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Friday, August 19, 2016

Active Surveillance for Some Cases of Advanced Kidney Cancer

My younger brother Mark arrived home last evening well-supplied for the camping trip he left on today with his girlfriend Bev ─ they were to head off to the Squamish area (if I am remembering correctly) and hook up with another couple.

So last evening, Mark showed up with three two-dozen flats of canned beer.

He also brought in a 15-pack of beer for home consumption.

I have no idea if he bought Bev any wine ─ that's her preferred drink.

As I mentioned in a previous post, he is not all that keen about the camping experience.  One night somewhere is one thing, but two nights are encroaching upon the uncomfortable ─ especially since the province issued a camp fire ban in that area just two days ago (vancouversun.comB.C. campfire bans are back, and they've been getting longer in recent years).

That really robs the joy of sitting up after dark drinking beer.  The campfire at night whilst drinking is 'part and parcel' of what makes a camping trip fully enjoyable.

Or at least, that's how it is for us.

Mark had to book today off work, and it will consequently be an unpaid day ─ he is self-employed as an owner/driver of a truck for a cartage firm.  If he's not making deliveries and pick-ups, he's not earning anything.

This was another reason he wasn't especially thrilled about the camping venture.

Yet he said that he would be getting up this morning at his usual time so that he could get as early a start as possible to avoid the bulk of the morning workday commuter traffic.

I expected that he would then retire to bed at his usual time.

He probably got home last evening around 9:00 p.m., and in fairly short order had swilled down five cans of beer from his 15-pack.

Around 11:35 p.m. I tuned in one of the late talk shows; and seeing that Mark had passed out in his chair, I decided to just call it quits and head on upstairs to deal with E-mails.

I was in bed at 12:07 a.m., I believe it was ─ Mark was still downstairs and probably passed out.  He normally has his clock-radio set for 4:20 a.m. to get him up for work, so that's what was going to be ahead for him once he got himself to bed.

But good luck to him today.

I rose shortly after 7:00 a.m., and he was clearly gone.  The only other person home was my youngest step-son Pote ─ and he soon left ere 8:30 a.m. to catch his bus to take him to his job at Guildford.

It would have been a great day to do some sunbathing ─ hot and sunny!

However, because I failed to get out yesterday to locally mail a credit card payment that is due on Monday, I now had to ensure that it would arrive on time by hiking a mile or so to the nearest postal substation ─ Pearl Cleaners over at Surrey Place (Central City).

I thought that I might first manage to complete the post I've been working on since Monday at my Lawless Spirit website, but I now realize that I will be fortunate to finish and publish it by tomorrow.

I was obliged to cease my work on it, and late in the morning began preparing for my outing.

It was early into the noon-hour when I finally began the trek.

I was also entertaining the notion of returning home indirectly and doing a little grocery shopping at the No Frills store at Cedar Hills (128th Street & 96th Avenue) here in Surrey.

I got my bill payment mailed as planned, but was never entirely sure if I would be making the detour to do the shopping ─ Cedar Hills is roughly four blocks from where I live, but in a direction different from that of Surrey Place (Central City).

As I began the trip homeward after mailing the letter, my wife Jack texted me to find out if the Pattullo Bridge was going to be closed for rehabilitation work.

Fortunately, I had the forethought before leaving home to check the translink.ca website and had taken note that no closures before August 24 were being announced; so I texted back that the bridge would be open.

Her final reply to that:
K c u
As I made my way back, I kept wrestling with the notion of whether I should add that extra distance and go to No Frills ─ doing so would make my original two-mile round trip into a three-mile outing.

If I did not do the shopping, then I would have to do it on Sunday.  But I am running out of rum, and want that day free so that I can make a hike to the government liquor store about two miles from where I live.

I resolved that I had no option but to visit No Frills, and so I did.

As I was returning  home with my purchases, I encountered a most lovely young brunette wearing white skimpy shorts, a black halter top, and fashionable dark sunglasses.  As good fortune had it, we met up along a narrow walkway that had a metal fence on one side, and a prickly hedge on the other.

Etiquette for pedestrians tends to be to keep right, just as if in driving.  However, that would have exposed the dear thing to that prickly hedge ─ the walkway was maybe a yard wide.

So I called out to her to take the side with the metal fence and spare herself from the threat of the hedge, and we eased past one another ─ she smiling and expressing her gratitude.

Man, I wish that I could photograph some of the people I encounter!

That walk will be my exercise for the day ─ it is just too hot.  And this morning, I felt as rough as if I had a hangover, so I never felt up to doing anything then, either.

I would have, though, had it not been necessary to do that trip to mail the bill payment.

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I have an old photo to post that is from an album belonging to my younger brother Mark.  I had to scan the photo right from the photo album into which it is glued.

The description below the photo is from the Google album where I have the scan stored:

This photo is likely from 1974, and was taken at the Surrey home my younger brother Mark rented with his girlfriend Catherine Jeanette Gunther and her two young daughters.

