Treatment Options for SLL

Options for SLL generally include:

Chemotherapy - Chemotherapy medicines can be given orally or through an injection into a vein. Some chemotherapy drugs for SLL are: Cytoxan or Neosar (cyclophosphamide), Fludara (fludarabine), Leukeran (chlorambucil), Nipent (pentostatin), Treanda or Bendeka (bendamustine), and Revlimid (lenalidomide). These drugs are often used in combination with each other or with another type of medicine.

Monoclonal Antibodies -  These medicines use the body’s natural immune system to fight cancer. They’re typically administered by an injection and are often given along with chemotherapy or another type of drug. Monoclonal antibodies that are used for SLL may include: Rituxan (rituximab), Campath (alemtuzumab), Gazyva (obinutuzumab), and Arzerra (ofatumumab).

Targeted Treatments - These therapies attack different targets on cancer cells. Imbruvica (Ibrutinib) and Zydelig (idelalisib) are examples of targeted treatments for SLL. Both of these medicines are pills that are taken by mouth and are sometimes used with other therapies.

Steroids Steroids  - may be used to destroy cancer cells or treat autoimmune issues in people with SLL or CLL.

Radiation Radiation -  therapy uses high energy rays to destroy cancer cells. It’s occasionally used in people with SLL.

Bone Marrow Transplant - A bone marrow transplant, also called a “stem cell transplant,” may be an option for some people with SLL. It involves collecting stem cells from the blood or bone marrow of the patient or a matched donor. These cells are given back to the patient to restore damaged bone marrow after they receive high doses of chemotherapy, which wipe out the remaining bone marrow in their body. Because it can be hard on your body, a bone marrow transplant is often only performed on healthy, younger people.

Splenectomy Surgery - to remove the spleen doesn’t treat SLL itself, but some people might need to have it if they develop complications.

Almost 14 Years

Six months from now, I will be celebrating the 14th year passing since I was diagnosed with cancer...  and, five years into my treatment for non-Hodgkin's 'B' cell Lymphoma and probably because of certain treatments, I was diagnosed with Melanoma that subsequently moved from my foot to my groin to my neck where it was surgically removed and found to be dead because of my radiation and immunotherapy treatments.

After my two cancers were under control, my Oncologist informed me that he wasn't sure if he could stop them from growing because both of them had turned aggressive, but he stayed with the most recent protocols in fighting both cancers and did not back off on either one; consequently and fortunately, the two different types of treatments complemented each other and he was able to get both my cancers under control, at least for the time being.

I told my Oncologist that he should published his treatment of me and get some national credit, which he declined and said he was just fine with his life as it currently was.

Looking back at these 14 years, there were times where I was sicker than a dog and vomiting so consistently that my wife had to take me to the ER...  those were days that I would rather not relive under any circumstances unless I absolutely had to.

• Am I lucky?
• Did I have the right Oncologist?
• Was God looking out for me?

Ya know...  I think it was a little bit of all three...  but, to be quite honest with you (not to imply that I have not been), I have felt and continue to feel that there is something left for me to do...  and, that is why I am being kept alive.  I have no idea what it might be but I have spent my entire life preparing for it nonetheless.

Living with cancer is not as comfortable as one might think it is, especially if one is doing fine and feeling good, but there is a constant threat hanging over one's head as to what might happen...  if this...  or if that...

Plus, one must eat differently than others.  One must not drink alcohol if in very small quantities like a glass of wine once a week or once a month.  One must stay out of direct sunlight with UV clothes of the highest sunscreen.  One must get a good night's rest and one must learn to manage one's stress as it does have an impact.

I find myself eating lots of veges, onions, garlic, peppers, black beans, fruits, and other foods high in anti-oxidants.   I may have a hamburger and/or a hotdog once a year.  But, I may have a pizza every other month.

The killer of all cancers is a LOW IMMUNE SYSTEM and more people die of some other disease that they die of their cancer because of their low immune system.  For example, I would not have survived COVID.

The one thing that I do not get enough of is exercise but my fatigue which is minimal most of the time is still strong enough to provide me with the motivation to exercise...   even just walking around the community for 30 minutes would help.

