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In the past I have written posts on the adventure of having two stage 4 cancers and the journey down the rabbit hole one takes as treatment goes forward. Three years ago I had surgery, radiation and cis-platin for throat cancer. Three years later my throat or oropharyngeal cancer is undetectable. Of course, this is good news.  What remains of the experience are the lasting effects of intense radiation exposure in and around the target volume. I developed the normal array of after effects: stunted salivary glands resulting in chronic dry-mouth; periodontal disease and the loss of a few teeth; a substantial loss and distortion of the sense of taste; inadequate thyroid function requiring medication; difficulty in swallowing dry foods; radiation scarring on the neck; and lymphedema where 33 lymph nodes were removed from my neck. I’ve adapted and manage quite nicely to plod down the timeline much as before.

My situation with the stage 4 prostate cancer (Gleason 8) is stable. One of the treatments for prostate cancer is chemical castration. Since testosterone has the effect of accelerating the growth and spread of prostate cancer cells, the commercial drug Lupron is used to down regulate the production of testosterone. Loss of body hair and muscle mass as well as the onset of hot flashes were some of the highlights of my experience. A substantial nulling out of the sex drive happens as well.  Effectively I spent about two years as a eunuch.

It’s been nearly a year since the Lupron injections have stopped. I’m getting a more strength and some body hair is returning. I’ll leave it at that. The radiation treatment was intense in the target zone, but largely without significant discomfort overall. The tricky part of external radiation treatment of the prostate is it’s proximity to the bladder and the bowel. Fortunately, modern IMRT equipment is capable of modulating the x-ray beam intensity as well as shaping the beam with a multileaf tungsten collimator as it rotates around the patient.

After 11 months since the last Lupron shot, my PSA has increased only slightly from being non-detectable.  The return of testosterone after having it shut down for 2 years is a weird experience for a fella. But weirdness is normal in the world of cancer treatment.

Now we’ll pivot to a different topic.

A delicate parting thought for friends and family of those with cancer. Invariably a well intentioned friend or family member will say that their thoughts and prayers are with you or that a prayer group is holding you in the light. Another expression of sympathy might be that there is a reason for everything and that God has a plan for all of us, and as the story goes, our lives have purpose after all. Such sincere well wishes are expressed with the best of intentions, but for myself and other non-theistic people it rings hollow and offers little consolation. A prolonged and agonizing illness is part of some plan? Seriously? If a person set forth such a plan we would rightly consider this foul individual a psychopath worthy of punishment.

People express these sentiments when presented with an existential conflict- it is when the need to connect their belief system with reality the observable world is confronted with the paradox of the divine sanctioning of pain, suffering and untimely death. The need is met by the supposition that there must be divine purpose rather than the unthinkable alternative of the illness happening in the stark emptiness of a godless universe. If such a universe existed, what possible purpose could there be in existence? Well, yada yada. I’ll take this topic up in a later post.

Here is an alternative for your non-believing friends and family. Consider renewing and expressing gratitude for their love and friendship. Confess what the person means to you and commiserate with their condition. Let your emotions flow. Hold their hand. A bit of listening goes a long way too. Mirth is always welcome- the regaling of past exploits, funny stories or people, jokes or the sharing of what experiences you have in common. A light heart and cheerful smile is always welcome in sickness and in health.

 

The US Chemical Safety Board has approved and released the final report on the Macondo /Deepwater Horizon  blowout and explosion of 4/20/10 in the Gulf of Mexico. The report is in two volumes and does include an animation of the sequence of events. I have found the CSB animations to be particularly helpful in understanding the key features revealed by their investigations.

The CSB recently released their final report on the ammonium nitrate fire and explosion in West, Texas on 4/17/13. A few months after the release of the final report the ATF announced a reward of up to $50,000 for information leading to the arrest of person or persons responsible for the industrial fire and explosion that killed 15 people.

If the forensic aspects of industrial accidents is of interest to you, I’d recommend having a look at the CSB website. Knowledge of various initiation and propagation modes in past industrial accidents is useful for those of us trying to prevent initiating events on our own sites.

After a weekend in the Alma, CO, mining district, I have come around a bit on the merits of gold mining. Oh sure, I have always known that it was a dirty business, what with the mercury, the cyanide, the acidic tailings piles, and the blighted landscapes. But for God sakes man, it’s GOLD!

