Parting Shots

While I’m Strong

Nobody, anywhere in the world, is recorded as having survived my particular sort of radioactive train wreck

By Dave Skinner

“That which does not kill us, makes us stronger.” German philosopher Friedrich Nietzsche said that first. I still say it when times get rough.

Trust me, when I stroked last spring, things got darn rough. “That which does not,” I kept reminding myself, fully intending to dig out from under yet another train wreck. What I didn’t know then was, I was under a radioactive train wreck. After I’d figured that out, and brought in an oncologist (scans confirmed tumors, including active cancer), I then learned that nobody, anywhere in the world, is recorded as having survived my particular sort of radioactive train wreck.

Could I be the first? A September procedure made it clear I won’t.

Obviously, I am not quite dead yet. I still have no external symptoms, and none I can feel except for my loss of vision. But I am well and truly killed, with two terminal cancers locked in a death race, plus a crazily-elevated chance of sudden stroke and/or heart failure, left contemplating those which do kill, plural.

My options, and time, are going away fast. And while seeming complex, my priority set is actually simple. My trouble is old radiation damage. The cardio damage MIGHT kill me, suddenly in minutes, or not. And second scans in early February showed while not all my tumors are cancer, two cancers will kill me, the only question being how quickly. Either way, bad outcomes on one side automatically completely void any work done on the “other side.” 

Here’s one example, focused on the cancers. One is prostate, the other is mesothelioma. Prostate is common, mine is “castration-resistant.” Yep, I’m a steer now, but that operation failed in terms of tamping down the fire. Survival runs a couple years at best, mine is not best. The meso is not the Libby kind, but in my stomach and really rare, like one in 600,000 each year. 

Chemo? Um, every chemo veteran I’ve talked to was knocked absolutely flat by treatment, and in these COVID days, the crushing of immune response seems counterproductive. Even better, treating the prostate (or vice versa the meso) has no “crossover” effect. Separate treatments, billed separately of course. For meso chemo, average survival is around 50 months and “treatment” normally buys two or three months of extension.

My oncologist presented me with a prostate “option” that initially didn’t seem too bad, some new (2012) “enzalutamide” stuff (brand name, Xtandi), with comparatively mild, yet multiple side effects including fall risk and broken bones. Four pills a day. $150 a pill, $600 a day. “That’s 18 grand a month! How many months?” Oncologist: “The rest of your life.”

Dang, but I just missed another stroke right there – $218,000 a year. I was so dynamited by that enza price tag my brain seized and the rest of the office visit is fog.

But I gather enzalutamide is given prior to subsequent chemo, that OncLive says “increased median survival by 4.8 months compared to placebo,” holding things off that long.

But we did agree that the September mesothelioma finding needed confirmation through a second exploratory operation. I might still have the juice to try some chemo just to back the prostate off a decent interval, but not both meso AND prostate. The surgery was the day before St. Paddy’s and I’m fine in that regard.

So, like me, I’m sure you’re dying to know what’s what, ASAP. I mean, here we are after hundreds of thousands of dollars of cutting and poking, down to the nitty-gritty. Wasted or well spent? We’ve settled the question of if, so can we please get to the what and when, print the expiration date on the carton?

Sorry, but nobody has revealed any findings to me. I’ll see the meso guy March 31, and will learn my expiration date then, I guess. As for the oncologist, I was scheduled to see him April 7. But I cancelled. There’s a logger party in Spokane that day, then I’m off to run a steam train, see my other boss – while I’m still strong.