Category Archives: Cancer

Cancer, Health

The Gate of Guarded Hope

Leave a comment

Imbolc and the Moon of Liberation

Wednesday gratefuls: Samantha. Salivary gland tests. CT w/ contrast. So much bloodwork. Ruth and David, taking me to Rocky Mountain Cancer Care.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe: Ruth

 

Kavannah: Histapkot. Contentment.   Seek what you need, give up what you don’t need.

Tarot: #11, The Woodward. Strength found in facing inner darkness. I read the diagnostic reports, reeling, then steady.

One brief shining: I counted eight, no, nine vials when Angie, the phlebotomist, placed them on the small table. My left arm had the sleeve rolled up since the right one had had an IV inserted a half an hour before. The clinical trial demanded the nine vials including tests for Hepatitis B, C, and HIV. “I’m gonna be about a pint low.”

My final procedure for this round of treatment. After I swished 5 milliliters of lemon juice for a minute, I chewed on a patch of gauze for three minutes. It got weighed. But. Would it support my admission to the trial?

Samantha, Sam, took my medical history. “So. Polio.”  Aortic aneurysm. Arthritis. Labrum tear. Compared to most others in the trial, Sam said, my medical history was straightforward. Oddly comforting. A threshold I should pass.

I texted Done to Ruth. She and David pulled up to the entrance of the Littleton clinic. She had an iced Americano for me and a bag of free beans. As a Starbucks barista, she has perks.

Next week I find out the start date for the clinical trial. I’ve taken all the tests, filled out questionnaires, had interviews. Now it’s the trial’s turn.

Sometime soon, probably next week as well, I’ll be randomized into one of the arms of the trial: one does not hold what I believe I need. I plan to discuss with Christina, a Bupathi P.A. whom I like, what to do if I’m in the arm with no Actinium. Might be admission. Yet with less treatment than I need.

Gatekeepers. Check boxes. Say enter. Or not.

This latest gate, call it the Gate of Guarded Hope, is the most consequential I’ve had to face in a long time. When we stand, like Kafka’s K, outside, the interior is a mystery, yet a mystery in which we wish to invest. Amelioration of a dread disease.

I’m calm now, having given myself over to the protocols of a phase three drug trial. Samantha. Angie. Bupathi. Guardians. Caring for me, yes, but through the trial, for others yet to come.

Standing at the gate.

Waiting to be let in.

 

 

Cancer, Health, Judaism

Content?

Leave a comment

Imbolc and the Moon of Tides

Shabbat gratefuls: Rabbi Jamie. Rabbi Rami. Teshuvah. Tikkun. Talmud Torah. Bagel table. The Mishkan. Shabbat. Colder.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe:  Torah

 

Kavannah: Histapkot. Contentment.   Seek what you need, give up what you don’t need.

Tarot: Page of Stones, Lynx.  “Begin something new that supports your health.” Clinical trial for me.

One brief shining: Each night before I go to bed, I say three things. Hands over eyes, I first say the Shema. Then, hand on the mezuzah, “I am content with who I am. I’m content with what I have.” Last: “I love that little Shadow–all to pieces.”

 

When I say I’m content with who I am, I mean histapkot. This body, linked to all that becomes, has been, is, will be enough. The Shema says that plainly, yhvh is one.

The second part, “I’m content with all that I have.” has become a challenge. Money? Yes. Shadow Mountain Home? Yes. Shadow? Yes.

But. Am I content with cancer?

Cancer and contentment. What about those days I read unwelcome news? What about all the treatments, all the uncertainty?

I am content with having cancer. It can churn my stomach. Yes. It cannot be cured, so it’s a permanent resident. We are not two. We are one. When I eat, the cancer part of me eats. When I sleep, cancer rests with me. I am not content with cancer killing me. I do what I can to prevent that. Then again, I am not content with my heart killing me either. I do what I can to prevent that.

Railing against the cancer. Fighting it. Struggling with it. All those war-like metaphors. No. Why? Because they bind me to self-hatred, stir the anxiety pot until it overflows.

