 to 1800 each day with the understanding that I could exceed that amount but hopefully not going over 2000.

This week, my plans are the same except that I will not take Wednesday off but may take Saturday and Sunday off instead.  I want to make sure that I do not push my body too hard and strain some of my muscles which would cause me to take off several days until they mend.  I also don't want to build muscle just tone and strength the muscle that I already have or at least slow down the atrophy.  At 73, I am hoping that I can keep up this conditioning until I am 83 or beyond.

My Main Concern Now

One would think that my MAIN CONCERN now would still be my two cancers, or my heart, or my thyroid, or even my impending prostate biopsy...  and while those are of extreme concern to me on a daily basis, what I have been thinking about most is my BLEEDING EPISODES because I am taking XARELTO to keep my blood thin so I do not experience AFIB again or the possibility of a STROKE...

• I have to watch how I shave
• I have to watch how I work in the yard
• I have to watch playing with the cats
• I have to watch when cutting up food
• I have to watch how I scratch something

And, while it may seem like an easy task to undertake which it is...  it is still nonetheless a PAIN IN MY ASS to have to do this on a regular basis.

I have band aids all over my body and each morning, I have to check the sheets and pillow case to see if somehow I was bleeding during the night from a place that was overlooked or difficult to cover like the inside of my nose.

Because of my very low immunity, it is easy for small cuts and scraps to get infected which leads to a scab being formed which then in turn leads to itching and scratching...  and, this is typically done from instinct and without thinking.

Marriages Tested

Because I have no idea when my body is going to experience night sweats, I sleep on a mattress that is not only double sheeted but has another layer of covering just from my waist up that is tucked in around the mattress on top of the other two sheets.  When I twist and turn in the night, the upper layer moves around and sometimes gets crumpled up making it a tad uncomfortable to sleep unless it is spread back out again...  so, every time I am up peeing which is usually about 2-3 times each night, I simply straighten out this upper layer as a matter of routine.

This practice is not something one thinks about all the time, it's just an added activity because of the side effects of my cancer meds.

Another issue that one does not think about all the time or at least I do not is the fact that most of the time my sense of taste and smell is gone and I cannot really taste or smell the foods that I eat, making everything just seem sort of bland.  However, this sensation does come and go and when I can smell and taste, I find myself wanting to eat everything I have not been able to taste even if I am not hungry.

There is a daily awareness of weight gain, night sweats, general fatigue, and depression that accompanies that struggle or battle or journey that one continues to have with cancer.  Each day is a little uncomfortable even if there is no one around to whom it can be admitted or shared due to the "HERE WE GO AGAIN" response.

Spouses get tired of hearing what YOU are going through when THEY are going through something equally as combative...  and, it is difficult for a cancer patient to think about others, when all these side effects are influencing only your behavior.

MARRIAGES SUFFER if one spouse has cancer, even if there are no children present...  CHILDREN make the SUFFERING worse.

Relaxing to Sight and Sound

 

Having cancer is not the best life circumstance with which we must contend either as we grow older or should this happen to us at a much younger age, but if it does, then relaxing oftentimes puts life into perspective for me...  similar to one standing on a sandy beach looking out at the vastness of the ocean or walking along the concrete walkway looking at the Grand Canyon.  Equally as relaxing is the notion of sitting in a chair or recliner looking at the movement inside an aquarium while listening to calming music.

It does not change a damn thing about one's condition but it does slow the mind down some...  and if, I cannot look at an Aquarium what also works for me is sitting in a warm hot tub leaning back against the porcelain sides with my eyes closed.

At other times, I get into my recliner in our living room and sometimes with the cat in my lap I lean back and stare at the Aquarium Screen Saver on ROKU and even though I know that the fish are all digital, it is still relaxing to me and it is without music but for me that is not a problem...

We need to relax our minds and bodies...

Having cancer forces us to sometimes move in that direction out of necessity.

This Past Week

Am I back to normal?

Not completely sure...  but, I think that I am getting there...

