Broken streak . . .

After 39 consecutive morning hikes, the streak ended this morning. But with good reason.

I spent the entire morning weeding in the vineyard. Good, productive exercise. Five rows this morning following another row a week or two ago. Six down, seventeen to go.

As previously stated, you don’t pull weeds from a vineyard while contemplating the elimination of tumors from your body without having overlapping thoughts. The crew that used to weed my vineyard insisted on hoeing them. I’ve always thought that hand pulling is a more effective means of eradication, but what do I know. And as usual, I’ve always been too busy to argue the case. So hoeing and check writing it has been.

But I’m amazed at the physiology of the weeds I’ve been pulling. They establish a tap root that is truly impressive. It is clear that hoeing simply won’t do the job unless your objective is the job security of recurrent weeds.

My previous two cancer episodes did not require much from me other than going to sleep while a surgeon cut out the tumors. To be sure, there was some pain and recovery effort involved, but relatively little was asked of me. And nobody sent me home with any instructions as to how to prevent recurrences. Some emotional and life perspective adjustments are inevitable, but by and large it was business as usual.

And now, sixteen years later I can’t even obtain consensus from the medical community as to whether the recurrent tumors are multicentric (of spontaneous origin just like the original tumor) or metastatic (long dormant cells that had spread from the original tumor or its successor before their resections). In truth, there is very little understanding of such issues and that does not provide me comfort in terms of placing my destiny in the hands of those that understand so little. It may be true that in the valley of the blind the one-eyed man is king, but I’ve yet to meet the one-eyed man in this valley. One thing is clear: this time around my full attention will be required. And hand weeding.

Back in 1992 when first dealing with this matter, my physician father and I found common ground in our agreement that only “tried and proven” therapies would be considered. And that meant surgery. Unfortunately, such a therapy does not appear to exist this time. Surgery alone appears impractical, so some form of systemic treatment is clearly called for. Chemotherapy is akin to spraying the vineyard with herbicides and pesticides, but not necessarily as effective. And oh, the collateral damage. Some of it immediate, some longer term. And as if the situation were not complicated enough, the literature on chemotherapy in soft tissue sarcomas is varied and controversial. And paradoxically, chemotherapies that have been successful in stabilizing or regressing liposarcoma growth do not appear to be particularly successful in extending life expectancy.

And then we have the always optimistic clinical trials of new, unproven “therapeutic agents”. I fully recognize that the results of such trials are useful to future patients, but I really don’t want to become just another lemming in the endless stream of hopeful patients that ultimately prove what treatments don’t work. That’s certainly useful, but not useful enough for my purposes.

So I continue my contemplations about how to proceed. And I marvel at those weeds and how they crowd the vines and rob them of nutrients. And at how easy they are to eradicate by hand. Can they send out roots deep enough to reach the soul of a vineyard? I think not. Do tumors root deep enough to touch the soul of a man? Most definitely not. So that is where the defense must begin . . .