I refuse to live a life where cancer consumes not only my body, but my mind, my spirit as well. Like Medworld from yesterday, I will not allow cancer any more room in my mind and heart than it already has. I do not forget about it. Neither do I focus on it.

I turn to the lodgepole and the aspen. To life with Shadow. To improving my writing. Life is for living, not for waiting to die.

An enduring lesson of the Shema. The oneness of all becoming.  All is part of the one. Nothing lies outside it. Not cancer. Not war. Not crime.

Oneness challenges me to calm myself. To not let life be colonized by fear or self-pity. That’s why saying the Shema can act as a shield against anxiety and discontent. Stay here. Stay now.

Seek what you need.

Give up what you don’t need.

 

Cancer, Fourth Phase, Health

Machine Medicine

Leave a comment

Imbolc and the Moon of Tides

Thursday gratefuls: Mariposa. Andres. Alan. Bubble study. A long walk. Morning darkness. Ruby. Gas prices. Iran.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe: Resilience

 

Kavannah: Groundedness. Yesod.    Yesod is about establishing oneself in reality, refusing to rely on comfortable illusions.

Tarot: Knight of Arrows, Hawk. I need to look at the big picture, see cancer as only a part of a long journey.

 

One brief shining: A cold gel. A sonar wand. Andres took the measure of my heart. Possible shunt. A walk, long, to the Evergreen Building for my PET scan. Pleased with how I held up. Once again radioactive tracers. Lounged in the recliner for an hour, reading a Joe Pickett novel. Kindle app on my phone. Lie down.

 

My body, investigated. Bone scan. Echo. PET scan. Baselines for the clinical trial. No more even mild claustrophobia. Too familiar.

Wearing the soft brace around my neck while out and about. My head drops. Not as far. Doesn’t strain my back. I don’t get as worn out. Though. Feels clunky. Odd.

Second Uber back from Sky Ridge. Mariposa, a squat Latina with six-inch all black nail extensions. Drove eighty m.p.h. Quiet. As I prefer due to my poor hearing.

Shadow greeted me with wiggles and kisses. I remind myself, don’t take this for granted. Remember how long it took. How much heartache.

Getting ready for this clinical trial is a trial of its own. Organize rides. Co-pay. Not cheap. A volunteer guided me each time, the hospital a maze. Sit. Again. Wait.

Charles? I’m Andres. Charles? I’m Andrew. Out of the waiting room. Lie on your side. Lie on your back. Do you want a warm blanket?

No results yet. The doctors sit in their offices far away. Reading scans. Looking at results. I sit at home, tired and lacking information.

The life. Chronic disease. Periods of being home, petting Shadow, reading. Periods of whirs, hums, the stick of a needle. Data. Learning what happens next.

Like that frog. Warming water. I grow accustomed to each test.  One of these tests. One of these days. There’s nothing more we can do. The cancer has gone too far. Earlier, that would have been unwelcome news. Now? One point on this path. I’ve had a long life, one not marred by disease or disability. Enriched.

Punctuation marks. My cancer diagnosis pushed me over the line into life’s last phase, the fourth phase. In the fourth phase I acknowledge my mortality. Not as distant. No longer with that slight hesitation. Maybe not me?

I lean on friends and family. Feel my body gradually giving way.  Everything is harder. Yet. I would not change this time. I’m writing my way into it.

I sit in my chair. Calm.

Back Pain, Cancer, GeekWorld, Health, Post Polio

Abraxas

1 Comment

Imbolc and the Moon of Tides

Friday gratefuls: Andrew. Nessa. Bone Scan. Radioactive tracers. Abraxas. Tesla. Uber. Tough day. Noem. Gone. Morning darkness.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe: Technology

 

Kavannah: Shleimut.   Being present to myself.

Tarot: Six of Vessels, Reunion     Shadow reminds me. My little boy plays with her. Feeds her.

