MSI Press Blog

(Carl, returning from chemotherapy, getting out of car and onto chair lift)   An inescapable decision--and a potentially life-changing one--can be whether or not to provide chemotherapy at advanced stage 4 of cancer. Chemotherapy given when a cancer is incurable (and side effects are minimal, manageable, or acceptable) is called palliative chemotherapy .  As with nearly anything medical or existential, there are pros and cons.  On the PRO side are the intents (if actually realized) shrink the cancer reduce the symptoms (e.g., pain) improve quality of life prolong life On the CON side are the peripheral aspects uncomfortable and/or disconcerting side effects (the same that accompany any chemotherapy: nausea; neuropathy; in the case of some compounds, hair loss) "end of life" chemotherapy can feel like grasping at straws, especially when/if the intents are not all met or met at all (an emotional side effect of depressions, desperation, anger--it depends upon the person) difficu

  Carl, whose experience launched this blog and the MSI Press's Carl's Cancer Compendium (CCC) died after a very short 5 months post-diagnosis of occult cancer, or, as the official term goes, Cancer of Unknown Primary (CUP).  Carl fell February 23 and went to the local hospital where staff found advanced stage 4 metastatic cancer in five organs and subsequently transferred him to Stanford University Hospital, stating he would not likely return him. He did return home, for a brief four months--and he died at home on hospice almost a month later, having spent only 10 days in that capacity.  Stanford spent almost a month trying to determine the original cancer that had spread to these five organs (none of these organs was the original.) That is the problem with CUP. Finding the original seems out of reach and a guessing game. The doctor made his best guess, based on the spread pattern, but the cocktail he came up with for chemotherapy while doing no harm also did no good. The pro

  When Carl , MSI Press LLC graphic designer and co-founder, was dying from cancer of unknown primary , which has a very grim prognosis and no routinely accepted treatment, he wanted only hope -- that he would be in the 1% that has been reported to survive CUP at least for a year or more. He steadfastly avoided talking about death with his children, friends, and me. He resolutely did not want to talk to a professional of any sorts although he was willing to talk to a priest friend. Unfortunately, he was semi-comatose and near death before even one meeting could take place, given his frequent unplanned trips to the ER and regular trips out of town for chemotherapy. (The oncologist made an educated guess as to the possible primary cancer and gave two drugs, one a wide-sprectrum which generally does not work well because it is not targeted and the other targeted against his best-guess that the cancer started in the GI tract.) So, when the priest was finally able to connect with us, it was

The cats in the window, Intrepid (tabby-mau mix) and Murjan (red & white Turkish van), were the best of friends. Murjan "raised" Intrepid after he was found as a small kitten crying in the grass after his mother died. Both were born in Jordan and were brought to the USA when we moved back home to California. Both were diagnosed at the same time with lymphoma though the vet said that it was pure coincidence. Intrepid was the younger by four years, but he had the worst case: his kidneys and liver were already damaged when we found out he was sick. Both began chemotherapy in summer of 2018.  Intrepid In October 2018, Intrepid , named for his daredevil approach to life, died. He was only 11 years old. As the days went by and the chemo did little more than make him loopy--actually, it was difficult to know whether the progressing disease was causing him to walk drunkenly or the chemotherapy side effect or both--he ended up on IV at home at times and IV in the pet hospital at t

  A recent article brought back a raw memory:  Dad died 44 days after his cancer diagnosis. He never received the chemo he was promised (msn.com) . That was pretty much what Carl experienced. He fell February 23, was diagnosed with late stage 4 cancer in five organs, and was set up for testing to determine the primary (never was found, and the diagnosis became cancer of unknown primary ). He had to wait to begin chemo until he could receive the second covid shot (remember back then?). Once all the tests and shots were over, it was the end of June. He received three rounds of chemotherapy before falling again on July 23, at which time, tests showed that chemotherapy was not working. From that point, it was only 23 days until he died. It felt like chasing after water as it was flowing over a waterfall. No way to keep up. Would those original 4-5 months have made a difference had he started receiving chemotherapy earlier? It is impossible to know. Could those early tests have been pushed

