Update January 17, 2003

Jeff is still at Stanford Hospital. He appreciates visitors, but has suggested that potential visitors have a few expectations:

• you might not be able to see Jeff
• Jeff might be sleeping
• it might need to be a quick visit

Jeff was admitted to Stanford Hospital on January 5 for severe dehydration related to his condition. After a week, the situation has improved slightly but is still being worked on. During the course of this, it was additionally found that he has a large blood clot in his left jugular vein. Both of these conditions are likely to keep him in the hospital for several more days. He regrets not being able to answer your phone calls and emails but wanted to keep you apprised of the situation.

The biliary stent procedure went as expected, and I went home on Monday with a drain from my right side. Connected to the tube is my precious "bag o' bile", which must be emptied every 3 hours or so. This stuff is similar to motor oil, and it's amazing how much shows up. I'm slowly losing my orange color and returning to pink. The bag is due to be removed on Monday. I'm beginning to feel a little better now, but is hasn't been such a good week, feeling-wise.

I hope you all had a wonderful Thanksgiving-- I did.

I was fortunate to have a fairly long period of feeling pretty well before and after the party. The last two doses of Gemcitabine were increased doses, hoping to improve its effect on the cancer. However, in the last two weeks I've been feeling tired and sleepy again. Last week it was determined that I have jaundice, due to constriction of the bile duct by the tumor in my pancreas. On Tuesday I will have a scan to determine where the obstructon lies, and then a stent will be inserted to drain the duct. I hope I will feel better once the backup of bile clears. This should be a same-day procedure if all goes well.

After I recover we will resume chemotherapy ASAP, however it is not clear at this point which drug(s) are my best option at this point.

A year ago it was questionable whether I would see my 50th birthday. This week it became a reality, and I am thrilled. I also feel very lucky to be able to feel good enough to fully enjoy the occasion. Many thanks to all those who joined me in celebrating and making it perfect. You can re-live the experience by visiting the photo gallery, where you will find hundreds of pictures and video clips of the event. It also marked the launch of the JJS Lung Cancer Foundation, raising over $25K to support research in lung cancer (see Cancer Foundation link above).

I was waiting for the results from my recent CT scan for this update, and I was anticipating good news based upon how good I feel and the remarkable shrinkage of the nodule on my chest. Unfortunately the results were very disappointing. The scan shows my kidney and pancreas tumors have continuted to increase in size since the last scan. Even worse, I now have several new lesions in my liver. After consulting with my doctors, we plan to continue with Gemcitabine treatments for a while under the theory that it may be helping me to some degree, and taking to account that other treatment alternatives at this point are very risky at best.

I am deeply saddened by the untimely loss of two fellow cancer patients and dear friends, Robert and Joel, in the past weeks. My heart goes out to their close friends and families.

At last the long-awaited "Hats" section has arrived!!! Just go to the "Photo gallery" and click on one of the new "Contributed Hats" pictures. If you are using an old version of Netscape you may have some problems with spacing of the pictures- time to upgrade or switch to Internet Explorer. Thanks again for all your contributions, and if you see ??? under your contribution, please remind me which one you sent.

Last week's MRI showed the brain tumor we treated with the CyberKnife had shrunk significantly, which is a very good sign. It's still there, but I don't feel it any more. Even more important, no new problems showed up (I had been a bit worried).

Gemcitabine doses 3 and 4 went fairly well, thanks to the tireless care of Carol, Stephen, and Jeannie. Next week I will switch treatment from Stanford Hospital to the Hope Clinic in San Mateo. Here they promise a more humane (and rapid) treatment style, along with a more "folksy" environment assisted by their advertized canine greeter, "Millie". I will have to find a way to live without the controversial Stanford "clown", who had a rather annoying proclivity toward showing up at precisely the wrong moment. An irritated "Get the Hell out of here right now" coming from the next room usually preceed his appearance at my armchair. It will be several more weeks before we can assess the effect of these treatments on my tumors.Thinking positive.