 

One brief shining: Encountering high technology: Radioactive tracers. The bone scan machine. Uber. A self-driving Tesla.  An organic among computer chips and software and radiation sensing crystals.

 

 

Retired Army Sergeant Andrew inserted an IV into my arm at 11:35. Flushed it with saline. Left the room to retrieve a lead box about 10 inches long and five wide. Removed the syringe with radioactive tracers that light up on bone. With a single push he sent it into my blood stream.

He took out the IV. “Come back at 2:30.” Three hours in a place where I could not rest my head. That soft brace? No match for hours in cafeteria and lobby chairs with no head rest.

By 2:30 I was so grateful to lie down. The too familiar curved table. Accepted me and supported my neck. The forty-minutes sandwiched between two cameras sensitive to the gamma rays coming from my bones? The most comfortable I’d been since I got to the hospital.

One of four imaging tests.  Baselines for the clinical trial.

After my much needed rest: time to enter another technology tunnel. Called up the Uber app on my cell phone. Of course. Credit card expired. The ritual:  Card number. Security code. Expiration date. Ah.

I entered the network of self-employed drivers near to me. Who would drive me home? Abraxas took my request.

Abraxas, a man in his early sixties drove a black 2025 Tesla. “Abraxas?” He nodded. “Charlie?” I nodded back while closing the heavy door and looking up through the transparent roof.

“Abraxas?”

A five-thousand year old Egyptian god. Rooster head and snakes for arms. Represents that God is one with everything.

Hmm. OK. Not sure about snakes for arms. Can roll with all is one.

A mind-stretching combination of magical thinking and a self-driving car.

When Abraxas bought his Tesla, he opted for a full self driving kit. Used it all the way from Skyridge Hospital to 9358 Black Mountain Drive. His hands fluttered, on occasion, below the steering wheel.

He even took the Deer Creek Valley road. A road through the mountains. I use it when I’m tired of the freeways. Very curvy. With bicyclists. All on self-drive.

When we got to my house, the Tesla dutifully parked itself.

Bones scanned by machine. Curves navigated by software. Me in my body.

Home again, home again.

Shadow wiggling. Smiling.

Cancer, Fourth Phase, Health, Science

In time, leaves brown

3 Comments

Imbolc and the Moon of Tides

Thursday gratefuls: Alan and his new knee. The Hummingbird. Diane. Alfred North Whitehead. Process metaphysics. Shadow the Coneless.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe:  Kristine

Week Kavannah:   Yetziratiut. Creativity.   Learning novel revision as part of the craft

 

Tarot: Ten of Vessels, Happiness

In the midst of medical turmoil: friends and family, reengaged creative work, Shadow bring fulfillment home.

One brief shining: Radiation ended December 11th, a PET scan on January 28th showed failure of androgen deprivation therapy. No wonder I slipped into I’m not gonna make it mode. Uncertainty. The bane of those of us with chronic, progressive illnesses.

 

Cancer, as my journey typifies, never gives up. Removed my prostate. Came back. Radiation. Recurred. Since then, 2019, it’s here to stay, a hostile partner I must feed.

Within that overall arc there are periods of relative calm. I had six years with androgen deprivation therapy, six years of stable PSAs. Glad I did. Within those years Kate’s illnesses took hold, changing our lives and ending in her death. Jon’s divorce rattled the whole family again and again. His death shattered Ruth and Gabe.

How could I have been present and effective for my loved ones without six years of a cancer detente? Here’s a generous offering of gratitude to the scientists who discovered and perfected androgen deprivation.

If I’m to live fully into the happiness I feel, I’ll need another tranche of medical discoveries. Especially therapies like Pluvicto and Actinium which deliver toxic radioactive energy preferentially to cancer cells. Not the systemic poison of chemotherapy.

How else can I continue ancientrails into its third decade. Revise and market Superior Wolf. See Ruth graduate from college, maybe even medical school.

Folks with manageable terminal illnesses now encounter shuttered laboratories. A defunded NIH.

