Possible Movement on the Cancer Front

I got a second PET scan* on the 19th; and the results were basically the same as the one I’d had four months ago:  the cancerous lump hadn’t gotten any bigger, and there’s still no evidence of any spread to my lymph nodes.  It’s possible that I might have to get another biopsy of the lymph nodes just to make sure; but the last I heard, the biopsy guy didn’t think it would be necessary.  We’ll see how that goes.

Assuming that I don’t have to worry about the lymph nodes, which the oncologist I saw today said he thought was highly likely, I’ve decided on radiation and chemotherapy.

I’m told that the radiation will be something like a dental x-ray, except that it’ll take about fifteen minutes during which time I’ll be immobilized inside something that they’ll mold around my body.  IIRC, there will be three treatments on separate days, and I’ll be able to drive myself home after each one.

The chemo will be more complicated:  three treatments on consecutive days repeated three more times at 21-day intervals.  This would bump into my trip to Hawaiʻi in November by a day or two; but the oncologist said that he could work around that.  He also said that, although some folks do get nausious from the drugs that he’ll use for the chemo, very few do; and I should be able to drive myself home after those as well.  That’s important because the flip side of there being no one who depends on me for anything is that there’s nobody whom I can reasonably ask to drive me to and from the hospital and then take care of me after I get home.  (This will be an issue if I need another biopsy since that requires general anesthesia; and so I’d need to be admitted to the hospital overnight for observation.  I wouldn’t mind that except for the boredom, but it seems wasteful to me…like I was hoarding a hospital bed for what would likely be no good reason.)

If there are no lymph node issues, and if the radiation and chemo work as expected, both the radiologist and the oncologist assure me that I should retain sufficient independence and cognitive abilities to continue serving on the ISO C++ committee through next year at least.  That’s good news because next summer’s meeting in Stockholm has fallen through, and I’ve made an offer to host the committee next June or July.

I feel a whole lot better now that I have a plan.

*This was basically like a CAT scan except that they shot me up with radioactive sugar; and the cancer cells said, “OOO, FOOD!”  Unlike a CAT scan, I had to observe a low-carb diet the day before and not eat or drink anything except water after midnight the day of the test; and it took about 45 minutes of my just lying around to get the sugar distributed around my body.

New Subject

Katydid commented on my ethics post:

OT: Amtrak in upstate NY halted as tracks were washed out by “once-in-a-thousand-years” flood.

Yes, I’ve been reading about that on an e-mail list, AllAboardRailDiscussion@groups.io.  That’s Metro North’s Hudson Line to Croton-Harmon and Poughkeepsie, so it’s a big problem for commuters; but it also shut down Amtrak’s Empire Service and the Lake Shore Limited which use that track.

I’m not sure exactly where the flooding happened, but I’ve ridden on that line numerous times on the Lake Shore, and there are places where the track runs right along the eastern bank of the Hudson.

Update:  some photos

There’s also flooding on CSX’s River Line on the western bank.

Elementary Ethics

I watched the Podish-Sortacast today because I thought it would be interesting to hear other FtBloggers talk about how they became atheists.  The reason I bring that up is that, during the wrapup, PZ remarked that arguments for and against the supernatural really aren’t that interesting because they tend to be the same old arguments that have been made for centuries.  Far more important these days are various social issues like humanism, ethics and social justice, which I agree with; so I thought I’d jump in with my own admittedly abecedarian understanding of ethics.  Maybe commenters can help me get my thoughts more orderly.

Almost certainly because of the way that I was raised, there are a couple of points that I treat as if they were axiomatic:

  1.  People are more important than things.

  2.  It’s not all about me, and not all about my tribe.

Point 2 makes it easy for me to reject egoism and relativism as ethical principles; but between utilitarianism and a more Kantian approach, I confess to being very confused; and indeed I’m skeptical about both of them.  “The greatest good for the greatest number” doesn’t really have any meaning absent a calculus for it; and it has always seemed to me to be a pretty good general principle that the consequences of my behavior matter.

But point 1 means that I have an obligation to get through the day without being a jerk…without causing harm to others, and particularly without exhibiting the pridefullness and hatefullness that we see in the loudest of the far right; and so, as a practical matter, I need to pick one.  I tend to be more Kantian about big issues (things like hatred of folks not like me are just wrong); but I’m more utilitarian about smaller matters that are well understood.  (Should I get my flu shot?  Yeah, sure:  herd immunity.  That’s not the only reason, but it’s a sufficient reason.)