This past week, I was at the gym 4 days out of 7 where I exercised on Monday and Tuesday, took Wednesday off, and was back at the gym on Thursday and Friday.  Those 4 days were spent riding a stationary bike for 30 minutes, walking on a treadmill for 20 minutes, and using strength machines that focused on my upper and lower back, and shoulders but in so doing keep the weighs down and the reps low.

I want the weights down and the reps low because I want to TONE not BUILD muscles. The problem with building muscles is that in order to build muscle, you have to rip/tear those muscles so that they can enlarge.  In order to keep that muscle from turning into fat later on is to keep on lifting weights...  and, as one ages, one slows down, and muscles turn to fat...  and, fat is difficult to remove as one ages.

My fatigue is no longer in the morning or in the afternoon but has shifted to the late afternoon or early evening what while it is not severe, it is still there and I have to concentrate more or less to keep me from closing my eyes and taking a quick nap.

No More Early Mornings

When I was working, my morning typically started around 5am where I would drink coffee and write for 60-90 minutes before taking a shower and getting ready for work.  Most of the time, I lived about an hour away from my employment choices, so in order to arrive by 8am, I would need to leave the house around 7am...  Outside of coffee, I typically would eat nothing until lunch unless someone from work brought bagels.

Nowadays, I am up around 8am +/-  depending upon how bad I have to pee as peeing seems to be regulating my nights and early mornings these days...  I am now peeing about 2-3 times each night and the last time I need to pee could be anywhere from 7:30am until 8:30am so whenever that happens, I just decide to stay up and start my day.

I am not sure if the peeing is related to prostate cancer or not, but in about 3 weeks, I will be having a prostate biopsy, so I will know for sure...  if not, then this could just me my new norm...

Week's End Plus Two

Most of us working folk consider the end of the week to be Friday since we will not be working for an employer on Saturday or Sunday; however, for us religious folk, we see the end of the week as Sunday as we faithfully attend Church to reaffirm our faith...  or, what we consider to be our faith...

For us retired folk, we do not see either the end or the beginning of a week but simply the continuance of days...  all of which appearing shorter than the day before even though time remains constant.  Many of us don't really know what day it is unless we consult our calendars to see if this is the day we have an appointment of some sort relative to our health.

In this house, we keep a calendar on the door of the refrigerator that each of us consult daily to determine where we are plus we watch the news each morning for about an hour or until we get bored with the rhetoric and then we turn to our laptops and tablets and pads to determine what the day might bring for us in the way of understanding, happiness, or fear.

We are all VICTIMS of technology, allowing technology to control our lives more and more each day because of the so-called convenience it provides...  but, in reality, this technology is collecting data on our personal interactions with life and then sending us information that might reflect those interactions in the hopes that purchases will be made.

Each life has a VALUE in that how much will be spend each day, each week, each month, each year, each decade, and each LIFETIME...  we maintain our health to be of economic value...

The Faithfulness of TIME

Most everyone is equal in that how much time they have to live their lives on earth...  and, on average, that's been about 80 years or so, although there are reports of being living well into their 90's...  and, this also takes into consideration living with or without serious illnesses and/or diseases like heart attack, cancer, diabetes, COPD, or Parkinson's just to name a few.

Not everyone will ever contract these diseases and they are fortunate that they will never have to experience the side effects of the treatments that are keeping them alive.

But, for those of us who are living with the side effects of treatment, there is a different life entirely for us...  and, a life that is not always met with anger and resentment as much as it is with gratitude that we are still ABOVE GROUND.

At 73 years of age, one could easily say that one's life is almost over in that it is closer to death than it is to one's birth...  and, if there are 100 years on the clock for me then almost 75% of my life has passed; whereas, if there are only 80 years on the clock then, 91% of my life has passed.  Numbers does a much better job of putting things into perspective than age.

However, I like to think that I have a good 20 years left to live even with all my illnesses.

ONLY TIME WILL TELL...

Last Will and Testament

My and I have decided to right our WILLS and while I don't care what she puts in her WILL, I do care what I put in mine...