The practices of physicians like Dr. Bupathi and Dr. Carter deliver to me the fruit of decades of basic science, clinical trials, pharmaceutical advances.

Like turning off irrigation to a field of vegetables, the results will not be immediate. In time, leaves brown, Tomatoes and Beets rot. I’ll probably live long enough to enjoy treatments created in the recent past. Like Actinium.

The next generation of prostate cancer patients may not. Joseph? Mark?

I’m a lucky guy. Options, sound options, exist even as I enter my 5th year of stage 4 cancer. A gift to me. Letting me fill my days  with happiness.

Cancer, Dogs, Health, Post Polio, Shadow Mountain

Living

3 Comments

Imbolc and the Moon of Tides

Wednesday gratefuls: Taylor. Dr. Bupathi. Clinical trial. Dan Herman. Monarchs in Mexico. Honey and bud. Treatment burden.

Rene Good. Alex Pretti. Say their names.

Sparks of Joy and Awe:  Write on

Week Kavannah:   Yetziratiut. Creativity.   Keeping my lev focused on life, not treatment

 

Tarot: Three of Arrows, jealousy

Danger now. Confusing treatments with living. Treatments support living. Not the other way round.

One brief shining: Treatment burden can give us long term cancer patients blinkered seeing. Our world consumed by this decision, that lab test, the next protocol. The next. I’ve fallen into this trap. What Kate meant when she told me on her death bed, trust your doctors. I hear you now.

 

Wrenching myself back, into the life the treatments make possible. Writing. Shadow. Friends. Family. The life of the mind and body. Do not make living about surviving treatments.

Remember treatments give the gift of more life. Dig into revising Superior Wolf. Play with Shadow. Read another novel.

Living. Not for the clinical trial. Yet. Show up for the clinical trial. One pillar of a life well lived and one still worth living.

Do not descend into the swamp of the best care so I can see the most birthdays. No. No. Rise up from the swamp to live this day with as much passion, creativity, and joy as I can.

Back from Rocky Mountain Cancer Care. Thick clinical trial document signed. Questionnaires filled out for baselines. An EKG administered by Sarah, a young hijab wearing Muslim woman.

Asked her. Are you fasting? Yes, Yes, I am. When I mentioned the break the fast meal, her eyes lit up. My mom’s a great cook. We’ll have plenty of food. Sarah said fasting energized her. It’s cleansing. Ramadan in Colorado.

Met Kristine, Dr. Bupathi’s other P.A. I liked her. She answered my question about any opportunity cost to waiting six weeks to start a new treatment. Doesn’t matter to the outcome of my cancer’s progress.

Four weeks of imaging, blood tests. Also, a four week washout period for Erleada which I stop taking today. Orgovyx, Kristine said, is forever. It keeps my testosterone repressed.

After I signed the consent form and had my helpful conversation with Kristine, I felt I regained my agency. No longer floating in an uncertain time, between one treatment and the next, but headed toward a new, potentially better drug.

On another, less sanguine note. It was 70 in Littleton. 70! Shadow Mountain? 49. No Snow. Late February.

Also, high winds yesterday. Chinooks, Snow eaters. Would be fire spreaders.

Working with my writing coach, next moves on Superior Wolf. Editing, revising each Ancientrails post.

When I got back from RMCC, Shadow greeted me with hugs and kisses. Makes me want to see her first when I get home.

Found a new way to use my foam collar. A tighter cinching of it around my neck. Seems to contain the fatigue from my head drop.

A win.

 

Cancer, Dogs, Fourth Phase, Health, Writing

A Strong Link

1 Comment

Imbolc and the Moon of Deep Friendship

Monday gratefuls: Robin. Shadow the bandageless. Audrey, winning at regionals. Sports. Joe, the three letter guy. ICE. Minnesota.

Rene Good. Alex Pretti. Say their names.