Unanticipated Controversy

Fourteen years ago, my wife and I purchased an above ground pool along with a Hot Springs Prodigy Spa or Hot Tub...  a year or so later, I was diagnosed with non-Hodgkin's "B" Cell Lymphoma and a year or so after that, I experienced a rather serious heart attack that caused the surgeons to want to perform a triple bypass...  a second recommendation and I was left with the option of installing 5 stents instead.  A couple of years after that, I was diagnosed with Melanoma that later moved to my groin and and a sentinel biopsy was perform resulting in the removal of lymph nodes and my left leg experience lymphedema...

All of these conditions are not necessarily conducive to spending time in a Hot Tub, let alone spending in a Hot Tub several times a week...  and yet, that is exactly what I have been doing for the last 14 years.  Oddly enough, my time in the hot tub does not seem to be adversely effecting any of my conditions...  at least not yet...   but, with that said, I am not spending as much time in the hot tub as I used to spend.  And, when the weather gets warm, I turn the temp down from 104 to 98 or 95...  I still get the benefits of a heated massage.

However, one issue that I did not anticipate was the fact that as I age, it gets more and more difficult for me to lift my leg over the side of the hot tub in order to lift and pull my body inside...  and,  it is increasingly more difficult for me to reverse the procedure when extricating myself out of the hot tub.  

I have built myself a little bench, but I have it too high, so I need to cut it in half or possibly more than that in order for it to become a helpful too/aid.

Cancer Insurance

Back in 1990, before my wife and I were married, she purchase a cancer insurance policy that applied to her as well as her husband should she married which she did about 8 years later.  In 2007, when I was 60 years old, I was diagnosed with non-Hodgkin's "B" Cell Lymphoma and about 3 years after that, my wife was diagnosed with non-Hodgkin's Folicular Lymphoma which she believes came from her use of a pesticide.

The cancer insurance immediately paid us both a lump sum of money for the initial diagnosis and according to the policy, for every year of treatment they would pay us a lump sum of money as well.  I started my treatment protocols in 2008 and for the next 13 years, I have been under ongoing monthly treatment for my cancer, and according to my Oncologist those treatments will continue each month for the rest of my life.

My wife however is in remission and has been in remission for over 5 years.

Every year about this same time in May, we submit a claim to our cancer insurance company for their agreed to allocation for my ongoing monthly treatments.  AND...  every years about this same time in May, our cancer insurance company contacts us and lets us know that our claim has been denied.

Each time we contact them about this, they tell us they need another piece of documentation which we retrieve immediately and about 60 days later we are paid in full.

This year, our claim was once again denied but not because of another document needed but because we submitted it two days before our new year began.  Because, those two days, put us into a new monthly cycle, we had to get documentation from our Hospital for the next month.

This is what pisses me off and others off about the healthcare industry...  and, if the Federal Government get their claws into healthcare, it is only going to make the SYSTEM WORSE...

There ain't nothing effective and/or efficient about the flow of work and productivity when the damn government is involved.

Over Thirteen Years and Counting

 

Except for the one year spent in KY where my Oncologist there prescribed the chemo drugs that made me violently sick two days after my infusions, lasting for another two day, my treatments since 2007 have been rather uneventful and have only caused me nausea, extreme fatigue, 30-50 pounds of  weight gain, no immunity from other diseases, and a damaged thyroid.  I would say that is pretty damn good for thirteen years of ongoing treatment that has included:

• Chemotherapy
• Surgery
• Radiation
• Immunotherapy

My hair never fell out, although I have been losing my hair since I was 21 years old.  My eyesight never deteriorated. My internal organs like my heart, liver, kidneys, and lungs were never damaged from the extended intake of infused toxins into my body.

Needless to say, I am glad that I am no longer vomiting all the time for two days straight ever month, but I am wondering if experiencing constant fatigue is just as bad if not worse...  especially for someone who has been physically active for their entire life or at least up until the age of 60.

Still, my life has forever been changed by my battle against two cancers.  I can no longer spend as much time in the sun as I want to spend without wearing long sleeve UV shirts and pants or a great deal of high UV protection sun screen...  and the clothing is by far the better choice.  I also have to watch what I eat as certain foods encourage the growths of cancers.

One out of every five Americans will contract some form of cancer during their lifetimes and I don't wish that experience on anyone.

A Good Day

The middle of May 2020 will be looked back upon as a transition point for my change of health conditions which could alter in a heartbeat, but this has definitely been a transition month for the better.

First, my Cardiologist, after wearing a heart monitor for a month, said I no longer had to take Xarelto, the super duper blood thinner.  So now, my arms will no longer show the blue and black tattoo bruises that have been so obvious recently.