First of all, if we die together, I wanted it legally stated that I DIED FIRST...

Here is MY WILL:

Being of sound mind and body, here are my wishes...

• Everything I own goes to my spouse, except for the following:
• An antique desk that I asked for from my parent's estate because my daughter at that time was into antiques.  She has the right of first refusal.  After that I don't care.
• My purchased artwork is given to The Alamance County Arts Council in Graham, NC and if they decline I don't care.
• All of my writings, poetry, articles, novels, and daily pages goes to the English Department of Elon University, Elon College, NC to be housed in the Library.  If they decline, then I would like for my brother to be the caretaker of these documents.   If my brother declines, then anyone who wants them can make a request otherwise they need to be destroyed.
• My body is to be given to the University of TN Medical Center for research.
• I don't want a funeral service but if my wife desires closure she can do what she pleases.  My brother, sister, and daughter are not to be invited to any activity since they willingly decided not to participate in my life before I died.

Exercising Off and On Again

Yesterday, began 3 weeks of having no appointments except one for a PET/CT scan to determine growth/non growth of my two cancers, specifically targeting the Melanoma.  So, my visits to the gym, M-F will be basically uninterrupted.  I usually arrive there shortly after noon when there are very few people around, I suppose because it is lunchtime for most of them.

My routine lasts a little over an hour where I start on the stationary bike for 20 minutes then move to the strength machines for my shoulders, arms, upper and lower back, and end with a 20 minutes walk on the treadmill at a speed of 2.5 which I will increase to 3 eventually as my endurance builds.  According to the machines and my estimates, I burn about 150 calories with this routine which is not much but it helps to keep me below the 2000 calorie intake limits I have set for myself.

My workout not only strengthens my endurance and tones my muscles but my heart is also strengthen which was the main purpose of going to the gym about a decade ago.

Amazingly, I have lived past my heart attack and past the two cancers that have attacked me for over 10 years....  2008 it was first detected but 2007 is when I started with all my tests to find out what the hell was wrong with me and why I had lost over 30 pounds in 4-6 weeks.

Recently, I have not felt like exercising due to extreme fatigue which I had attributed to the cancer meds but come to find out that it was a malfunctioning thyroid that was causing those sensations and when I started taking meds, my fatigued disappeared.  However, my thyroid has worsened so my meds have increased and it is still causing my body to be less than 100%...

ANY DAY ABOVE GROUND IS A GOOD DAY...

Monday

While I do not think about DEATH, I am cognizant of the fact that my life will not last much longer in that I have less years to live than I have already lived.  My mother lived to almost 96 and my father lived to 89, so there is longevity on both sides and both had diseases that might have killed them if they had not of died from old age first.  My father's body just quit all of a sudden one morning after talking with him on the phone and my mother declined rapidly as well but took several days...  neither disease killed them although their diseases influenced the ability of their bodies to last longer.

With my cancers, I suppose that I will be in a similar situation and figure that at the most I have 20-25 years left to live...  which would take me to 92 or 97...

So, what do I do each day?

What I do not do is sit around and ponder how long I have to live...  I do that only as an exercise to calculate how much money we will need and then how much money my wife will need to live to 95 if I were to die today or at the end of the year, making it easier to calculate.

SO...  the start year would be January 2021... and she would be 68 years of age...  and, 25 years would take her to age 93 which might be a little low but 25 years is a good target from which to build.

According to what I read online at the SS website, because she is also drawing SS, when I die, she would stop drawing her SS and receive 100% of mine.  If she had not been eligible for SS, then she would have only been able to receive 71% of my SS...

With that number in mind and estimating her future expenses and future deficits, she will need right around $2,000 each month or $24,000 each year or $240,000 each decade.  Given the estimated time at 2.5 decades, she will need $600,000...

AND, the longer I live the more that number is reduced...

Thyroid Meds Increased

Got a call from a NP in my Oncologist's office and because of blood work that I had on Thursday, part of my blood was sent out to an outside lab for further tests specifically regarding my thyroid...  it appears that a side effect of taking OPDIVO is having a screwed up Thyroid...  and, since my results indicated that my number was going up my daily dosage was increased from 25 to 50 mcg's.