 

Sparks of Joy and Awe:  Actinium

Week Kavannah:   Bitachon. Confidence.     I need to focus on confidence this week. Important decisions for cancer treatment, how to stay confident when physical weakness challenges me.

 

Tarot: Seven of Arrows, Insecurity

Between treatment protocols. Exhausted. Not working out. A time of deep uncertainty.

One brief shining: A trigger finger locked. Life hinging on unproven chemicals, tests, blood draws. A sore right shoulder. Love of friends and family. Shadow. Unavoidable mortality.

 

Underlayments. Love. Joseph and Seoah. Ruth and Gabe. Mary and Mark and Diane. Korea to Melbourne to Saudi Arabia. Kate across the threshold. Knowing and seeing each other anyhow.

The love of old friends and new. Ancient Brothers. CBE.

Feeling connected in a Dog’s kisses. Coffee in the morning. The Shema.

So that. When cancer makes an aggressive move, I want to push back, get into a clinical trial. So that. When exercise falls away, my tennis shoes go back on.

And yet. Sometimes. I sit back in my chair. Think. Oh, come on. Enough. May I ride it all out from the comfort of this recliner? Surrender. Wait. For a miracle. For a finish.

Not the brave face. Nor a frightened one. Weary.

I do not want to scare those who love me. No. Yet I do not want to be dishonest either. This is not easy.

Not most of the day. When soreness or shortness of breath hits. Then. Pain suggests: a sick man who a moment ago was in his forties, eager. Whap.

Underlayments. I lean into love, buoyed up by Joe’s voice, by Tara singing happy birthday. By the regard in which I hold myself.

Underlayments. Remember. Shadow’s waggly tail. Gabe’s new poem. Superior Wolf’s second draft.

Consolation. More to do. Rejuvenation.

Not dead yet.

Knowing. Deep. This day, this singular unrepeatable day. All I’ve got. Ever. And this day, right now, hands on the keyboard. Shadow sleeping nearby. Morning darkness not dispelled. I am fully alive. Laying down breadcrumbs.

Underlayments. How to reconcile. Weariness and excitement. Pain and joy. Not easy. Not impossible. Most often through writing. Talking it out. Diane and her book club. Tom and a new book. Listening.

Realizing words. These words spilled in a certain order. Saying, hello out there, hello.

My one strong link to my journalist father. A need to express myself. Clearly. Often. Yes, a need. Not a want. That peculiar inside-out move of the artist: exposing the inner journey so others know they are not alone.

Cancer, Fourth Phase, Health, Reimagine. Reconstruct. Reenchant.

Keep This Clanky Body Working

1 Comment

Imbolc and the Moon of Deep Friendship

Sunday gratefuls: A Blackbird birthday breakfast with Tom, Paul, Ruth. Evoke 1923. Crème brûlée. Sweet thangs.

Rene Good. Alex Pretti. Say their names.

 

Sparks of Joy and Awe: Valentines Day

Week Kavannah: Bitachon. Confidence.     I need to focus on confidence this week. Important decisions for cancer treatment, how to stay confident when physical weakness challenges me.

 

art@willworthington

Tarot: Two of Vessels, Attraction

A Valentines Day card. Kate, always Kate. Love. Shadow. My sweet girl.

One brief shining: We sat, the four of us, in a booth, 79, 78, 79, 19, Paul, Tom, me, Ruth, ordering Corn fritters and sweet syrup, Avocado toast, talking, laughing, a fine birthday morning.

 

Oh, to be young and athletic. The condom supply ran out in three days. And Valentines Day thrown in, too.

I’ve been chemically impotent since 2019, because a lowered T score starves my cancer and my body of a hormone that gives me energy, aids in gaining muscle mass. No wonder I have trouble opening jars.

That drive, that two of vessels attraction. Desire-fenced out.   Bit by bit my inner assassin has claimed territory–gardening in fifteen-minute bursts, my male gaze dimmed.

But not my bitachon. Not my ahava. Not my lev. The assassin can only target flesh. If anything, my friendships have deepened. Spirituality broadened as I’ve grown Tomatoes and Beets in Artemis. As I say the shema.