Last weekend was different. It wasn’t a dispassionate examination of mining history. I could see miles of blighted landscape heaped with spent alluvium along the road from Fairplay to Alma. To the north, over Hoosier Pass, are the McMansions of Breckenridge where new and old wealth mingle.  To the south of Fairplay is a sizeable expanse of gravel and cobble heaps from past placer mining.

Placer mining north of Fairplay 6-14-14

The photo shows just a short stretch of the creek bed undergoing placer mining on the north end of Fairplay. Granted, the mining company is using gravity separation by way of the sluice to recover the gold. The stones are all rounded and well weathered, so one might expect the tailings to release little in the way of toxic leachate. But what a colossal mess they have made of the landscape. Perhaps they have put up a bond assuring that restoration of the landscape will happen when the mining ceases. I don’t know. That does not seem to be the way of past mining in the district.

My point is this. Isn’t there some madness in gold mining? At best a handful of people get wealthy from putting more gold on the market. I would argue that gold does not have the utility of iron, aluminum, or copper for instance. It does not go into items that advance civilization and economics like tractors, bridges, ships or wires. Gold does not go on to enable the growth of industry in the manner a base metal. Some of it adorns our fingers but most falls into the hands of anonymous individuals and governments who hoard vast caches of the metal. Granted, a bit of the annual production goes into electronics and a few other applications.

The madness in gold mining is that people are willing to go to any length or bankrupt themselves to obtain a metal that in the end benefits approximately no one. Most of the metal will quietly sit in a vault somewhere producing nothing. It won’t support a building or a roadway over a river. It won’t produce goods or services, nor will it bring a silent heart back to life. It can only support abstractions like the notion of value. We’re willing to put up with scarred landscapes, mercury pollution and acidic runoff produced by other people for an abstraction. That is pretty funny.

 

I just have to say that in regard to the deteriorating situation with the Soviet Union Russian Federation, it does not appear that either the EU or the US have their best thinkers working on it. I think US leaders have misunderstood Putin from the beginning and I see very little to convince me that Obama’s people, the Congress, or any other high level functionaries known to me have a clue how to get their arms around Russian behavior or a workable diplomacy.

Certainly recent (post-Ford) US incursions into foreign lands with troops or drones have taken us off the moral high ground in this regard. How can the US lecture Russia on the invasion of Crimea when we invaded Iraq based on lies, subterfuge, and outright errors?

Bush 43 and Clinton had historical opportunities to gain better alliance with Russia. But we supported Yeltsin in the Clinton years and ignored Putin’s offers of assistance after 9/11. The Russian people were mystified when the US supported Yeltsin, widely regarded as a drunken buffoon. Gorbachev’s memoirs paint a lackluster and untrustworthy picture of Yeltsin.  And the US has done nothing but confirm Putin’s paranoia about US intentions by adding membership to NATO, ABM’s in Poland, petroleum wars in the middle east, and the general appearance of weakness by in-house political fratricide.

We have no use for milquetoast administrations like Obama’s, nor do we need rabid swingin’ dicks like John McCain or his hawkish brethren. We do need Russian and Slavic scholars who speak the language and understand the history of Russia at least back to Peter the Great. They can be immigrants from former Soviet territories of the ilk of Zbigniew Brzezinski, Madeleine Albright, or even a world savvy guy like Henry Kissinger. Who are the current brain trust for eastern European politics and is the CIA giving them good intelligence? Did the CIA predict the takeover of Crimea?

Being a devotee of the HBO series True Detective I became intrigued with the purported allusions to the 1895 book of short stories The King in Yellow by Richard W. Chambers. I received my copy from Amazon yesterday and read the first three stories.

I have never ventured into the horror genre so this is refreshing. Chambers was reportedly influenced by Ambrose Bierce. His prose is considerably less dense than Bierce’s- closer to a 20th century cadence and vocabulary. H.P. Lovecraft took notice of Chambers as well. Lovecraft and Bierce are next on my reading list.

As with the story line of True Detective, The King in Yellow (or Yellow King) is not really centered on the fictional play of the same name. Rather, it is a kind of story telling device that motivates and launches characters along the arc of another story. It’s an interesting device.

I have been an advocate of thorium based nuclear power for a long time. There are certain advantages that thorium based nuclear technology has over uranium and plutonium systems that make it appealing, as long as the nuclear genie is out of the bottle anyway. Others have written about this and there is no point in my wasting bandwidth on it here.  Fort St. Vrain Generating Station, one of the very few HTGR Thorium plants ever operated in the US sat a half hour from here from 1979 to 1989. As prototypical operations go, the plant had a history of upsets and unforeseen complications and was decommissioned after a decade of sub-commercial output. Eventually the plant was converted to a natural gas turbine plant and runs to this day in that capacity.