It is so long ago now, but I think the house may have been located along 144th Street, above 108th Avenue.

I remember that the rather deep ravine of a creek was at the rear of the backyard; and the only creek I can see on any Google map is Bon Accord Creek.

There seemed to be a bit of a party happening when this photo was taken.

I don't remember the girl at the far left, but that is Mary in the centre with her arm raised.  I only know her as the female half of a couple I knew as Bob & Mary.

That appears to be my old friend Norman Richard Dearing seated beside her and taking a drink.

The hairy head in the foreground is my own ─ I recognize the top I am wearing.
As I recall, I was to shred that top one drunken night when I toppled into that ravine.

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What would your reaction be if you had yourself given a thorough medical check-up and it was discovered that you had advanced kidney cancer?

Would you want to begin immediate chemotherapy?

That seems to be the course taken by most specialists ─ start treatment as soon as possible.

But just what is 'advanced' kidney cancer?
Kidney cancer is called advanced if it has spread to another part of the body. It is also called a secondary cancer or metastasis. Your cancer may be advanced when you are first diagnosed. Or for some people it can come back or spread some time after surgery to remove the cancer.
That's a quote from cancerresearchuk.orgAdvanced kidney cancer.

Now concerning chemotherapy for advance kidney cancer:
Antiangiogenic drugs that target the vascular endothelial growth factor (VEGF) pathway, such as   sunitinib, sorafenib, and pazopanib, axitinib, and bevacizumab, can produce objective responses and extend progression-free and overall survival in patients with metastatic renal-cell carcinoma. Although these drugs are considered standard of care, they are not curative. Furthermore, disease control necessitates chronic therapy, and thus the benefits must be weighed against the overall burden of treatment including toxicity, time commitment, and cost. 
Wikipedia doesn't cater very much to the layman where scientific definitions are concerned ─ this is a simpler explanation of what antiangiogenic drugs are or do:
Angiogenesis means the growth of new blood vessels. If we can stop cancers from growing blood vessels we can slow the growth of the cancer or sometimes shrink it. Anti angiogenic drugs are treatments that stop tumours from growing their own blood vessels.
That's another quote from from cancerresearchuk.orgDrugs that block cancer blood vessel growth (anti angiogenics).

So although the drugs "are considered standard of care," they cannot cure kidney cancer.

Anyone taking them cannot cure their kidney cancer ─ they are only hoping to prolong life.

Unfortunately, the chemotherapy will likely ensure that it will be a rather miserable life, though; and the 'treatment' will be very expensive.

That quote is from the introduction to a study published August 3 in The LancetActive surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial (doi: 10.1016/S1470-2045(16)30196-6).

The general public has to pay a fee to see the full study, including that introduction quote; but I accessed the full study for free as an eight-page .pdf document at Sci-Hub.ac.

Anyway, here are a couple of reports on the study:

 

I hope no time is wasted determining the value of active surveillance in terms of advanced kidney cancer.

And I wonder just how long it takes from the time of diagnosis for specialists to determine that the advanced kidney cancer is slow-growing?

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Here is where I close off today's post with an entry from my journal of 41 years ago when I was 25 years old, and living in a basement unit in New Westminster.

The house I was renting the room in was located on Ninth Street at Third Avenue.
TUESDAY, August 19, 1975

My faint sore throat still exists.

I awoke about 6:00 a.m.  

I had a dream of a wooded place near, I believe, the foot of a large bridge.  The place was secluded.  Mark & I were conscious of weirdness hereabouts, and had located a pit of some sort.  We entered.  There were all manner of strange, glowing, variously-coloured minerals and things all about.  I think at one point we were made aware that the creatures responsible for the pit took note of us, and we made a precarious flight.  I have no clear memory of these creatures, but later on I met up with one, and it resembled a house cat.  I really remember little of the dream.

I cooked a soup before cashing my cheque; then I bought a $5 money order for Famous Fantastic Classics #1, and at Safeway bought 2 loaves of bread and some ground beef.

The girl at the bank told a fellow handling me that it was unnecessary to check my I.D., as she knew me.

I came home shortly after noon and had a snack.  

When heading for the bank, after I'd crossed Agnes St. Esther in the truck honked at me.

Leaving home a second time I bought a  package of Maple Leaf cheese; then I proceeded to the McBride liquor store and bought 80 ozs of Caravel Sherry.

I came home planning to leave Bill a note stating I would make hamburgers Saturday rather than eat at a smorgasbord, but his car was not home.

I finished typing a reply to Jean.

While exercising, during my Bullworking, Bill called; he showed me our camping photos; sexy Cathy never turned out close or distinct enough.

All day the sky has been cloudy.

I can't escape the image of how exciting and desirable Cathy is.

I am going to drop in on Art for awhile, mailing my letter to Jean first ─ no, I shall save it.

Well, I intended not to drink, and to leave at 9:30 p.m.  Art, Angie, and Keith were there, and for a very brief while, a guy called Ed.

