The '60 Minutes' Treatment

A.K.A. the questions that some people want to ask but are not sure how and the answers I want to give if I had time to think them through.

The other day I went to the local Hawaiian BBQ joint in sunny downtown San Rafael in my continued effort to eat way more food than I need so that I can gain weight before the next treatment phase begins. And who should be sitting at a table in the back but Dan Rather. He beckoned me over, and I sat down.

After some initial idle chit-chat, I asked him why he was here. He made it pretty clear that he was still bitter about his release over the whole ‘Recordsgate’ fiasco, and that he wanted to get back down to the business of reporting on the news. And he wanted to make me his first feature story. I was so embarrassed I blushed, but how could I say no?

How are you holding up?

Fine. I am not sure how the cancer got here, or why it keeps coming back, but I am not overly stressed about the situation yet. I am still quite optimistic despite the events to date. I am not one to dwell too much on the negative, which has helped get me to this point. No reason to change now. Instead, I have focused my thoughts and effort on understanding the specifics of my case and my treatment, researching future options, and having fun.

How is Michelle holding up?

So far, so good. Like me, she is not one to dwell on the negative. We all are a little worried, of course. However, we are far from exhausting all possible treatments, so no reason to give up hope.

How is Lucy holding up?

Well, this is not really the type of hard journalistic question that Dan would usually ask, but he is a grandfather, and he couldn’t resist asking. She is doing great. Just take a look!

How have you changed since the diagnosis?

I spend a lot more time in hospitals and doctors offices. I stay out of the sun. I have some cool scars on my arm, neck, and head. I own a lot more hats. I am not working, which is definitely a change. Otherwise, I still have the same ole good looks and charm.

What is the success rate of biochemotherapy?

My doctor has had 140 patients that have gone through the biochemo program under his watch. Of this group, 20%-25% have had no recurrence occur over the first 2+ years. In a separate entry, I will post more detailed information from a presentation on the subject.

Are you scared?

Sure, a little. You’ve seen the stats. It definitely gets your attention. If nothing stops the spread, within a couple of years it will be too late.

But I can’t say that I am overly afraid. When I train staff at work, I like to train them on the importance of statistics. But I also emphasize that stats do not tell the whole story. Stats point you in the right direction, but you need to dig in deeper to understand the full story.

That is the case here as well. I am young compared to many of the people that have gone through biochemo. Youth will help me fight. Also, I don’t yet have cancer in any major organ, which most people who go through biochemo do.

What happens if the biochemotherapy doesn’t work?

If the treatment does not successfully prevent additional cancer from developing, then we stop this program and look towards more experimental treatments. I would work with the melanoma experts at UCSF and CPMC to determine which trials would make sense for my situation. One option, MDX10, is in expanded trials and would be high on the list of potential options.

By the way, one of the main reasons that I have been reaching out to friends to find doctors, researchers, and melanoma survivors is to prepare for the possibility that the biochemo does not work. I want to start to understand what other options are out there ahead of time, instead of waiting for potential bad news to begin that process.

What are your biggest worries?

Besides the obvious, I worry most about losing any of my mental sharpness (insert dull knife joke here!).

One way that I am able to cope well with the current situation is that I can easily visualize what life will be like after treatment and recovery. And, as anyone who knows me well knows, that involves work. I enjoy the challenge of a new project/job/issue.

I will be looking for a new job in 2008, the first time in over 4 years. This is exciting. But this vision includes me being able to perform the kind of roles and maintain the kinds of responsibilities that I can currently. The good news is that, in my conversations with two people who have gone through the biochemo treatment successfully, neither expressed any long term negative impacts to their mental capacity.

Otherwise, I guess I would worry about a surgery that would remove a limb or scar my ‘oh so pretty’ face, as it would be a shame to ruin something so perfect. But, this is much less of a concern.

Of course, if any of this comes to pass, we will figure out how to deal with it.

How should people act around you?

I think that the best way to act around me is to walk up to me and hand me a check for one million dollars. You would feel great about yourself for being so generous, and I would feel most excellent because I had just received ONE MILLION DOLLARS! Mwahahaha, Mwahahaha, Mwahahaha.

If that is not your thing, I suggest that you mail the check to me. Or, if you really want to be difficult, I can go the bank and find out how you can wire me the money. But that really would be an inconvenience!

Seriously, I understand that some people may feel awkward around me, or feel that they should say something about my situation but not know what. This may prevent some people from wanting to talk to me.

Don’t feel that you have to say something about the situation. I know about my situation, and I know that you know about my situation. You should not feel required to address it if you don’t want to, and I don’t expect you to.

If you do want to say something about the situation, feel free to do so.

More than anything, I am just happy to hear from people via phone, email, or mail. I prefer to try to live my life as normally as possible for as long as possible, whether that is 3 years or 30 years or more. So, let’s be sure to catch up when you have time.