Second, my Dermatologist put me on an antibiotic that is dealing rather well with my skin infection that was present on my face, little welts that itched and when scratched bled real bad and turned the area around the welt a dark shade of red, but not really a bruise.  

My Oncologist sent through an order for monthly IVIG infusions, so within a couple of four months with these and my sinus infections should stop and it should also help with my skin infections and perhaps I can stop taking the antibiotic.

My ongoing cancer treatments for Lymphoma and Opdivo seem to continue to be working in that there is no metabolic activity present with either cancer which is a very good sign and it is hoped that this will continue to be the case.

My weight is down 30 pounds largely due to three factors:

1. I am counting and reducing my calorie intake
2. My staph infection and loss of appetite
3. My colon cleanse for my colonoscopy

And...  while I am still about 20 pounds over-weight I still feel a lot better physically not that I have shed 30 pounds.

My constant fatigue has almost disappeared and has become intermittent and my daily nausea has disappeared as there have been no signs of that for weeks.  My appetite has returned but I do not feel constantly hungry.

My diet is totally focused on fish, chicken, beans, and vegetables with heavy doses of onion, bell peppers, mushrooms, and garlic, along with eggs, oatmeal, non-processed cheeses, whole wheat breads.

My sleep habits are uninterrupted and I no longer feel the need to take afternoon naps nor do I wake up still feeling sleepy after sleeping for 8-10 hours.

These are all good signs for a person of 73 years of age.

A Constant Reminder

 My cancer journey began in 2007 and in 2008  I began having chemo treatments for non-Hodgkin's  Lymphoma (SLL/CLL) and in 2012 and probably a direct result of my treatment for Lymphoma, I contacted Melanoma (bottom of left foot) and in 2017 found that it had spread to my groin.  

After the fact, my Oncologist informed me that both my Melanoma as well as my Lymphoma had turned aggressive and that he was not sure that he would be able to stop or slow down the process.  It was almost like a HAIL MARY that he combined radiation treatments with Opdivo infusions while maintaining my daily Imbruvica pills.  The Cancer Team at UT Medical was not sure that he was doing the right course of action, but he stood his ground.

AMAZINGLY...  he proved to be right...

I also remember listening to the Surgical Oncologist who had removed the melanoma from my foot who told me that "I WAS LIVING ON BORROWED TIME," and that it was too dangerous to remove the cancer from my groin...  and, that the cancer was all over my body.

TODAY, both cancers are under control...  and every time I feel around my groin area, the dead cancer tissue is still there and is a constant reminder of what I went through.  These lumps are no longer worrisome but at one point-in-time they were.  I will live with these lumps for the rest of my life.

Back Home

My early morning visit with the Oncologist had me back home before NOON toady with good news...  There has been NO PROGRESSION of my two cancers and a lesion on my lung has actually disappeared which is good.  The lesion on my liver is benign and seems to be a collection of blood vessels so there is no need to do a follow up MRI unless it starts increasing in size and it is doubtful that it will increase but one never knows.

My blood work continued to show that I am anemic, have a low immune system because of a low white blood count, and my platelets continue to be about 2/3 of what they should be...  so, basically I have remained consistent month-after-month for the last two years...  and, because of all the infections that I have been experiencing, my Oncologist wants me to receive monthly IVIG treatments and since it is too late for anything this month, and since I have a treatment scheduled for May, my monthly treatment will begin in June...

All-in-all, it was a good report.

What was really encouraging was the fact that apparently my gastrointestinal doctor sent my colonoscopy results (which included his concerns about a lesion on my liver) to my family doctor who in turn had corresponded with my Oncologist about those concerns...  and now, my Oncologist will follow up with my family doctor to let him know that the lesion on my liver is a benign collection of blood vessels...

I like it when the system works and doctors are interlinked and actually correspond with each other in order to ensure positive patient outcomes.

T. G. I. F.

After 13 years of cancer treatments for non-Hodgkin's "B" Cell Lymphoma with 6 years on concurrent treatment for Metastatic Melanoma (Braf negative) along with6 treatments of concentrated radiation, my overall health is good to excellent but I continue to deal with FATIGUE that leaves me with the mentality of not really wanting to do anything... even though there are many things that I need to do, now that the weather has improved...