So it was of interest to learn that the venerable European company Solvay has teamed up with AREVA to develop thorium technology. Uranium and rare earth processing, as well as other minerals produce side streams enriched in thorium.  According to the link, both players have been accumulating inventories of thorium.  Hmmm. What could they be up to…?

2/23/14

Five months past treatment for throat cancer I will set aside The Squamous Chronicles and instead post The Adenocarcinoma Chronicles. Having won the advanced prostate cancer lottery as well, my current adventures involve treatment below the beltline.  Here are my impressions of the experience to date.

Physicians, or more specifically in this context, oncologists, are ethically constrained to apply agreed upon treatments for the indications presented by the patient. I have gotten no “off-label” kind of advice up to now. In my case, my PSA was 39 and the biopsy readings from the pathologist were assigned Gleason 9. Well, sonofabitch. That was a fine kettle of fish. Looks like my watchful waiting was long in the waiting and too light in the watchfulness.

The standard treatment regimen in my case is hormone ablation and radiation. For hormone ablation I have had Degarelix and Lupron. For radiation I have begun IMRT (Intensity Modulated Radiation Therapy) with a dose of 76 Gy to the targeted tissue mass. I asked about scatter dose to the testes just because of the obvious proximity. The Rad Onc looked it up and said it was 1 Gy. I then pointed out that I’ve had a goodly bit of radiation in the last year and was there anyone who keeps a running total on the cumulative dose? As expected, the answer was “no” followed quickly by the standard rationale that the disease was far more dangerous than the radiation. I’d say the same thing I suppose.

Things that my docs are reluctant to offer are opinions on how this whole disease plays out. There seem to be several elements to this reticence. First, predicting the future is difficult, especially with a stochastic phenomenon like cancer radiotherapy. Second, there are good reasons for the doc to not focus on gloomy topics like life expectancy, especially if the survival stats are not the best. Most people at some point spontaneously think of cancer as a death sentence. At present I view it as a chronic condition that will play out stepwise in terms of a convergent treatment and remission series that eventually ends with refractory and widespread disease. Seems pretty obvious. It is the time-scale that I am uncertain of.

I am writing about this because my treatment regimen seems relatively ordinary to this point given the status of the condition. Perhaps there are some fellows who have yet to climb on this train who are uncertain of where it goes. This is my journey and I’ll pass along my notes.

Update 3/13/14

Now 14 treatments into radiation. With the help of medical textbooks ordered from Amazon, I have slowly been learning more about the disease and the treatment. During my weekly consult with the Rad-Onc I asked the question- “What was the T number from the pathologists notes?” He replied it was T3c N1.  The N1 means there is a node involved so it’s Stage 4 cancer. No one actually came out and said this to me so I had to ask. It is one thing to suspect it and another to hear it. Hard to say if this knowledge is in some way empowering.

If you knew me personally, you’d know that as a reductionist my profile can be reduced to that of a liberal atheist scientist with marginally good manners. I broke the shackles of magical thinking in high school after reading a few books by Bertrand Russell and Carl Sagan. Though I have not been the same since, I have come to sympathize a bit with Quakers and their predilection for peace.

My religious upbringing was quite ordinary for a young Iowegian lad in the 1960’s. Confirmation in the Lutheran Church (Missouri Synod) in 8th grade followed by a short stint as a reluctant acolyte. The church seemed firmly footed in bedrock as an institution and adept at indoctrinating the young. In catechism studies I tried to understand the authoritarian system that is outlined by Martin Luther and the strange collection of narratives that make up the King James Bible.

There were abstractions that didn’t make sense then and are still a mystery to me today. The concept of the Holy Trinity always seemed suspiciously anthropomorphic. Then there is the crucifixion as a kind of “ghostly sorting mechanism” for salvation. It stands out against the backdrop of natural phenomena like physics and biology- mechanistic systems which seem to suffice for everything else. Finally, there is God’s seemingly endless requirement for worship and admiration which has always struck me as a vanity unnecessary for a supreme being. The whole scheme reeks of iron-age anthropology.

