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 A blog of no uncertain musings. What goes on in my mind is often a source of wonder to me. |
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My mind and my life are wonderous things ... as are yours, I'm sure. I have more slips of paper and pages of notebooks with musings and thoughts than I really know what to do with. Someone, actually several someones, have suggested I start a blog ... or a journal as a means of focusing some of this mental energy. To be honest, I don't even know what the difference between a 'journal' and 'blog' is--or if there even is a difference. Read on, my friends, and you can judge for yourself whether it even matters. And so....  I'm JACE. Yep ... that's me! And somewhere in all my writings my last name may be posted. But I'll just leave it at Jace for right now. I'm 70 years old and heading full tilt to 71. It's strange that while I'm going through some rather serious medical issues, I still consider myself to be in the prime of my life--pretty good shape physically AND mentally, though I don't run for competition anymore  . I love to ... dang, if I put this stuff here, I won't have anything for my blog.Guess you just have to be patient until such stuff leaks out.  Perhaps 2025, having embraced my retirement, will see more participation in my journaling efforts. Well, one can hope.... |
| Many of my blog entries over the past few months have chronicled my journey with kidney cancer. This one follows that journey but represents a departure ... no, that's not quite right. It signifies a change in direction about how I'm handling the treatment going forward. Some background, courtesy of my appointment with Oncology yesterday. I was scheduled for my first immunotherapy (IT) treatment yesterday. That process is a series of events and meetings beginning with a blood draw checking for various things, but most of all to ensure my condition hasn't changed enough to warrant a different course of treatment. Apparently my kidney function is some 10% lower than optimal--which is understandable since I only have one remaining kidney. Dr. P, my Oncologist, says it's nothing to be concerned with presently. Just keep drinking lots of water to flush that little bugger out (my words, not hers). On the other hand, that's easy for her to say as I've never been much of a water drinker, preferring sweet tea and soda. The latter is definitely a no-no. The next step is the meeting with Dr. P., followed by the actual IT treatment. The entire process should take about three hours. Add the four-hour total drive and it's a long day. The meeting portion is what changed my direction. Dr. P. presented me with three options for the future: Opt 1: Complete the immunotherapy treatments with CT scans for the next year. Opt 2: Find and enroll in a Clinical Trial engaged is my specific strain of kidney cancer. Opt 3: Do nothing--no treatments at all, though CT scans would be done every six months. By the numbers, I'll begin in reverse order. Option 3 is not as dismissive as it sounds. My specific cancer is a non clear-cell Renal Carcinoma cancer (papillary type). Sounds impressive, huh? And there are some numbers that further identifies my cancer, but you get the point. The bottom line is two-fold: All post operative test results indicate the surgeon removed all the cancer. Of course, there is a chance (probably a good chance) that some microscopic cancer cells remain. But them growing would take time with expectations that the scans would reveal them, thus potentially changing my treatment direction again. And the current IT treatments for kidney cancer currently use a drug called pembrolizumab, also known as Keytruda. That keynote trial did not include my specific cancer type. Thus, there's little or no data to support any positive effect of the IT treatments for me. Option 2: Clinical Trials would provide the most effective treatments as they would be geared toward my specific type of cancer. Having been re-classified as Stage 3, I'm eligible for them. But being enrolled in one is still not assured. I have found two trials--one in St Louis, the other in Kansas City. the first would be closer to home (only 2.5 hrs. away but right up I-44); the other is 4.5 hrs. away, but without an easy way to get there. The advantage of KC is my wife's daughter lives there, allowing for an overnight stay. Since I don't know any particulars regarding the trials, specifically how long any treatments would take, having available lodging is a distinct advantage. Option 1: Taking the already scheduled IT treatments would provide some piece of mind that I am taking steps to combat (or suppress) the cancer discovered within. Notwithstanding the fact that there's no real evidence that the immunotherapy drug being used is effective against my cancer type, this option seems like a fallback position. Even taking one treatment might disqualify me from participating in the Clinical Trials. Not much up-side here. All things considered, I've decided to pursue option 2. My doctor will place the required consult request to Kansas City. I should hear something within a week whether or not I can meet with them. Even if accepted, it may take a month for the vetting process to be completed. My doctor stated with my current health status based on the CT scan last week, this should present no problem for me to wait. Until then, I forge ahead. |
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