There are all sorts of projects outside the house that need to be accomplished on a regular basis like mowing the yard and weed eating along with other activities that include transforming flower beds into grass areas, putting down mulch, building up the rock areas around the house, securing the water hoses so that they do not leak, staining the deck boards that were put in last year, and other little maintenance projects which involve wear and tear around the outside of the house.

My FATUGUE stands in the way of these projects and I need to force myself to take action and/or the initiative to get the project started.  Each of these projects will be worked on just a little each day but the fact remains that I needed to get started.

"B" Cell or "T" Cell Lymphoma

In order to determine whether the surface marker phenotypes of non-Hodgkin's lymphomas affect the prognosis, we have studied the differences in response rate and duration of survival between T- and B-cell lymphomas. Sixty-four patients who underwent first-line therapy, including combination chemotherapy and/or radiotherapy, from February 1979 to August 1985 were evaluated. 

With the aid of standard immunological methods and monoclonal antibodies related to T-cells and B-cells, 21 T-cell lymphomas and 21 B-cell lymphomas were identified. In the other 22 cases phenotypes were not determined mainly because of the inability to obtain fresh samples. The complete remission rate was 100% for B-cell lymphomas and 52.3% for T-cell lymphomas. 

The median survival time for patients with lymphomas of Stage III and IV, excluding those with low-grade histology, was nine months for T-cell lymphomas and 17 months for B-cell lymphomas. T-cell lymphomas were found to have significantly poorer prognosis than B-cell lymphomas. 

One patient with B-cell lymphoma and six patients in an undetermined phenotype group, who were treated with combination chemotherapy, have been alive more than three years without relapse and these patients are considered potentially cured. Our results suggest that the surface marker phenotype study of lymphoma cells as well as histological subtyping is important in prognosis and that more effective therapy is needed to improve the prognosis of T-cell lymphomas.

Staying Stable

My IVIG infusion will give me a boost for about 3 weeks before it starts to wear off...  so, what does that mean exactly?

For me,

• I sleep better
• My appetite is suppressed
• My energy level is high
• My fatigue lessens
• an end of sinus infections
• I am more active

My Oncologist wants me to receive IVIG infusions every month instead of every other month which would result in me feeling pretty darn good all the time.  And, if one feels good then one is also emotionally healthy as well which then leads to having good psychological health.   This is important, at least for me because having Lymphoma and Melanoma simultaneously means that at some point-in-time there is always the possibility that either one of these cancers or both could turn AGGRESSIVE at any time putting me in a critical health situation and threaten my life.

CAR T Cell Therapy

As reported by The University of Helsinki:

In cancer immunotherapy, cells in the patient's own immune system are activated to attack cancer cells. CAR T cell therapy has been one of the most significant recent advances in immunotherapies targeted at cancer.

In CAR T cell therapy, T cells are extracted from the patient for genetic modification: a chimeric antigen receptor (CAR) is transported into the cells using a viral vector, helping the T cells better identify and kill cancer cells. When the antigen receptor cells identify the desired surface structure in the patient's cells, they start multiplying and killing the target cells.

CAR T cell therapy was introduced to Finland in 2018, and the treatment form has been used in support of patients suffering from leukaemia and lymphomas.

So far, the application of CAR T cell therapy to solid tumours has been difficult: targeting the therapy at just the tumour is difficult when the cancer type is not associated with any specific surface structure. In many cancer types, there is an abundance of a specific protein on the tumour's surface, but as the protein also occurs in low numbers in normal tissue, CAR T cell therapy is not able to discriminate between target protein levels. This is why genetically modified cells are quick to attack also healthy cells and organs, which can result in fatal adverse effects associated with the treatment.

A study recently published in the Science journal has found a solution to applying CAR T cell therapy to solid tumours as well: through collaboration, American and Finnish researchers identified a new way of programming CAR T cells so that they only kill cancer cells, leaving alone healthy cells that have the same marker protein as cancer cells.

New technique based on ultrasensitive identification of HER2 cells, further investigation underway

HER2 is a protein characteristic of, among others, breast cancer, ovarian cancer and abdominal cancers. The protein can also occur in great numbers on the surface of tumour cells, since, as a result of gene amplification, HER2 expression can be multiplied in tumours.

A new CAR T cell engineering technique developed by the researchers is based on a two-step identification process of HER2 positive cells. Thanks to the engineering, the researchers were able to produce a response where CAR T cells kill only the cancer cells in the cancer tissue.

