Second Holiday Scan Results

I had my second scan last week (since going on chemo break) and met with Dr. S a few days ago to get the results. As expected, I had some more growth but not an outrageous amount. The larger lesions are a little bigger than a nickel. That’s slightly larger than when I started way back when. At their minimum, about 9 months ago, they were about the size of a dime. So the end result is that I have been given another two months off!

I had some time to discuss future treatment with the doctor and I am quite encouraged. He indicated that I will probably go back on treatment after my next scan but it’s possible that I could hold out until after Thanksgiving. And, although he never makes predictions about future treatments, he did imply that we might get into a pattern where I would be in treatment for six months or so and then get another break for a few months and then back in treatment again, etc. This is exceptionally good news as I am coming to realize that, perhaps, we are turning this thing into a slow moving, chronic condition. While that certainly has a downside, it is a huge positive in my mind and, frankly, changes my perspective quite a bit.

I have been concerned since the start that I was on shaky ground and that, without treatment (or even with treatment), my condition would rapidly deteriorate. And the statistics on my prognosis bear that out – at diagnosis, the averages for guys like me were: an average lifespan of 21 months and a 5 year survival rate of 8%. But as I see it now, after 22 months, I am barely worse off than when I started. My goal had been to reach 21 months and I have done that without giving much ground at all. I think the chances are good that I can continue in a cycle of treatment and rest periods for several years. And this realization has broadened my view a lot. I no longer feel that gnawing anxiety of wondering if I’m about to step off a cliff. It’ll be a grind during treatment but I will have the break periods to look forward to. I can also think more long term and feel more confident that I will be here for the kids in something like a useful way. This makes me incredibly happy and hopeful! My new goal is to be an 8%er!

So HOORAY and THANK YOU all for your tremendous support!!

Of course, this means that you will have to put up with my blogging for the foreseeable future…

"The Big C" on Showtime

In case you haven't heard, Showtime has started a new series called "The Big C" starring Laura Linney. The plot of the show is that a woman is diagnosed with Stage IV melanoma at the age of 42. She doesn't tell anyone, not even her family, but she begins to act differently. She had a reputation as a careful, rather "boring" person and is now doing bold and spontaneous things. It's pitched as a comedy but I guess it's more of a "dramady". Laura Linney is excellent as the lead character, so I will keep watching. But I am interested in seeing where they take this.

I like the idea that television is taking on a tough issue like advanced cancer and further that they are doing it through comedy. We have to be able to keep laughing, and laugh at ourselves, especially when things seem bleak. I'm a little concerned, though, that a) she decides not to tell her friends and family and b) she refuses treatment.

By talking about cancer honestly, we help to de-mystify it and make it easier for everyone to deal with it. In some ways, I think cancer is scarier to those who don't have it than those who do. Also, by talking about it as something that we deal with, like so many other difficult things people deal with, we can keep our sense of who we are. Being a "cancer patient" is a bit de-humanizing. Being a person who has cancer isn't. Also, a cancer diagnosis is tough emotionally and affects your spouse, your children, etc. You need the support of those around you and you need to help your loved ones understand what's going on so that they can cope with their own feelings about the things that will be changing for them, as well as for you.

And finally, I'm concerned about the character's refusal to be treated. Her reasoning seems to be that she has been given a certain amount of time to live and wants to live it without the effects of treatment, most notably the loss of her hair. I hope the show addresses the fact that no doctor can tell you how long you will live. They can only give you a statistic for how long, on average, people with your disgnosis lived. There is a broad band of actual outcomes. For example, all the oncologists I spoke with when I was diagnosed gave me the same figure for how long I would live (on average) - 21 months. This was my life expectancy with treatment. That was 22 months ago and I've still got a long way to go. So you can never let yourself succumb to the statistics, you need to fight your own battle.

I hope these things emerge - along with some good humor - over the coming weeks of the series. And, I hope you give the show a look. The first episode (last week) was pretty good.

By the way, I don't have Showtime - it's available for viewing on Showtime.com and other on-line sources.

Hope you are having a fun finish to the summer! BB

11 Percent Unemployment?

I'm going to make an economic prediction - hey why not, everybody else does!

The Bureau of Labor Statistics July report puts the unemployment rate at 9.5% after a July net loss of 131,000 non-farm jobs. The private sector is credited with creating 71,000 jobs while government (at all levels) shed 59,000 jobs. The total government loss was 202,000 but 143,000 of them were temporary census workers. So the structural drop in government employment is 59,000 jobs.

The drop in government jobs reflects the budget cutting going on mostly at the state and local level to balance budgets. In New Jersey, we have seen it at the state level as this year was the first year I ever recall the state balancing the budget. At the local level, it seems that every town in the state is cutting payrolls to balance their budgets. This, by the way, has led to almost daily reports in the papers about what jobs were eliminated in what towns. In Morris Township, our budget was balanced in part by eliminating 16 positions and furloughing various groups of employees (essentially cutting their number of paid days in the year). The cuts hit all departments, including fire services, road maintenace, etc.

For fans of smaller government, this means that the economic crisis is a dream come true. State and local governments are getting smaller and services are being eliminated. It's just a matter of time before the same occurs at the Federal level. Also, since most (perhaps all) economists are predicting a long slow recovery in terms of job creation, I would expect unemployment to stay high as any growth in the private sector is likely to be matched or exceeded with declines in the public sector.

One thing that is unclear to me is the effect of the "Stimulus" of 2009 on the unemployment rate. The Congressional Budget Office has a wide range in it's calculation of how many jobs have been saved. But, I think that it's safe to say that the jobs being saved are in the private sector. After all, when they put stimulus dollars into fixing a road or funding a new industry, it is private sector contractors that get the government contracts to do the work. The range of CBO estimates is currently a low of 1.4 million jobs and a high of 3.4 million jobs. So how has that affected the unemployment rate?

The 9.5% unemployment rate is based on a count of 14.6 million people seeking jobs. Without the stimulus, this number would range from a low of 16 million to a high of 18 million, depending on which calculation of jobs saved is correct. Let's split the difference and say 17 million. If there had been no stimulus, then, the unemployment rate would be approximately 11%. Since all of the stimulus "projects" I have seen are of limited duration - once the road is built, the job goes away - it's effect on employment will diminish over time. Therefore, I would predict that unemployment will rise toward the 11% mark unless the private economy can get more steam without this government support.

Isn't that a cheery thought! BB

Stieg Larsson is an Addiction

I'm not much of a fiction reader but I thought I'd write a quick review and warn you all to stay away from Stieg Larsson. The last of the "Dragon Tattoo" series came out recently, but naturally, I hadn't read the first two so I paid no attention. However, my voracious novel-reading daughter insisted that I read "Girl with the Dragon Tattoo". I put it off as long as possible, but while flying back from France, I was stuck with an 8 hour block of time so I started it. By the time the plane landed, I was hooked. I read that book straight through and then went immediately to the second book "Girl who Played with Fire" and read that like a man possessed. Finally, I begged a copy of "Girl Who Kicked the Hornet's Nest" from a friend and just finished it. The main characters in the book are, each in their own way, obsessive and if you read these books, you too will become obsessed - obsessed with reading more. The novels are at times creepy and disgusting but always intriguing - a bit of "Silence of the Lambs" here, a little "Bourne Identity" there. And, in some cases, there are so many characters, you'll be tempted to take notes!

But - if you decide to read them, be warned: you will stop bathing and shaving, you will leave the dishes in the sink and eat only sparingly, your family will become just background noise and the mail will remain unopened in the box. You will simply sit there reading into the wee hours until you've read every word! In short, Stieg Larsson is an addiction.

But I have my life back now...