Sorry for the late update- I have been having some difficulties with file transfers.

The CyberKnife procedure on Aug 13 went exactly as planned and was not a big deal at all. I went back to work that afternoon and had no trouble remembering where my car keys were. I enjoyed being able to say, "If what I said didn't make any sense, it's probably the BRAIN SURGERY talking".

I began Gemcitabine treatments on Aug 21, and a second on the 28th. Many thanks to my brother Scott and my friend Marian for taking excellent care of me for these first two doses. I have this week off, then start again next week. So far, the side effects are not too bad; I just hope it is working on the cancer. We won't know for several more weeks, however the new tumor on my tummy doesn't seem to be getting any smaller. I do have a fair amount of pain in my hips most of the time, and have had to stay on vicodin constantly. :-(

I was able to participate in our group raft trip on the American River, after a 1 year delay, and really had a blast. I even swam one of the rapids. This year set a new record for water bucket fights. It was great to be outdoors again, and I enjoyed spending time with such a great group of kids and parent/friends.

I had just written the Aug 6 update (see past updates) when I received more bad news. Last weekend's MRI of my brain found an 8 mm metastatic tumor in the left frontal lobe of my brain. This is the scenario I had feared from the beginning, and it completely blows my treatment plans, again. I'm told this has been caught very early, that it has occurred in a relatively safe region of my brain, and that treatment has an excellent chance of success. Therefore, next Mon I will undergo treatment with the new CyberKnife at Stanford. It uses fractional radiation beams that precisely irradiate just the desired regions, with mm accuracy. I won't feel it at all- I hust have to endure being strapped to a table unable to move for an hour. I will then resume chemotherapy the following week with a different agent, Gemcitibine.

This is another setback, but my spirits are good and I'm feeling pretty well, except for pain in my hips in the evenings. In fact, I'm looking forward to going rafting next weekend.

Thanks for all your support.

This Wednesday I will begin a new trial for Epothilone B. This is a new taxane analog designed for tumors which have shown resistance to taxol (like mine, unfortunately). It is a Phase I trial, so it is early in development, and I will be admitted to Stanford Hospital to receive the drug. It's a bit of a long shot, but I would very much like to have some of the other kind of luck this time around.

I am able to function pretty well during the day, however at night my hips get quite sore and I have to take pain medicine to get through the evening. I know I have at least one new tumor, right on my chest. It doesn't hurt much yet but it's a useful monitor for what the rest of the tumors are doing.

We're pleased to have a new addition to the household-- Twiggy; a 7-year old cat we have adopted. Thanks to Amy and Roman, who will surely miss her. You can see her posing on the photo gallery page.

Now that I've had some time to absorb the last bad news (see previous update), I'm feeling a little better. The tumor in my left leg has progressed to the point where I can feel it on the surface and it hurts more. Nevertheless I'm getting around very well and am busier than ever. I'm currently in a 4-week "blowout" period before I can start another trial. There are several to choose from and the choice is far from obvious. Whatever the decision, I'll probably start again in early August. In the meantime, I'm having loads of fun with friends, wearing goofy hats, and entertaining visitors. I've also been experimenting with acupuncture (not self-inflicted), Chinese herbs, and alternative diets. I'll let you know how that turns out.

I have received quite a few hats, they are cheering me up greatly, and I'm enjoying wearing them at most inappropriate times. So thanks for all your donations. I may be a little slower than planned getting the pictures posted so please excuse me.

Now that I'm fully "exposed", here's a chance to have some fun with this. Many have mused, "Is there anything Jeff won't do?" I have indeed asked myself that same question on occasion. So now we will find out the answer. Here's how it works: If you wish to participate, you send me a hat, of your choice. Be as creative as you like, within the limits of decorum. I will commit to wear the hat at work, at least half the day, and will record the event with a picture on this site, credited to you if you like. My only requirements are that it fit me (7 3/8) and that it not be too painful (my head is getting pretty sore just now so think soft). If you need a shipping address, send an email through my picture above. Count is already up to 3. Maybe I should start pleading for mercy now...