"Our solution requires the preliminary identification of the surface structures associated with the cancer. When the preliminary recognition ability that induces the CAR construct is adjusted to require a binding affinity that is different from the affinity used by CAR to direct the killing of these cells, an extremely accurate ability to differentiate between cells based on the amount of target protein on their surface can be programmed in this two-step 'circuit' which controls the function of killer T cells," says Professor of Virology Kalle Saksela from the University of Helsinki.

Further studies for the application of the technique are already ongoing. Postdoctoral Researcher Anna Mäkelä, who works at Professor Saksela's laboratory, is coordinating a project funded by the Academy of Finland investigating the use of CAR T cell therapy on various cancer types and their surface structures.

"We are very excited about these results, and we are currently developing the technique so that it could be used to treat ovarian cancer. As the work progresses, the aim is to apply the technique itself and the targeting molecules of CAR constructs even more broadly to malignant solid tumours. Our goal is to develop 'multi-warhead missiles', against which cancer cells will find it difficult to develop resistance," Mäkelä says.

It Never ENDS...

In 2007, I was diagnosed with Non-Hodgkin's "B" Cell Lymphoma which is also referred to as SLL (Small Lymphocytic Lymphoma) and quite interestingly is treated the same way and considered to the be companion of CLL or Chronic Lymphocytic Leukemia.  Leukemia starts in the blood while Lymphoma starts in the lymph nodes...  it is also widely believed that SLL can turn into CLL at some point in time.

In 2012, I was diagnosed with braf negative acral lentiginous Melanoma in the foot which was surgically removed and later moved to the groin and then to the neck.  It is entirely possible that my Melanoma was contracted because of the drugs I was taking for my Lymphoma.

Over the past 13 years (2021 begins my 14th year) I have received:

1. 150+ chemo infusions
2. 60+ Hemoglobulin infusions
3. two surgeries
4. 6 radiation treatments
5. 20+ CT Scans
6. 20+ PET Scans
7. 2 MRI's
8. Immunotherapy 

In 2009/2010, I experienced a heart attack and underwent 3 heart surgeries to install stints rather than enduring a triple bypass.

For the rest of my life, I will have:

1. monthly chemo infusions
2. daily immunotherapy pills
3. 2 CT scans a year
4. 2 PET scans a year
5. 4 full body scans by a Dermatologist
6. quarterly visits to a Cardiologist
7. dealing with constant fatigue and nausea
8. dealing with intermittent night sweats
9. monthly hemoglobulin infusions
10. constant anemia
11. on-going anxiety attacks
12. a non-existent immune system
13. susceptibility to other diseases
14. the anxiety of my cancers turning aggressive

And...  while there may not be that much to report from one day to the day, the items listed above have a direct and cumulative effect/affect on one's state-of-mind which causes sporadic depression...  to mention this every day or even every week or monthly seems kind of REDUNDANT to say the least...  but, let me assure you that having cancer, especially the kind that cannot be cured, is NOT FUN AT ALL.

I Have Watched Myself Grow Old

Ever since 1990, when I moved to TN from NC at the age of 43, I have been aware of myself physically and mentally rather than via instincts and have, for the last 30 years, watched myself grow old...  older and older each day...  each week...  each month...  each year...  each decade...  and, the aging process is not always that pretty or welcomed.  I lost my closest friend along the way who died of colon cancer in his 60's and my other closest friendship was ended when I decided to have my taxes prepared locally.  Losing friends is not so easy...  and, making new ones is harder than one might expect...  so, for the last 30 years, my friends have been my co-workers and/or the friends that my wife brought into this marriage...  who would not really be my friends any longer if we were ever to divorce...

So...  from age 43-60, there was hardly any aging process at all...  at least none that I could detect.  I was eating healthy, sleeping appropriately, never got sick, never got the flu, and my wife and I were fast walking 5 miles a day around our community (so it was not always flat) and the healthy eating included hardly ever any red meat, no fried foods, minimal sugars and/or sweets, minimal alcohol, and mostly fruits and vegetables...

My blood pressure was low and my cholesterol was low (both the good and the bad) and the only issue that could have bothered me during those 17 years of relative BLISS was the amount of STRESS that I encountered each day.  My career had taken off in that I was working 60+ hour weeks and bring work home on the weekends...  and, it was not because my bosses demanded that amount of time but because I wanted to give it or that I felt like my job needed it as I always went above and beyond.