Levothyroxine is used to treat hypothyroidism (condition where the thyroid gland does not produce enough thyroid hormone). It is also used with surgery and radioactive iodine therapy to treat thyroid cancer. Levothyroxine is in a class of medications called hormones. It works by replacing thyroid hormone that is normally produced by the body.

Without thyroid hormone, your body cannot function properly, which may result in poor growth, slow speech, lack of energy, excessive tiredness, constipation, weight gain, hair loss, dry, thick skin, increased sensitivity to cold, joint and muscle pain, heavy or irregular menstrual periods, and depression. When taken correctly, levothyroxine reverses these symptoms.

Monthly Lab Work, Visit with Oncologist, and Treatment

Results of my blood work and monthly meeting with Oncologist:

Blood Work                          Acceptable Range           Meaning    

RBC              3.39                    4.35-5.65                        LOW

WBC             4.9                      3.9 - 9.6                          Low side of range

Neutraphils   68%                    55%-70%                       High side of range

Platelets        121                     135-317                          LOW

Hemoglobin  11.2                    13.2-16.6                        LOW

Hematocrit    33,6                    38.3-48.6                        LOW

My Oncologist is pleased with the results because while I am low in several areas, I am not THAT LOW which according to him is GOOD NEWS.

Today, represented my 37th INFUSION OF OPDIVO...  and each infusion lasts 30 minutes which is much different than the 5-6 hours  for Rituxan and the 4-5 hours for Triandra.

In 3 weeks, I have my quarterly scan...  this time it is a PET scan there is nothing to eat or drink 6 hours before which is fine because my scan is at 6:30 am whereas with the CT scan, I can eat and/or drink right up to the moment of the procedure.

There will be no prostate surgery only radiation and/or chemo and possibly some pills to take orally which my Oncologist will monitor instead of the Urologist.

I continue with my IVIG treatments every other month as originally planned.

Worried Unnecessarily

When I was 19 years old, I was diagnosed with SPASTIC COLITIS and put on medication something like Valium but I don't believe it was Valium to calm down my INNER VOICE that was causing all these outside problems...  while I suppose that worked for me then, I am not sure it actually corrected my internal problem because throughout my entire life or for over 50 years, I have been plagued by this INNER VOICE that keeps me worrying unnecessarily...  although, these bouts of worry come and go and the older I get the more manageable they seem to have become, unless there are numerous outside influences attacking me at one time.

Currently,

• I am worried about losing both my social media accounts due to hacking
• I am worried about the possibility of having prostate cancer
• I am worried about the actual prostate biopsy procedure
• I am worried about my ongoing cancer treatments
• I am worried about my next PET/CT scan which should be this month
• I am worried that I will have AFIB for the rest of my life
• I am worried about not sleeping at night
• I am worried about my list of things to do

YES...   I could turn all these issues over to GOD and trust that HE will take care of me...  but, knowing that HE has always taken care of me in the past and will continue to do so does not keep me from worrying...

Prostate Biopsy

It would appear that since my PSA numbers continue to remain high, I have now been scheduled for a BIOPSY of my PROSTATE and it is the day after the Presidential Candidate and I hope that my surgeon voted for the candidate that won...  lol

However, before this procedure, I must be cleared by my Cardiologist to stop taking my Xarelto.  I must be cleared by my family doctor that I am healthy enough to undergo surgery...  I suppose in case something goes wrong they have someone else to blame.  I have to drive down to the office 2 days before the surgery and take a COVID test and then the night before the surgery, I have to have an enema...

It seems like a lot of crap just to check and see if I have prostate cancer or not...  but, it must be necessary and if I do have cancer, then I will be dealing with three cancers simultaneously...  These cancers are just tearing me down a little bit at a time.

New Normal I Suppose

For the past two weeks (more or less and since it cannot be more then it must be less) I have been going to a local gym to exercise for about 60 minutes, starting off with T/Th then M/E/F, and this week it has been M/T so far and we will see about the rest of the week.