Have I gotten off on the right foot at least?  I hope so because, at age 76, I’m pretty set in my ways. 😎

More Cancer Thoughts

Introduction

I have a telephone appointment with a cancer surgeon on Tuesday, and I’ll probably be referred to an oncologist who can discuss various treatment options; and since I’m more comfortable with the written word than with the spoken word, principally because I can fix my mistakes before others know that I’ve made them 😎 , I want to write a short post to get my thoughts together in (I hope) some cogent way, and maybe to help the doctors be prepared with objections if they think I’m on the wrong track.

It’s possible that they’ll want me to communicate on-line using something called “MyChart”, but the messages that I can send are kind of like what I imagine tweets to be except for allowing more characters, so I’ve split this into four sections that will easily fit into four MyChart messages.  In any event, I’ll try to keep it short.

My goals

First of all, since I don’t believe in the supernatural, I’m not afraid of being dead:  it seems highly unlikely to me that there will be any me to be dead.

But I’m guessing that the process of dying won’t be any fun; so I think I’d like that to happen in some controlled way rather than, say, being surprised by a heart attack.  At present, I think I’d want to let the cancer take its normal course, eventually in some kind of hospice care where they keep me as comfortable as is legal in Missouri (most definitely a red state).

Also, since I’m a fairly extreme introvert, I don’t have anyone that I’d be selfishly leaving behind.

My questions

What I’m hoping for are guesses, for various treatment options, about how much time I have left 1) to be sufficiently independent that I can travel to meetings of an ISO standards committee that I serve on and 2) to retain sufficient cognitive abilities (e.g., not all hopped up on pain killers) that I can still use my computer.

– I’ve already made all the reservations for the trip to Hawaiʻi in November.

– I’ll probably just Zoom in to the Tokyo meeting in March in any event because I wouldn’t want to sit in an airplane long enough to get there.

– I’d like to make one or both of the Summer and Fall meetings in 2024 if I’m still around then.

Bottom line

I understand that surgery is the best option to let me die of something other than cancer; but like I said, that’s not my goal.

Can I make any reasonable guesses about how much longer I’d have a reasonable quality of life given other treatment options (including doing nothing at all)?  I’m not nearly as good at math as I’d like to be, but I understand some elementary statistics.  If I can get median, mean and standard deviation, I’d know what to do with that.  Alternatively, if I can get min and max along with probabilities that those numbers are close, I could deal with that as well.

With that information, I think I could make a rational decision about what I’d want to do and to make plans for it.

Update 2023-07-12:  as expected, the surgeon couldn’t really talk about anything except surgery; but he did refer me to a radiation guy with whom I have an appointment in a couple of days.

Since writing this post originally, I’ve made an offer to host a meeting of the C++ standards committee next summer (the plan for Stockholm has fallen through); so there’s now some urgency to decide on a course of treatment, possibly including doing nothing at all, that will give me a good likelihood of still being active enough for a year or so to do all the necessary administrivia.  We’ll see…

Human Resources

In a comment to one of PZ’s posts, jeanmeslier wrote:

Imagine being reduced to a resource …

Don’t get me started on the “Human Resources” paradigm of business management.

OK, you got me started.

<rant>
The Human Resources paradigm is fundamentally flawed because it denies the moral distinction between people and things.

Oh, it makes operational distinctions:  it recognizes that people are more complicated than “other things”; and it recognizes that people are more “costly” than “other things”; but it asserts positively that managers ought to treat their employees decently for the same set of reasons that, say, carpenters sharpen their saws.

It’s that “for the same set of reasons” bit that’s the error; and it’s an error that can’t be fixed.  You can’t wash it off and peel the skin; it’s rotten to the core.  All you can do is throw it away and hope that the next one isn’t so disgusting.
</rant>

OK, having gotten that off my chest, I’ll back off slightly and allow as how the Human Resources paradigm does have one bit of utility:  it presents an argument that the Mr. and Ms. WIIFMs* of the world can comprehend.

*WIIFM — pronounced WIFum — “What’s in it for me?” — actually taught as a Good Thing in pseudoscientific pop psychology classes at the American Management Association.