AT THE AGE OF 60...  my world turned to shit...  not literally but figuratively or metaphorically I suppose would be better because my world of health turned upside down...  I was diagnosed with non-Hodgkin's Lymphoma (SLL) and started treatment in 2008.  In 2009, it was discovered that I had experienced a heart attack while walking on the treadmill and exploratory surgery indicated that I needed a triple bypass.

My LAD (the widow maker) was blocked 100% and two other arteries on the left side of my heart were both blocked 90%.  Instead of having a bypass, I had my arteries cleaned out and stints inserted that took 3 operations in 2009 and 2010.  There procedures were performed at Presbyterian Hospital in NYC.  My Cardiologist said that because I was so damn healthy that my body created its own bypass by created dozens of vessels to transport blood which is what actually saved my life.

In 2012, Melanoma appeared on the bottom of my left foot probably brought by some of the drugs used for my chemo treatments and after being surgically removed reappeared in force in 2017 which resulted in me receiving radiation treatments.  Fatigue and nausea were my daily routine until my doctors discovered that my Thyroid was out of whack due to my chemo treatments.  And, while the fatigue and nausea have almost disappeared, they are lurking just around the corner I fear.

A prostate biopsy in 2020 left me with negative results but a high PSA puts me in a situation where I will be monitored often from now on...  And, because I had several polyps removed in a 2018 colonoscopy, my new routine for that procedure is now every 2 years instead of 5 or 10...  with my next one being scheduled for January 2021.

One would think that this would be enough, but the past July I was admitted to the ER with a Staph infection in my blood and because of afib, heart failure, kidney failure, and a blood pressure of 79/59, I was admitted to the hospital for 6 days.  Now my Cardiologist has informed me that once one has experienced afib, it will be with them for the rest of their lives.

My last PET scan that showed no metabolic activity in either of my cancers revealed that I have a tumor in one of my lungs that is just a few CM's in length (too small to biopsy) and I am scheduled for another CT scan in a couple of weeks to see if it has grown.

Because of all the chemotherapy, immunotherapy, and radiation my body virtually has no immune system and is experiencing anemia...  so, every other month, I am now receiving an infusion of IVIG which is supposed to help supplement what the treatments have taken away...  but, I am still susceptible to catching almost any other disease...  especially COVID...  and, that scare has kept me in the house unless I have to leave for any doctor's appointment...  but, when I do, I ALWAYS WEAR A MASK...

For 17 years I did everything right and was a model of physical health, exercise, and eating habits, but that made no difference at all...  and, while I am not angry or feel wrong for what I did, I still don't really understand why it happened to me and not someone else...  especially that someone who does not take care of themselves like I did.

Today, except for some major and minor adjustment, I feel pretty good about myself and my health and if you were to see me on the street, you would not suspect that I had a serious heart attack and had been receiving cancer treatments for 13 years.

Always Something

If you recall, my cancer was first diagnosed when I was 60 some 13 years ago and there is a good probability that because of all the various chemo regimes through which I went, one of them caused me to contract a second cancer of Melanoma that traveled from the bottom of my left foot to my left groin area in just under 5 years.  And, it is because of this migration that I was given radiation along with an immunotherapy of Opdivo which seems to have substantially reduced it and actually killed a bunch of it.

It is difficult to ascertain whether the dead cells are Lymphoma or Melanoma because they are a combination of both and the only way to be sure is to perform a biopsy which if they are dead seems rather irrelevant.  However, whenever I lay down on my back and feel around the left side of my groin, I can feel the lumps of dead tissue there that will never disappear and be constant reminders of what I have endured with my cancers.

Every day I take two pills for my Lymphoma and every day I take medication for my Thyroid because it was damaged by my cancer treatments.  Every month I have an infusion to control my Melanoma and every other month, I have an infusion of IVIG to help boost my low immunity and improve my anemia.  Every 3 months, I have alternative CT and PET scans to see if my cancers are still under control and every 3 months I have a full naked body exam by a dermatologist to see if my continued cancer treatments are creating any new skin cancers which is often the case as I have had half a dozen removed since this process was started.  AND...  every three years now because of my cancer treatments, I have a colonoscopy because my treatments could trigger cancer there.

Next month, I have a special CT scan to see if the tumor in my lungs has grown large enough so that a biopsy can be performed.