  This is not the first time we have written about cat cancer in a Caturday post. We learn more about it over time, and it seems that more in general is learned about it over time.  Blind Cat rescued share the following interesting and information post about cat cancer:  Feline Carcinoma (blindcatrescue.blogspot.com) . Cat cancer not only occurs, but at least in our household has become common as our cats have aged. Among our cats, three have died of it, and two are living with it. The breed does not seem to matter; it appears that cancer is blind to breed. Intrepid was the first to be diagnosed with cancer and the first to die with it. In his cancer, it was small cell lymphoma. He lived only a few months after diagnosis. His vet missed the cancer -- that happens with people, too. After describing Intrepid's late night howling to a friend who works at the SPCA, he gave us the name of a vet with excellent diagnostic skills. She immediately intuited the problem, scoped Intrepid, fou

  Personal experience from the editor: When three of our six cats were diagnosed with cancer, it was at a late stage. (The number is normal; 50% of cats over the age of 10 end up with cancer.) Even talented feline oncologists cannot turn the clock back. They can try to stop the clock, but sometimes the damage is too great.  We lost Intrepid to cancer three years ago (and wrote a book about him). He survived only a month of chemotherapy; he was diagnosed too late, and several important organs were in the process of failure: kidneys, pancreas, stomach. His older "brother" (not biological) who came from Jordan as well was diagnosed at the same time.  Murjan  managed to survive three years on chemotherapy, but by the time he died last Sunday, he was on seven medicines, periodic hydration, and down to 5 pounds (from 16). He fought valiantly, but ultimately the cancer won. Likewise, our young Lynx Siamese cat, Snyezhka, has breast cancer, diagnosed at stage 4, treated with surgery,

  When my beloved Murjan was dying from cancer , I was desperate for information, but my husband was dying from cancer at the same time, which gave me very little time for seeking out answers. Murjan was almost 19 years old and had been on chemotherapy for three years. His vet did not know how to help him further, but she apparently did not want to admit that -- and subconsciously I did not want to admit that she did not know what to do and had essentially given up on him. I was unable to get timely appointments, or any appointments at all, even in the emergency room. We do not have any vets in town. I have to travel no matter what. Murjan's vet was located an hour north of us. To get help, I contacted other vets. A vet to the west of us recommended hydration, and so we stated hydrating Murjan every other day. His vet to the north allowed as to how that might help. But Murjan kept losing weight. He was down to 5 pounds (from 16 pounds) when he died.  Finally, a vet to the south of

  In March, Carl was diagnosed with advanced stage 4 (metastatic) cancer of unknown primary. In August, he died.  When we got the diagnosis, we had to choose a detour from our normal life. There was no way to move straight ahead with life as usual because, you see, there was this big obstacle, called cancer, straight ahead. So, the question was to detour to the left and choose a treatment option, hope, and focus on the living or detour to the right and let nature takes its course, choose to accept the situation at face value, letting nature take its course, and focus on the dying. To fight or to surrender? There was no logical superiority of either path, not knowing what lay behind the cancer tree and how long was the path for it  continued out of sight. We decided not through reasoning but through conditioned reaction to fight. That is what we had done all our adult lives, as we successfully navigated life for four children, two with rare birth defects, and three grandchildren, two wi

  Recently on Twitter, a cancer victim complained that friends kept elatedly sending her information about a potential cure for rectal cancer. She suffers from breast cancer! Sort of like rubbing salt in a wound, but the confusion is understandable for those who know little about cancer. Our vet (oncology expert) suggested that we ask Carl's oncologists to consider immunotherapy for Carl. We clung to that possibility initially since immunotherapy had thrown our little Snyezhka into full remission after having been given a maximum of four months to live. Nearly two years later, she is still with us and is healthy.  Carl was given just days to live when he was diagnosed with advanced metastatic cancer involving five organs. We clung to the hope that Stanford University Cancer Center might recommend immunotherapy; that was one of the possibilities the oncologist mentioned. Yes! However, immunotherapy is highly targeted -- against the source cancer. Test after test ruled out each of th

photo: care.com When Carl was dying from Cancer of Unknown Primary , we were facing the question of how to handle his 24/7 needs for care. Everything was compressed during that time -- decisions had to be made without the time to reasonably research them and rationally make them. (That is the primary reason MSI Press established Carl's Cancer Compendium : to pull together a lot of the basic, time-consuming research that could be accessed with just a couple of clicks).  When we decided to try chemotherapy, he became not eligible for hospice care. IMHO, there is a problem with the binary system behind hospice availability. Decide to work on dying - hospice is available. Decide to work on living -- you're on your own. Yet, this is exactly the time that patients and their families need help; being on your own is certain to result in a range of emotions, including anger and frustration, as well as poorly informed decisions, burnout from family member who cannot do everything and be