First thing Art had me wrist twist with Keith; a stalemate.

I had some vodka, and time passed.

Eventually the Smiths decided on going out (I snacked earlier), and they finally decided on tripping over to dad's while Keith retired.

Angie was in an amorous mood, and I had some bad moments of conversation in the truck while Art bought some wine and beer; she fingered my arm the entire trip.

I took the 2 peanut butter & honey jars in with me that I was given, and we visited my sober father and Marie, both of whom lasted commendably.

As I said I would all along, I refused to leave with the Smiths and thus miss my allotted run; I had to promise to turn up Friday though.

I remained a while longer, then from the Kensington light I ran every step home, feeling the bit of wine and beer I did have.

Going to shower, I found and tossed outside a slug; it left an area of jelly on 2 fingers that adhered like nothing I have ever encountered, but it finally washed off.

Bedtime, finally, at nigh 3:15 a.m.
As I have often said here in my blog, I wish dearly that I could remember dreams today as well as I did back then.   

I had a $50 cheque to cash ─ it was payment for working one day a week at a New Westminster charitable organization called S.A.N.E. (Self Aid Never Ends) that today calls itself Fraserside Community Services Society.

While on my way to the Royal Bank on Columbia Street to cash the cheque, I was honked at just past Agnes Street by Esther St. Jean ─ she generally drove the S.A.N.E. pick-up truck that I worked as a swamper on.

Now, concerning the bank, I never had a bank account anywhere, nor did I have any photo identification.  Yet a dear girl who worked at that branch of the bank ─ I believe the girl's name was Mary ─ always rushed over to serve me, sparing me the discomfort of having to deal with somebody else who would be suspicious of me and reluctant to cash a cheque for me based upon things like my birth certificate and Social Insurance Number card.

Those were all the official identification I had.

On this day, she told her co-worker that I was okay ─ that she vouched for me because she knew me.  But she did not ─ we only knew one another from the interactions she and I had whenever I came in to cash a cheque.

I really liked her, but felt like too much of a loser to show it or try to be social with her.

To this day, I still think of her.

Anyway, after getting back to my room, my next foray was over to a shopping plaza at the intersection of McBride Boulevard & Eighth Avenue.  It was a government liquor store where I bought the Caravel sherry ─ I vaguely recall that defunct brand.

Back at my room again, I finished typing up a letter to an American pen-pal I had ─ Jean Michelle Black, or Jean Michelle Martin.  One of those last names was her married name, but I now cannot be sure which was which.

I was exercising with a Bullworker when my old friend William Alan Gill showed up.

He and I had recently spent two days camping at the Chilliwack River with my younger brother Mark, Mark's beautiful girlfriend Catherine Jeanette Gunther, Jeanette's two little girls, and the family German shepherd Daboda.

Jeanette ("Cathy") had put on a bikini and Bill and I were absolutely blown away by how spectacular the young woman looked.  He was the only one of us who had a 35-millimetre camera ─ my mother had borrowed mine for a trip she and her husband were to make.

If Bill ever gave me the film negatives, I was never to get them developed.  I wish I had those old photos now.

Following Bill's visit, I then decided that I would visit Art Smith ─ he also worked part-time at S.A.N.E.

He was a married man in his early 40s.  Angelina ("Angie") was his wife, and only about 33 years old.

She had a strong attraction for me, and it sometimes got very awkward and uncomfortable for me.  If not for Art, I might well have succumbed to her advances, for she was certainly attractive enough.

However, I was also something of a prude.

I have no idea now who "Keith" was that seemed to be staying at their home.

Reading that the Smiths and I were to actually drive off to visit my father Hector and his girlfriend Maria Fadden quite surprises me ─ I cannot recall it happening.

At that time, my father and Maria were living in an apartment building at either 5850 or 5870 Sunset Street in Burnaby.

I have no idea if the locator map below for 5870 Sunset Street will properly display or not, but Sunset Court appears to be 5850:


I often got annoyed by how interaction with Art meant that my fitness plans would fly right out the window, so this time I refused to ride back to New Westminster with him and Angie (and weather her flirtations or advances, too).

Art would just take me back to their home and the drinking would continue.

So I stayed behind and visited with my father ─ it was not often that he and Maria were sober.  And this evening, they were even controlling their drinking and behaviour.

Then I left for home at some point, hiking Canada Way to Kensington Avenue.  If you scroll along on that map, you will find Kensington just beyond the RCMP station on one side of Canada Way, and Sade's Lounge and Banquet Hall on the opposite side.

It was from there that I was to run the entire way back to my room at Ninth Street and Third Avenue.

Earlier in that journal entry I had mentioned buying a money order to mail off for Famous Fantastic Classics #1 ─ this is an Amazon link to the book, but I have no memory of it whatsoever:

Famous Fantastic Classics 1

It is now just after 6:00 p.m., and my wife Jack has been home for awhile. I must proofread this post and then get it published.
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