When one is living with cancer...  there is always something.

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...

SURVIVAL RATES

Around 70 out of every 100 people (around 70%) survive their cancer for 5 years or more after diagnosis. almost 65 out of every 100 people (almost 65%) survive their cancer for 10 years or more after they are diagnosed.  SOURCE:  Cancer Research UK

I am in my 13th year of treatment for non-Hodgkin's "B" Cell Lymphoma and in my 7th year of treatment for Metastatic Melanoma (which basically means it has come back).  My Lymphoma started out slow growing then became more aggressive; whereas, my Melanoma started out as what was believed to be a wart on the bottom of my left foot and was surgically removed with clean margins and no future treatment because of its tiny size.

My Melanoma returned like a BAT OUT OF HELL in my groin area where it was impossible to surgically remove because of its extensiveness.

Melanoma moved to my neck but when it was surgically removed it was DEAD...

I have never really considered my survival odds until I decided to look them up for this posting.  I live each day, maybe not to its fullest, but I live the day nonetheless doing what I want, not necessarily what I need to do; however, my wife has a list of chores

and I make an exception for her.

I sleep as long as I want to

I drink as much coffee as I want to

I eat healthy because I want to

I exercise now because I want to and my fatigue is minimal

I shave when I want to

I comb my hair when I want to

I write blog posts when I want to

I write poetry when I feel so moved

AND...  while I don't pray to my God everyday or even occasionally ask for HIS guidance, I am ABSOLUTELY CONVINCED that my life is in HIS hands and that I have become that which HE wanted me to become and will live as long as HE wants me to live and will do whatever it is that HE wants me to do...

Keeping the Faith for Over A Decade

ODYSSEY is a Greek epic poem written by Homer (a poet) about the long journey of a man named Odysseus (Greek King of Ithaca), or a long and eventual journey or experience...

My journey/experience has lasted almost 13 full years and while this journey started with one cancer:  non-Hodgkin's "B" cell Lymphoma, treatments for that cancer resulted in me having to remove 4 Squamous Cell Carcinomas on my upper body and a Melanoma off the bottom of my foot as well as upsetting the balance of my Thyroid.  Interestingly, surgery did not prevent my Melanoma from aggressively returning.  

My body, over the 12+ years, has suffered bouts with nausea, violent vomiting, constant and extreme fatigue, as well as the stress of weight gain (due to steroids) and the anxieties associated with my cancers becoming aggressive and unstoppable.What has been the most traumatic is not the nausea and vomiting because they can be offset or stopped with drugs and/or visits to the ER if necessary which is what I had to do several time; but the constant and extreme fatigue...  pills WILL NOT STOP fatigue from taking place...  Once fatigue starts, it NEVER leaves...  HOWEVER, recently it appears that my body has finally come to terms with its fatigue and is no longer (at least temporarily) present to the extent that I do not want to do anything.

WILL EVERYONE experience what I experienced?  Maybe or Maybe Not, the experience could be the same, no as bad, or worse...  each individual is different...  Last year, radiation was used with Opdivo infusions to KILL THE MELANOMA and it worked whereas in some individuals under similar circumstances, the combination has not worked.

Life In The Middle

Life in the Middle of what?


Oftentimes, over the last 12 years, I have perceived myself as being healthy or unhealthy, not necessarily because of exercise and/or eating healthy foods but because of my heart and cancer issues.


I have not really considered myself healthy or not healthy and yet I am both.


What brings this to my attention is every month when I go to the Cancer Center for treatment, I am always asked questions about by health because I look so healthy and when I inform them that I have been getting treatment for over 12 years, they are utterly amazed and look at me as if I am not telling them the truth,

On the other side of the coin:

• Some days, I feel wonderful
• Some days, I feel lousy 
• Some days, I feel nauseous
• Some days, I don't feel nauseous
• Some days, I feel fatigued
• Some days, I don't feel fatigued

It is like I do not belong in any one category.

For example:

When I had my severe heart attack, my Cardiologist said there was absolutely no reason for it

Non-Hodgkin's "B" Cell Lymphoma put me in one cancer group

Metastatic Melanoma put me in another cancer group

Thyroid issues now puts me in another group with/without cancer(s)

If there is Prostate Cancer discovered, I will be in yet another group

I cannot get into any cancer clinical trials because I have 2 cancers, not just 1