Cancer

2015 in Review

by Jonathan Sterne on January 2, 2016

Like most years, 2015 was mixed with both good and bad. It was a tough year for a lot of my friends, and lots of terrible stuff happened in the world, but I’m not one of the “good riddance to 2015” people.

On a personal level, I have a lot of good memories. My travel experiences have been SO good and so whirlwind that I haven’t said too much about them here. Delhi, Paris and Berlin were intellectual highlights. Maui was, well, Maui. Teaching was great as usual, and I am back to my own writing priorities, more or less, after digging out from having said yes to too many “small” projects that took me away from my own work. I probably read more finished books in 2015 (as opposed to student writing and work in progress) than in a long time, which was also immensely satisfying. As usual, I gave too many talks and did way more service than I probably should have. I didn’t swim enough — only some of which can be blamed on injuries. Carrie finished 4 years’ heavy admin and I finished 1 year’s heavy admin. Good riddance to admin.

Cancer-wise it ended well, with me being demoted to every-six-month scans (from every 3 months).  I’ll take it.

Probably the most important change in my life was musical. My 2015 New Year’s resolution was to spend 15 minutes a day (when home) with a stringed musical instrument, which was a way to get my head back into playing. I have done a lot of electronic stuff in recent years, which is fun but lacks the instant gratification factor of playing bass or guitar. It is without question the best resolution I ever made and the only one I’ve kept. A year later, I have six months of guitar lessons under my belt, which have in turn improved my bass playing in entirely unpredicted ways. I am in two bands that practice regularly and will gig (and MAYBE even record) in 2016. and in a related development Carrie is finally learning drums after a couple decades’ worth of my not-so-subtle suggestion and playing in one of them. I am absolutely certain that there is nothing else I could have done that would have been better for my general happiness and well-being.

My friend Loretta posted on Facebook that what you do on New Year’s Day says something about the year to come. Mine was spent watching the outdoor NHL hockey game, playing bass and guitar, doing a little gear maintenance, reading the paper, hanging out with Carrie and the cats, and eating leftovers and catching up on TV series we neglected while in Europe.

Given that I’m teaching two new courses and doing a ton of service this winter, I’m not sure that it’s an accurate picture of what’s about to come, but I’ll take it.

More Suspended Attention

by Jonathan Sterne on August 2, 2015

Since last fall, I’ve been on an every three months regime of getting scanned. Two have been chest and abdomen, other was just my lungs. They are tracking the speed of spots in my lungs, looking for anything to get bigger. The last scan, done at the end of June, showed my largest lesion at about 2cm diameter, and growing a couple mm every 3 months. It showed the other ones “unchanged.” This is too slow to be alarming, but they want to track it, along with a tumor marker in my blood.

One possibility is that they will shoot a beam of radiation at the big lesion if it’s growing faster than everything else. Another is that they’ll do nothing until they see a rapid increase in the pace of growth.

What all this means is that I’ve gone into a kind of cycle: the best parts of the year are between the time my doctor finishing the appointment where he says “we’ll do another scan in 3 months” and getting the scan in three months. Then there’s the waiting part in-between, which is less fun.

Health Update: Suspended Attention

by Jonathan Sterne on February 15, 2015

After last November and December’s adventures in cancer world, it isn’t surprising that I get a lot of questions about my health and emails wishing me well, often based on incomplete information.  Of course since have incomplete information, that’s no wonder.  So here’s some slightly more complete information.

We’re back to watch and wait.  Ideally, forever. But maybe not.

When I saw my endocrinologist before I left for India on Jan 9th, he read my situation a little differently than the oncologist, as in he thinks I’m in a different class of patient (and was unworried enough to want to talk about teaching evaluations, which I took as a very good sign).

But both of them are singing the same tune in terms of next steps.  In a couple months (give or take) I’ll have a scan that will give us a sense of what’s happened since the “new” baseline set in December, and then we’ll do partial scans throughout the year.  What they are looking for is when the cancer starts “trying to grow” at a considerably faster rate than it is right now.  When that happens, the slow-growing thyroid cancer is trying to start behaving like a more aggressive cancer, so the drugs start.  Once I’m on drugs, I’m probably on drugs forever.  At least with the medicine at where it is at today.  The thing is that “trying to grow” phase could come soon, or it could come in 10 years or even later.  And there are no other experimental treatments to try right now (the lithium/radioactive iodine was their best shot).

So now we pay attention every few months, and otherwise we suspend attention.  “Watchful waiting” it’s called, but I like to think of it as blissful denial punctuated by periods of intense ambiguity.

This is the best possible outcome at this stage, so around here we’re considering me lucky.

More on Cancer, Luck, and Behavioural causes

by Jonathan Sterne on January 4, 2015

A day later, I’ve been pointed to some nice writings but scientists and statisticians. See here: http://pb204.blogspot.co.uk/2015/01/science-by-press-release.html

A few things become clear: 1) the coverage is of the press release, not the actual paper but 2) there are still major problems in the assumptions of the paper.  The “luck” appears to be mostly an artifact of the press release and the abstract, though the analysis remains flawed. The lack of social and environmental analysis is definitely a property of the paper. And of course most of the journalists reporting it are innumerate to boot.

Statsguy has a wonderful critique of the article, but winds up writing about lifestyle as a cause for cancer, and I’m sorry, without environment and social analysis, that’s just bullshit.  Yes, HPV causes cervical cancer and smoking causes cancer, but what causes smoking?  And neither of those things are good explanations for breast or thyroid cancer, whose increasing prevalence appear to result from a combination of changes in diagnostic technology and practice and environmental causes.

So it would be wrong to say cancer in general is “behaviourally” caused. Some cancers are behaviourally caused, though even there, how you could say smoking causes cancer and not also look at policies that promote the tobacco industry around the world, I don’t know. Ditto for the HPV vaccine.  If HPV causes cervical cancer and the HPV vaccine prevents the cancer, then it suggests to me the important behaviour is vaccination, not sexual activity.

There’s a whole layer of moralizing that goes on top of the behaviour talk–which is typical of American (and I’m assuming some other) medical culture. But that will have to be for another post.

 

 

 

Medical Research as Ideology: Cancer is Luck

January 3, 2015

A new Johns Hopkins study finds “luck” as a major cause of cancer. This is a great example of how medical research turns social conditions into inevitability and writes ideology (the order of things is given and unchangeable) as if it were science. While there is talk of personal responsibility as a possible cause for […]

Read the full article →

2014 in Review

December 31, 2014

It’s been a really complicated year–some major highs and lows. We’ve spent the last couple days on unfinished business: seeing Laura Poitras’ gripping CITIZEN FOUR (highly recommended), doing our donations for the year, and it looks like I am actually going to get an article revised that I thought I might not be able to […]

Read the full article →

I got what I wanted, sort of

December 18, 2014

So after having three (yes 3) of my doctoral students defend their dissertations Monday and Tuesday, my reward was to spend yesterday and today getting tests and doctoring.  The good news is that they have decided to go back to watchful waiting for now.  I will have another full body scan in three months (this time […]

Read the full article →