I received chemo #2 today. It went much easier, but I'm feeling a little green and crampy already. Also I get hiccups whenever I eat. This is a bit annoying, but I can stand it. My "rash" is improving, thanks to some topical antibiotic I was given. It's still more than I want to deal with long term, but is a vast improvement over last week. The doctor is a bit worried about the long term effects of the neuropathy, of which I'm getting an unusually early effect. In fact I wasn't supposed to have that yet, and it doesn't ever go completely away, apparently. In other developments, my hair is beginning to part company from me, 2-3 hairs at a time so far, but I suspect it will pick up momentum sometime soon.

I have Karin's friend Carol here for a week, and also a nurse for 4 days. I am getting a great deal of help on request from my thoughtful neighbors and friends too. Thanks to all.

Feeling much better this weekend and I enjoyed the ability to do a few neglected household chores. Guess I'm getting used to tingling fingers and toes. The skin rash is bad though, and getting worse each day. I'm a bit worried about where the rash ends up... I'm already tired of it. Also have some painful sores in my mouth. Getting plenty of excercise, to get ready for the next cycle which begins in 9 days!

Thanks of all the prayers... I feel them!

I can now say from experience that chemotherapy is no fun at all. The treatment itself was just long and boring, and nothing hit till Friday, 2 days later. But when it did, WOW. The pain was intense, and while I've never actually been hit by a bus, I can imagine it being a similar sensation. My friend Mark took well beyond excellent care of me and nursed me back to some sense of "normality" by Monday. I still have neuropathy in my feet and fingers, which makes typing less fun overall. The big news is that I have broken out with "the rash" [which means I'm not getting the placebo treatment]. I will have to learn how to deal with it, because the plan is to receive the drug from now on.

I went back to Stanford yesterday to relieve my intense craving for i.v. lines and hospital food, and to receive my monthly Zometa infusion while there.

Thanks--I'm appreciating all the email!

Update May 24 2002:

On Wednesday I received my first dose of chemotherapy. It included first the Tarceva, then Paclitaxel for 4 hours, then Carboplatin for the last hour. My friend Eric S. was kind enough to escort me through the whole 9.5 hour ordeal. It was not painful, but overall I'd rather be in Philadelphia. Since then I've been under the excellent care of friend Mark S, who treats me like a king. I've had some bouts with hiccups, stomach cramps, unusually sensitive skin, and today some dizziness and fatigue. Not really all that bad, so far, but there is more yet before me. Now it's time for those little cancer bastards to DIE! Thank you all for all the good will and email- I feel it all coming in

Update May 15, 2002:

Last week's PET scan confirmed the presence of moderate size metastatic sites in my kidneys, pancreas, and discovered several other additional new sites. In addition, my hip site is growing again. The latter is particularly upsetting. Yesterday I joined an experimental chemotherapy trial with the new drug OSI-774, and will start next week. This is a new "biological" drug developed for cancers like the one attacking me. As it is a randomized trial, I will receive standard chemotherapy and may or may not receive the new drug also (I won't know). If successful, it will span the next 18 weeks. Prepare for my new fashionably "bald" look

Update May 7, 2002:

On May 1 my recent CT scan detected 4 new abdominal tumors: 2 in my left kidney, one in my right kidney and pancreas. Obviously, this is a major setback. I will need to undergo some additional tests to verify their origin, and then begin chemotherapy shortly. I expect it to last several weeks, and will likely put me out of commission well into June. I just hope it works. Other than that bad news, I have been feeling great lately. My hip and chest sites have been improving slowly but steadily, and I even was able to play a little tennis last weekend with Eric and do some work in the yard.