Our Cancer journey continues …

I last posted to this Blog in April of this year. Much has happened since then in the world and in my life.

The good news – out of character with 2020: My last day as a professional employee of Indiana University was 1 October. This was the 24th anniversary of my promotion to senior management in what was to become the Office of the Vice President for Information Technology. (I hit my 35th anniversary as a professional employee of IU in July). My announcement to retire was made with relatively little time between announcement and retirement. Nothing is more useless than an administrator that people think they can outlive. But the preparation was anything other than rash. I have been very quietly preparing to either retire gracefully or die gracefully since I first figured out that cancer was not going to kill me right away after I was diagnosed in 2017.

It took a while to get here, but I feel I am leaving IU and the Pervasive Technology Institute (PTI) at a good time. I’ve led PTI now for 12 years and I feel it is poised to be successful for years to come.

But it is still 2020. As I have discussed before, I am a person of faith. I have never much feared the wrath of the universe or our creator, but I have always been wary of what seems like a certain penchant for irony. And well so. My long-time colleague Rob Lowden was promoted to be Vice President for Information Technology on the 1st of August, after long-time VP Brad Wheeler stepped down to return to teaching and research. On the 25th of August I told him of my plans to retire. On the 31st of August I had a regularly scheduled CT scan that showed just a smidge of new cancerous tissue growth. The criteria for staying in the trial I was in are based on percentage growth. Because there was no cancerous tissue visible before, any amount of new growth was enough to bounce me out of the study.  (That whole “divide by zero” thing….). And that is as it should be. As much as I had hoped the treatment I was on would just keep working, it didn’t. And this is one of the issues with any kind of cancer therapy – cancer often finds a way to “mutate around” whatever it is you are throwing at it. Something happened to the genetics of the tumor cells to let them start growing when before the immunotherapy was keeping the number of cells so small that there was nothing visible on CT scans. But I am not complaining. On the contrary I am very happy with what this trial has done for me and what it might do for other people. The treatment I was on worked for 23 months. Eight months-ish of monotonically decreasing size of cancer tissue visible in CT scans. Twelve months of CT scans with no visible sign of cancer. And three – ish months of cancer growing to the point that it was visible again on 25 August. The medication I was on didn’t just “stop working.” My cancer mutated and a new mutant was resistant to the immunotherapy I was on. So put that tool away, take another out of the toolbox.

I am now on chemo – a therapy referred to as Flofiri, which is the standard chemo agent for a second round of chemo. I reacted well to Flofox, which is the standard first round. (The two cocktails have one drug in common, one drug different). The two anti-cancer drugs are Fluorouracil – referred to as FU-5. That is the drug that is common between Flofox and Flofiri. The drug that I haven’t had before that is part of the Flofiri cocktail is called Irinotecan. Irinotecan is a plan alkaloid that interferes with the replication of chromosomes when cells divide. The cells cannot successfully duplicate and separate the genetic materials in the chromosomes, so cells die rather than successfully divide. Like most chemotherapeutic agents, it messes with all cells as they divide, but because cancer cells divide faster than others this chemical kills cancer cells at a greater rate than other cells.

So far I am managing the side effects pretty well. Actually the biggest problem we had to begin with was that I was getting enough steroids with my chemo that I was very chatty. Too chatty. We have things adjusted now. I feel kind of punky on the two days a month I actually have chemo sessions at the infusion center. I would say that I am no more bothered by chemo in a given month than the bother experienced each month by the average woman of child-bearing age. 

As long as chemo works, we’ll go with that. That could easily be a year and a half to more than two years. Then I might have to change treatments again. We’ll keep track of new trials and new treatments as time goes on. I have been a Hoosier long enough that I am never daunted. I have things to do and places to go. And there are worse things. It’s tough to look around the world right now and feel sorry for myself. Marion is doing a better job getting a grip on herself and our situation as well. If there is anything I regret, it’s the impact of this on her. 

This is not the way I intended to ride off into the sunset. But Marion tells me she gives me full credit for having decided on my own to retire before I knew I was going to have a bumpier road than expected with my health. I am glad that I was smart enough to make the decision to retire when it was a decision. And I retire in faith, in the short run and the eternal long run.

Sincerely, Craig