Why am I going to this gym, you might find yourself asking?

Well...  my Humana Health Insurance has a Silver Sneakers Program which gives me a FREE MEMBERSHIP at participating gyms.  This one participates and is only a couple of miles from the house so it is really convenient.

I am building up my endurance on the bike and treadmill using each one about 20 minutes which I will be increasing to 30 minutes and maybe 40 minutes...  but, I would like to top out at the gym with a 90 minute program eventually.  There are also some strength machines that I have been using to strengthen my lower back, upper back, and shoulder muscles.  I do not increase the weights as I don't want to build muscle just tone what I have.

It is interesting but only the older, probably retired people wear face masks and wipe off the machines after using them.

The Daily Grind

Every morning when I awake whether it is a 6:30 am or 7:30 am or 8:30 am, my first order of business after putting on my pants is to take my thyroid pill and then make sure that I don't eat anything for 30 minutes which is usually very easy since I have to be up and about for 3-4 hours before I feel like eating anything.

My routine continues with giving a small snack to our 3 cats who by this time are loudly crying as they encourage me to hurry.  With the treat dispensed, I put on my shirt and prepare myself a cup of coffee while the cats clean themselves and disappear to catch up on must needed rest.

With a cup of coffee in hand, I set about watching FOX NEWS and drink my coffee until I realize that they are covering the same news over and over again, except approaching it from different angles by asking different people the same question.

The television is turned off and I retrieve my laptop and begin updating my blogs, the first of which is my Cancer Blog (this one) which I have deemed to be the most critical and reflective of my current health situation.  Today, I am feeling a little concerned but not stressed over the biopsy that has been requested on my prostate by my Urologist...  and, while he does not seem too concerned there is definitely an urgency in setting the date for the procedure.

The odds are that if I have Prostate Cancer that it is the slow growing kind based upon the lack of symptoms that are being witnessed and conveyed.

It the tests prove positive, this will be the THIRD CANCER that has invaded my body since I turned 60 years of age, almost 13 years ago.  What a pisser.

Being Cautious

At the end of this month, (Halloween), I will be 73 years old and going into my 13th of living with not one but two cancers.  Fortunately, my current treatment(s) has managed to keep my cancers from growing and/or spreading; although, that could change at any time.

MY TREATMENT

Infusions                                                        Side Effects of Treatments                                                

Rituxan                                                            nausea

Cytoxin                                                            vomiting

Fludara                                                            night sweats       

Triandra                                                           fatigue

Opdivo                                                            loss of appetite

Yervoy                                                            squamous carcinomas

IVIG                                                                sleeplessness

                                                                        sebaceous cysts

Surgery                                                           day sweats

Foot                                                                 apathy

Neck                                                                depression

Top of head/forearm                                        anxiety

                                                                         thyroid damage

Pills                                                                  possibly contracting melanoma

Imbruvica (2 X 140 mg daily)

Radiation

6 concentrated 20 minute sessions

After 10 years of monthly infusions in my arms, one of my experiences was painful so I decided to have a PORT installed.  This PORT should be good for 10-20 years, using it once a month and using alternating openings since it is a DUAL PORT.

My Declining Life

 At the age of 25, our cells stop regenerating 

and start dying...

SO...  I have already been dying for 47 almost 48 years...  and if it is God's Will, I will continue dying for another 20 to 25 years... or until I am 98 years old...

At the age of 60, I was diagnosed with Non-Hodgkin's "B" Cell Small Lymphocytic Lymphoma (SLL) and 2 years later I experienced a severe heart attack that I did not feel while walking on the treadmill except for a sharp pain in my chest.  I tried to duplicate that pain by walking as fast as I could on an empty stomach on the sand at Myrtle Beach but it did

not happen.  An exploratory heart surgery a few months later revealed that I had 3 blocked arteries:  LAD 100% and two other left side arteries 90% each.  It was recommended that I have a triple bypass but I found a cardiac surgeon at NY Presbyterian Hospital who cleaned out my arteries and inserted 5 stints by performing 3 surgeries over a 12 month period of time.

