Hope

Seems a bit cheezy for a title doesn't it?

Well, you have to comprehend how huge this past week was in order to understand that last monday, I had little and now I have a ton, of hope. And hope, is one of the most important things in life.

Last week: 1.5 years of uncertainty, with a significant possibility that the weird disease I live with had morphed into something more serious.

This monday: Significant evidence that my thyroid cancer is 'stable' in the form of:
1. Stable tumor marker
2. No radiological change in 16 months time
3. No significant physical symptoms

By stable, I mean no growth and no shrinkage.

That is awesome in my mind because:
1. The lifestyle choices I've made with respect to (a) work, (b) family, (c) family, and (d) exercise are having a positive affect. Yes, this is an n=1 experiment and as a future doctor, I couldn't actually Rx what I believe to be beneficial, but I can still feel empowered by it.
2. The fact that my thyroid cancer is stable, 'rules-down' the possibility that there is some kind of weird mutation suggestive of a more aggressive cancer (which was a significant possibility when we learned I had a met in my bone).
3. Because my disease is stable, there is more time for my bad-ass doctors to do trials on people who are really sick and hopefully come up with a cure.

That last part about a cure, well, that represents a HUGE psychological shift for me. My PhD will eventually be in the field of cancer biology. And some combination of being an adult, skeptical thinking, my own experience with cancer, and knowing so many young people who have lost the fight despite living as strong as fucking possible, has made me think that talking about 'cures' to cancer is intellectually and practically a forlorn pursuit.

Call me selfish, but this week I feel a lot more like a hopeful kid...starting over again with a sense that anything is possible. I have every confidence that in my lifetime, we will eclipse our current knowledge regarding the signaling circuitry and intercommunication between cancer cells and all of the other many types of cells in the body connected to these cells. To be sure, cancer is not a single group of cells, but a developed tissue...with perhaps as many different cell types involved in the pathology as is present in the normal physiology of the GI tract.

I now truly believe that in the coming decade, we will see "cancer research as an increasingly logical science, in which myriad phenotypic complexities are manifestations of a small set of underlying organizing principles” (Hanahan and Weinberg, Cell 2011).

This past weekend was a whirlwind. Saturday was a morning with the family at the farmer's market and library. Then a crit in the afternoon where I effectively buried myself and tried too work together with some other folks to bridge up to a break, but could never quite summon the necessary sustained ability to deal with pain.

Sunday was a 6hr team mountain bike race. I rode the new Kona Big Unit (single speed currently) which has a 20mm thru axle up front, and I must say that it is hand's down the best mountain bike I've ever ridden. Fatty TAs are the future.

My teammate and I ended up 2nd on the day. I felt like I'm finally getting some fitness back this year. Thanks so much to Bob Arnold for hooking up the rear wheel. Hopefully things will come together so I can run the Big Unit as a 1x10 for the next few races. The plan is to have another 2 weeks of hard riding, then a little taper, a race, then the long run towards cyclocross next fall.