Five years this April since Kate died. Five years with no human next to me in bed. No breakfast conversations. A long, but accepted sadness.

Not living without love. Close, dear friends. Family. Tom, Paul, and me last night. Cassoulet, Scallops, Beef Tenderloin. Ruth and her big bag of candy. Tara singing happy birthday by text.

Life still lived. While the executioner works.

Am I less than myself now? Paul carried canned dog food, that ceiling fan downstairs. I feel the concern in Tom’s voice. Yet. Ruth said, “I don’t see you as old; I see you as wise.”

A body in decline. Standing up to cook. So hard. Trigger fingers lock up over the keyboard.  Ageism sees physical decline as mental decline. No. I am not diminished. The assassin cannot have my mind. Challenged by cancer, by sarcopenia. My authentic Self–refined. Ready to learn more about my craft.

Where I am now: surrounded by friends and family, loved and loving. My sense of purpose clarified by my writing coach, ChatGPT. Eager each day to see how I can revise Ancientrails, polish it. Excited to work on revision #2 of Superior Wolf, then Missing.

Keep this clanky body working as long as possible. Not finished.

 

 

Cancer, Fourth Phase, Health, Myth and Story, Reimagine. Reconstruct. Reenchant.

Cancer or not

1 Comment

Imbolc and the Moon of Deep Friendship

Tuesday gratefuls: Dreams. Shadow and her doughnut. Tom and Paul. Happy Camper. Clinical trials. New drugs. Dr. Bupathi.  The long, slow march.

Teshuvah. Tikkun. Rabbi Jamie. Artemis in Winter. Gardening. Horticulture. Garlic awaiting Spring. Snow in the forecast. Moisture. Drought. Trees. Wild Neighbors.

 

Sparks of Joy and Awe: Snow

Week Kavannah: Hakarat Hatov. Gratitude.

I chose this because Tom and Paul are coming. Ruth, too. And, my 79th birthday. And, for life, my precious.

 

art@willworthington

Tarot: Seven of Stones, Healing.

Focused on physical healing, I sometimes lose sight of teshuva, returning to the homeland of my soul, my Buddha nature.

 

One brief shining: Healing, the delicate process of becoming whole, is not only for the physical body and reaches into life, whether in a healthy or a sickened body, so much so that even a body with a terminal disease can experience healing, wholeness.

 

Back to my then close friend Steven Miles’ question: What is health in a dying man? I’m inching toward an answer, or at least a personal response, one based on etymology and grounded in theology.

Yes, I’m thinking of myself, for whom healing has become a fraught term since my cancer could no longer be cured. True since 2019 when I finished my first and long series of radiation.

Two years later my first metastases showed up, tipping me over into stage 4 prostate cancer. That was also the same year Kate died.

Let me ask Steve’s question in a personal way. What is health for me in this stage 4 time, knowing stage 5 is death? It’s helpful to me to look at the etymology of healing. Healing comes from the  Old English hæling. It can mean restoration to health, of course, but it can also mean restoration to wholeness.

Before I go further, I want to say again: Life is a terminal disease, one with many paths but only one destination.  Cancer is no more the certain cause of my death than any other; it’s just the most obvious possibility.

What is healing in a dying man such as myself? Or, such as you, reader? Can I heal even in Stage 4? Can I be restored to wholeness? I say yes.

Wholeness and teshuva. When I let cancer dominate my thoughts, which happens more than I wish, I commit hamartia,  a Greek word that means to miss the mark though often translated as sin.

I find teshuva a much better antidote to hamartia than a desire for salvation to wash away my sin. A pox on that idea. No. When I miss the mark, that is, when I turn away from wholeness, I need not external salvation from a punishing God or his Son, but to return to the homeland of my soul.

We are whole, healed whenever we can look up from our blinkered obsessions with illness, money, achievement and see once again the unique and rare gift we are. Just as we are. Whether in robust physical health or further along our way to that most ancientrail and ultimate mystery, death.