At the age of 67 and probably because of my Lymphoma chemo treatment, I was diagnosed with Melanoma and it was surgically removed with  ABSOLUTELY NO follow-up treatment at all which was the PROTOCOL for the stage of my Melanoma.  Almost 5 years later, my Melanoma migrated from my foot to my groin and later to my neck. 

Shortly after this second diagnosis, I was taking a cocktail of 2 drugs that eventually led to dropping one of those drugs and replacing it with 6 doses of concentrated and strong radiation.

At the age of 72, it was discovered that I had a hyperthyroid which was causing most, if not all, of the side effects that I had been attributing to my cancer(s) treatment.  It was also discovered that my PSA numbers had double and have been seeing a Urologist who is considering performing a biopsy of my prostate.

It would appear that old age and cancer has been trying to hasten my dying process...

Non Hodgkin's B Cell SLL Lymphoma

What is small lymphocytic lymphoma (SLL)?

SLL is a non-Hodgkin lymphoma affecting the B-lymphocytes of the immune system. These B-cells may be present in lymph nodes and lymphoid tissue such as the spleen and the tonsils.

SLL has many similarities to a type of leukaemia called chronic lymphocytic leukaemia (CLL) which also affects the B-cells, primarily in the blood and bone marrow, with lymph node involvement also possible. Like SLL, CLL is classified as a low grade disease and due to their likeness; SLL and CLL will usually be coupled together when explained in the literature and expressed as: SLL/CLL. The distinction of this grouping of non- Hodgkin lymphoma is made by a special laboratory test that identifies specific proteins on the surface of the B cells known as CD5 and CD19.
How does SLL affect the body?

The first sign of SLL is usually a painless swelling in the neck, armpit or groin which is caused by enlarged lymph nodes due to infiltration of normal lymph nodes by the cancerous B-cells. Often more than one group of nodes is affected. The cells may also be present in other areas such as the blood or bone marrow to a lesser extent than CLL. Other symptoms of SLL may include night sweats, fevers and unexplained weight loss.

AUTHOR COMMENTS

For the last 12 years, I thought that I had Non-Hodgkin's "B" Cell Lymphoma which is true but I had not been adding the SLL classification to its title and in so doing had been laboring under a false identification of my cancer.

My wife has Non-Hodgkin's "B" Cell Lymphoma but her classification is FOLLICULAR... and my understanding was that she simply had non Hodgkin's follicular lymphoma and that would have been incorrect.

ODD, how it takes some of us a long time to fully understand a situation...  and, maybe it is not some of us but just ME.

Non Hodgkin's Lymphoma

There are more than 70 different types of lymphoma. They range from indolent (slow growing) to highly aggressive. Lymphomas are categorized into two broad groups: non-Hodgkin lymphoma and Hodgkin lymphoma.

Diffuse large B cell lymphoma (DLBCL) is the most common aggressive subtype. It affects about 30 percent of people with NHL in the United States.

Non-Hodgkin lymphoma is divided into more than 30 types, classified based on the type of lymphocyte involved: B lymphocytes (B cells) or T lymphocytes (T cells).

Here are the main B cells types of Lymphoma:

Follicular lymphoma
About 1 out of 5 lymphomas in the United States is a follicular lymphoma. This is usually a slow-growing (indolent) lymphoma, although some follicular lymphomas can grow quickly.

Chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL)
CLL and SLL are closely related diseases. In fact, many doctors consider them different versions of the same disease. The same type of cancer cell (known as a small lymphocyte) is seen in both CLL and SLL. The only difference is where the cancer cells are found. In CLL, most of the cancer cells are in the blood and bone marrow. In SLL, the cancer cells are mainly in the lymph nodes and spleen.

Both CLL and SLL are usually slow-growing (indolent) diseases, although CLL, which is much more common, tends to grow more slowly. 