I remember the day it happened. I was praying for something or other. Trying to have a little spiritual time with the Big Guy. It finally dawned on me that I was talking to myself and in doing so, wishing for some particular outcome to happen. All those years. Praying and wishing were indistinguishable. I’ll admit, I was never one to volunteer a lot of praise to God. Heaping praise on a deity seemed patronizing and wholly unnecessary. Surely if God could elicit wrath, then he’d certainly pick up on being flattered.

Well, in the end, so what? Another tedious atheist commits apostasy. Like most people in US culture, my moral basis was built on what has been described as Judeo-Christian morals or ethics. It’s hard to avoid. But just as the earth does not rest on a foundation, I am not limited to sensibilities derived only by the sons of Abraham in a far earlier age. My culture and my brain tell me that theft, murder, and the other spiritual crimes (sins) are bad for the common good. That respect for others has a pleasurable and sensible aspect that threats of eternal damnation do not improve on.

The reductionist in me can’t resist the following assertion. Deistic religion reduces to cosmology. In the end, a religion offers a theory of the universe. It is a kind of physics that defines relationships between the prime mover and his (?) bipedal subjects imbued with mystical sensitivities. It claims to define the outcome of the disposition of a soul, whatever that may be.  I don’t even believe in the existence of the mind, much less a soul.  As a form of physics, religion lacks means by which theories can be tested. Quantitation of a spiritual element is an idea that has yet to see practice. It seems to lack predictive capability to estimate an outcome that can be validated. It is definitely not a science. It is not about matter or energy. It is about how to conduct ones life against a backdrop of divine authority and within a box of behaviors.

But our brains seem to be constructed in a manner such that religious/spiritual notions are nearly irresistible. Billions of people have claimed to feel its draw and testify to its merits. The projection of anthropomorphic imagery in myth is common in diverse cultures.  The Abrahamic religions congealed from cultures that were apparently unaware of the concept of zero. Where heaven is death with a plus sign, hell is death with a negative sign. To an atheist death is just zero. It has no sign or magnitude. It is unconsciousness and devoid of the awareness of pain or pleasure. Zero sensory processing. It is neither exaltation nor agony. Just zero. Entropy prevails. Such an outlook is hardly appealing enough to gather followers. It is grim and without hope of graduation to eternal bliss.  The take home lesson is to live in the moment, not the future.

Who am I to argue with millennia of religious thought? I don’t know. All I can say is that even as a cancer patient, I remain refractory to the pull of religious and mystical thinking. So it was and so it is.

Post script.

Divinity students! Relax. I’m no threat to your faith. My conclusions on this life of ours offers no ceremony and precious little fellowship. I can say that I’ve had an eye-full of the clockwork of this universe. Adherence to evangelical doctrines could not have provided the amazing insights. And for that I have no regrets.

I recently developed a condition where I have ear pain and partial facial paralysis. Ear aches I can deal with, but when my face quits working, I go to the doc. So, that’s what happened. The ENT said that it resembled Bells palsy and the cause was idiopathic.

I can just imagine an attending physician and a resident in medical school taking future idiopathic specialists on their rounds. The doc walks in and greets a patient with an ear ache and a face that doesn’t work. “Yessir” he says with resignation, “another case of idiopathic syndrome. We just don’t know what the hell happened.” The resident turns to the med students and says gravely, “Look at this patient closely. Try not to confuse the distant stare and slack jaw with idiopathic disease. Even though this patient is from Iowa, we are convinced that there is an idiopathic condition overprinted on his presentation.”

The attending physician stands there thoughtfully for a moment, raises a bristled eyebrow and glances at his watch. “Let’s go people. The idiopathology wing is full of patients with mysterious conditions.” With that they shuffle off down the hall.

Update

A round of acyclovir and prednisone cleared up the apparent Bells palsy. I am symmetric again and can pucker up to whistle a tune.

The makers of Jeep have resurrected the standard Jeep Cherokee in, well, how else can I say it … a very stupid way. They have abandoned the classic boxy utility vehicle lines of the old Cherokee in favor of the now popular fat and squat ellipsoidal lines of contemporary design. In other words, it looks like a jelly bean or rugby ball.  The classic 4.0 Liter Cherokee had power to spare and it had the fantastic visibility of an inverted fish tank. It had troubles too, namely bad electric connectors and perhaps an under-designed cooling system. But at least it had the classic squared-off Jeep lines and lots of traction.

But the greatest sin of all was abandoning the 4.0 L straight-6 engine for the 3.2 L engines. Jeep?? WTF!! What were you thinkin’? I would love to meet the committee of marketing pencil necks and constipated MBA’s responsible for this one. It’s a travesty.

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