June 2020 update

It’s been a year since my last health update, and some of you have kindly asked, so I’m sharing an update – although it is far from definitive.

As of today, I’ve been off treatment for six months and feel better than I have in years. I’m living life at its fullest.

The chemo and radiation I had at Stanford for my rectal cancer from July - December reduced the cancer so there is nothing visible with a normal scope. Stanford has done two scopes and says I don’t need surgery now and we should continue to monitor every three months. UCSF, however, did a scope with CT and a biopsy, and they found evidence of cancer remaining and say I almost certainly will need surgery. They also said that it’s reasonable to wait for three months and get another scope and biopsy before making a decision. My situation won’t be materially worse in three months.

At the same time, the nodules in my lungs have increased slightly in quantity and size. These are most likely melanoma, but they could possibly be rectal cancer or, although very unlikely, benign inflammation. UCSF says they could try to biopsy the nodules now, but they are still small and it’s not clear what we would do with the results. The docs at UCSF, Stanford, Memorial Sloan Kettering and Mass General agree that it’s reasonable to wait for three months and get more scans. Whatever is there is growing very slowly.

The combination of my conditions is extremely unusual, and there is no clear plan of action. With both the rectal cancer and the lungs, waiting three months may provide additional data without reducing the effectiveness of any treatment path. The likely treatment for the rectal cancer is surgery, and for the lungs it’s an immunotherapy combination called ipi/nivo, which has nasty and significant side effects. Given the belief that waiting three months won’t reduce any treatment efficacy, I’ve decided to postpone treatment for at least three months to have the option value of possibly learning something new. It’s a long shot, I realize, but I’m holding out hope that the spots in my rectum and/or lungs disappear.

It's likely that this fall will be another rough one for me with difficult treatments… But as of today, I feel great. I look forward to a wonderful summer with family and friends, embracing every day as it comes, living in the moment and worrying only about what I can control.

Being part of BGCP continues to be a source of positive energy, better than any medicine.

With appreciation,

Peter