Mantle cell lymphoma (MCL)
About 5% of lymphomas are mantle cell lymphomas. MCL is much more common in men than in women, and it most often appears in people older than 60. When MCL is diagnosed, it is usually widespread in the lymph nodes, bone marrow, and often the spleen.

Marginal zone lymphomas
Marginal zone lymphomas account for about 5% to 10% of lymphomas. They tend to be slow-growing (indolent). The cells in these lymphomas look small under the microscope.

Burkitt lymphoma
This fast-growing lymphoma is named after the doctor who first described this disease in African children and young adults. It makes up about 1% to 2% of all adult lymphomas. It is rare in adults, but is more common in children. It’s also much more common in males than in females.

Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia)
This slow-growing lymphoma is not common, accounting for only 1% to 2% of lymphomas. The lymphoma cells are small and found mainly in the bone marrow, lymph nodes, and spleen. This lymphoma is discussed in detail in Waldenstrom Macroglobulinemia.

Hairy cell leukemia
Despite the name, hairy cell leukemia (HCL) is sometimes considered to be a type of lymphoma. It is rare – about 700 people in the United States are diagnosed with it each year. Men are much more likely to get HCL than women, and the average age at diagnosis is around 50.

Primary central nervous system (CNS) lymphoma
This lymphoma involves the brain or spinal cord (the central nervous system, or CNS). The lymphoma is also sometimes found in tissues around the spinal cord. Over time, it tends to become widespread in the central nervous system.

Primary intraocular lymphoma (lymphoma of the eye)
This is a rare type of lymphoma that starts in the eyeball and is often seen along with primary CNS lymphoma. It is the second most common cancer of the eye in adults, with ocular melanoma (eye melanoma) being the first. Most people with primary intraocular lymphoma are elderly or have immune system problems which may be due to AIDS or anti-rejection drugs after an organ or tissue.

Safe To Use Both

Immunotherapy drugs are revolutionizing the treatment of many cancer types, but not all patients treated with these new drugs respond. To enhance the efficacy of immunotherapy, researchers at The University of Texas MD Anderson Cancer Center are exploiting a rare phenomenon of radiation therapy in clinical trials for patients with lung cancer and other solid malignancies.
                                                             

“Radiation has been used for a hundred years to do one thing: achieve local control,” said James Welsh, M.D., an associate professor in the Department of Radiation Oncology. “We are now combining it with immunotherapy for systemic control, and that’s pretty exciting.”

Seeking synergy
Alone, drugs that inhibit immune checkpoints—CTLA-4 (cytotoxic
T lymphocyte antigen 4), PD-1 (programmed cell death protein 1), or PD-L1 (the PD-1 ligand)—can elicit impressive responses in some cancer patients, even in those with metastatic disease. However, immunotherapy eliminates distant disease in perhaps only 20% of patients with metastatic cancer; Dr. Welsh hopes to use radiation to push that rate to 30% or even 40%.
                                                                  

At first glance, the logic of combining radiation therapy with immunotherapy to fight cancer seems obvious. Radiation, which kills cancer cells by damaging their DNA, is given locally; immunotherapy is given to ramp up the immune system to attack the disease systemically. But this is only a partial explanation of how the combination might assault the disease. Rather than one treatment providing just local disease control and the other providing just systemic control, the therapies may work synergistically. One area of synergy is that radiation can stimulate immunogenic cell death and sensitize cancer cells to immunotherapy by promoting the expression of major histocompatibility complex (MHC) class I molecules and other apoptosis-mediating proteins.

“We developed a model of resistance to PD-1 inhibition in my lab. Tumor cells lose the expression of MHC class I molecules, which present antigens to cytotoxic T cells,” Dr. Welsh said. “Radiation can make tumor cells express those molecules and respond to immunotherapy. We’ve shown that in mice and a few humans so far.”

In addition to sensitizing irradiated tumor cells to immunotherapy, radiation can cause the cells to release tumor antigens that prime T cells to attack other tumor cells in the body, including those at distant, non-irradiated sites.

“Effectively, radiation can turn the tumor into a vaccine,” Dr. Welsh said.