Happy spring!

For those of you following along at home, it’s about time for another Joshua update, I figure.

As promised in my February post, I had my every-three-month MRI in mid-March. Disappointing, but completely expected, was the inevitable leveling out of my tumor shrinkage. Both the primary pancreatic tumor and its liver gremlins—which you will recall had already shrunk an “above average” amount—remained relatively stable from the December scan. Bright side: this means they didn’t grow at all, either.

So where does that leave my treatment plan? Even though they may have lost their primary punch of efficacy, I will keep taking my two oral chemo drugs—14 days on/14 days off—at least through early June. I will also keep getting my monthly horse-needle-shot of somatostatin. In late June I’ll go for my next MRI and likely stop taking chemo. June will be the year mark of taking the Cap-Tem regimen, and if it isn’t actively shrinking tumors, long term use can (rarely) lead to other issues like bone cancer. From there I will continue with three-month MRIs to track tumor sizes until something changes.

In April, Sarah, my mom, and I attended UPenn’s 13th annual Neuroendocrine Tumor (NET) conference in Philly. It feels strange to say, but I was very excited to attend. The day’s talks were a firehose of information aimed at current patients and caregivers, given over many dense 15-30 minute lectures from my doctors and others who treat or study NETs at UPenn. Much of it was review, some of it was new, but all of it was interesting. There were discussions of “survival free progression” averages that are counted in months rather than years, renewing some of my deepest fears. My emotions through the day ranged from excitement to dread; a teeter-totter of hope for immunotherapy trials getting underway and sobering reminders that my cancer journey is long from over, despite the fact that I’ve been feeling very well and normal since September.

So while I keep my eye out for more bridges to cross in the future, for now I celebrate another good-looking blood test last week. For now, I appreciate the needed rain when it comes, and revel in the days when the sun soaks the ground and the birdsong soaks the air. For now, I keep focused on the joy of being here, now.

A new spring of migrants is upon us, with hope on their wings. A year ago, during my favorite day of the year—the Birding Cup—I couldn’t figure out why I felt so terrible. A year later I know all too well why, but in the intervening twelve months have been blessed by prayer, love, and science to be in a much healthier place.

And so it was this past weekend that I once again found myself climbing onto my bike at 7pm on a Friday with six other crazy birders (Ellory included) packing binoculars, raingear, headlamps, and enough water and snacks to keep us happy for 24 hours. Except for four hours in the middle of the night when we caught some winks on the floor of my mom and Greg’s house, we never stopped for long. We made our way through near-constant light rain over fifty miles of trails and roads, forests and fields, creeks and lakeshores, to find as many bird species as possible. This exhilarating adventure was to raise money for Shaver’s Creek… and also to seek the glory of the Birding Boot—the award for most species seen by non-motorized means. I am proud to say that the Whip-poor-wheels once again snagged the title, with a respectable 102 species on the day!

As I sank into deep sleep on Saturday night with phantom Warbling Vireos still singing in my head, I felt thankful to be here for another Birding Cup. I look forward to many more Cups to come!

Peace, love, and good birds!
~Joshua