When I take my attention away from blood draws and clinical trials, I remain who I am, who I was, and who I shall be. Curious, active, a seeker after knowledge and justice. A guy thrown into the mid-point of the last century and tasked with being myself in the years since 1947. Cancer included.

 

 

Life Kavannah: Wu Wei    Shadow, my Wu Wei mistress

Year Kavannah: Creativity.   Yetziratiut.   “Inspiration exists, but it has to find you working.” ― Pablo Picasso

Acting, Cancer, Health, Science

Choices

1 Comment

Imbolc and the Moon of Deep Friendship

Shabbat gratefuls: Shadow, her bandage changed. Dr. Josy. AI help with the next step choices on prostate cancer. Jamie Bernstein. Bagel Table. Winter Olympics. Joe, the ski racer. Religion. Religions. Hinduism. Buddhism. Islam. Christianity. Judaism. Sikh. Jain. Parsi. Taoism. Shamanism. Paganism.

Sparks of Joy and Awe: AI

Life Kavannah: Wu Wei    Shadow, my Wu Wei mistress

Year Kavannah: Creativity.   Yetziratiut.   “Inspiration exists, but it has to find you working.” ― Pablo Picasso

Week Kavannah: Hakarat Hatov. Gratitude.

  • Literally “recognizing the good,” it is the practice of acknowledging the positive, often overlooked aspects of life.
  • Core Principles: It encourages focusing on what you have rather than what you lack, recognizing the humanity in others, and appreciating the natural world.

Tarot: 11 The Woodward

“…an “ancient guardian of the Wildwood,” it symbolizes inner strength, facing fears, understanding darkness, and managing primal instincts with quiet courage.”

One brief shining: Purpose porpoise deep sea waters diving down inside toward the great Holy Well of the collective unconscious, into the nefesh, the hidden places from which our souls gain nourishment, our bodies will, intent, courage and our lives find their firm foundations.

Health: Spent a good bit of yesterday trying to parse the difference between choosing the known Pluvicto and the gamble on the clinical trial. Hit on the idea of asking chatgpt which I’ve found a reliable interlocutor on questions medical.

Here’s the prompt I used:  My latest petscan showed significant increase in osseous metastases. I’m now in hormone resistant disease. My oncologist gave me the option of Pluvicto or a similar drug using Actinium but in a clinical trial. I’m not sure how to weigh the harsher Pluvicto against the possibility that I would end up in the control group for the trial. what do you think?

I also put the same question to Gemini 3.0 and Claude. I got a lot of useful, thought provoking material from all three. This came in a longer response from Gemini 3.0 and I found it helpful:

Why Choose the Trial?

  • Access to “Next-Gen” Tech: Actinium is often used as a “salvage” therapy for people who have already failed Pluvicto. By joining the trial, you are potentially skipping a step and going straight to the most powerful tool available.

  • Close Monitoring: Trial patients at RMCC receive much more frequent scans, blood work, and “concierge-level” attention from a dedicated research nurse compared to standard patients.

4. Why Choose Pluvicto (Standard Care)?

  • Certainty: You know exactly what you are getting and when.

  • Proven Track Record: It is the global gold standard for a reason. It works well and the side effects are very predictable.

Based on reading the responses from all three, I’m leaning toward the trial if I get positive answers to these questions from Annie Sauve, the Rocky Mountain Cancer Care nurse in charge of the trial:

  • “If I am randomized into the control group, what specific drug will I receive? Is it Pluvicto?”

  • “Does this trial have a ‘crossover’ provision if my next scan shows progression?”

  • “Given my concern about dry mouth, what salivary gland protection protocols (like ‘cold caps’ or injections) do you use during the Actinium infusion?”

  • How many times will l have to travel into Denver? I live in Conifer.  (I added this question)

As you can see, these are not straight forward matters. And, the stakes are high. I’m doing fine emotionally, looking forward to getting underway.