This cancer journey is so complex, in so many ways, with twists and turns. It does have its ups and downs.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295550/ a good read, what i have in me.

CTLA-4 and PD-1 Pathway Blockade: Combinations in the Clinic

Sometimes I project confidence, I am not certain why I am feeling so uncertain, maybe its the uncertainty of removab's response.
Maybe I am feeling really vulnerable that my survival is so dependent on my ongoing immune responses and these therapies. I think this uncertainty is whats driving my desire to understand our immune function. I think its the uncertainty of the ongoing nature of our immune responses, that drives my desperation to innovate, to seek alternatives.

The infusion room at hallwang brings up so many feelings, I see around so many brave and worldful cancer patients, all diffeent cancers fighting so bravely.
I also feel the unfairness that this medicine if the privilege of the rich.
To be honest I am also a little distressed that my wife still is not talking to me and I was really worried about the possible interaction removab and ipilumumab and nivolumumab.
I do feel the responsibility of the complexity of cancer, in all its types and stages. Coming to Hallwang is a sobering experience, I am so glad shar got here yesterday.

I guess being exposed to the next generation testing offered by hallwang is pretty humbling when I begin to realise what I dont know. I guess this means I have more respect and dependence on all the doctors around me. I am so aware of how little I know and how much more I have to learn.

I was trying to really understand at a detailed level the removab antibody structures and functions, my poor brain is letting me down. I guess I have to give it a break. I have had a few chills but nothing to dramatic from removab so far.

My thoughts and prayers are for shar and her treatments as well as mine and those here, in fact all cancer patients everywhere. What I found interesting here is the diversity of opinion here about diet, about therapies, I kind of shared my enthusiasm for the ketogenic diet and my reasons and understanding and that I have confidence in prof ruggiero about gcmaf and my friend florianschilling and his metabolic approaches. I was again however feeling attacked, I just said how I found the vegan diet has limitations. its like discussing religion.

I hope I dont come across as wanting to convince others, which I hope does not happen. I have my experiences, I have done my research, i do what i do. I do have a certain confidence in my experiences and my understanding, but I also know how little I know and how complex the science and clinical management issues are for each and every patient.

the principle of bic, best individual care, I really believe in, I have applied it to my survival, I seek to share what I learned and my approaches, sometimes I feel my limits. I will retreat to the peace of meditation and prayer, and ask again for courage and strength as this illness is as joyfully challenging as always.

I still have the intention of remission and a long and healthy life helping others firmly in my heart. I will watch moobeen lectures and seek to understand and retain more of his wonderful material about our immune system. Its a strange comfort to seek to understand the immune system thats keeping me alive, that indeed offers so much hope for so many with metastatic cancer.

maybe my lack of response to removab is due to my low tumour burden, I am simply grateful to try removab again, and to come back to hallwang. I find it so hard to relate to my fellow cancer patients here in someways. I guess its my somewhat extreme nature of my journey.

Tonight I felt like an outcast sitting on this table on my own, while another 14 cancer patients dinned and chatted next to me. I am that popular.

Really no matter how or what I say I get into trouble or conflict here, so its easier to be completely silent. there was very nice man, about my age who was interested in the ketogenic diet. so one friendly smile, and few others who were kind.

http://www.cancer.gov/clinicaltrials/search/view?cdrid=690107&version=HealthProfessional

http://www.nature.com/bjc/journal/v111/n8/full/bjc2014443a.html

http://www.biomedcentral.com/1471-2407/14/148

http://annonc.oxfordjournals.org/content/early/2013/11/26/annonc.mdt405.full


http://www.colonchat.net/forum/viewtopic.php?f=1&t=2497&p=6167#p6167

http://www.jcancer.org/v02p0309.htm excellent, see references, you can read all night i have!!!

dear shaker,
thanks, in some respects i feel like i am loosing my marbels.
we all know the implications of these persistent mets, 
particularly i am trying to be cool and focused while throwing every convievableimmunotheraputic and cancer based strategy at my few remaining cells.
the curse and challenge of minimal residual disease.

so its 11pm, i have sat on the drip all day getting 2.5mcgremovab, yes a low dose. my temp had a mild elevation to 37.5 degrees, often with full blow responses
you get 39 plus. i had this the first few times when removab basically in synergy with tace and infusions, got rid of my extensive peritoneal disease, liver and lung disease. that was over 2 years ago.

the consensus was that the hama antibodies ( which in themselves are a good prognoistic indicator ) should have decreased. not sure what the 
plan is, for tomorrow.

I am really on edge, my intuition tells me that the fact i have not established a rapidly falling cea/ca199 trend, means that something is fundamentally different with trip 8.

Now I did my markers today and I will see, this will be the third marker measurement trip 8.

yes we all have courage and determination, this illness that many of us attempt to out smart, and many help us with great support and ideas.

well i know my one strongest point, is I can take risks, they may appear reckless to onlookers as i often fail to explain my fully contemplated rational and reasoning.

but trust me, I have done so much to stay alive, that i will not recklessly endanger my life, but I am so aware that using these antibodies in concert the way I have just done, could have fantastic, tragic and no effect.

I suspect removab today has had minimal effect, i have such little disease, this microscopic residual disease, I was throwing removab in, just to help activate, tcell, macrophages, and hopefully use epcam to latch onto any difficult to see tumour cells in the peritoneum.

launching all the immunotherapy weapons, while i have these fantastic antibodies circulating still is a commendable strategy. the goal of seeking a comprehensive and complete immune response a tantalising goal.

with the model of my treatment, and that of the few friends I am trying to help, well all we can do is learn and observe and innovate. I suspect to take the most aggressive, potentially effective.

one of the best benefits of coming back to the hallwang clinic, is to catchup on their new asprin therapy, to also look into there next generation sequencing using lab reports from 5 different german universities. To that end I have asked my oncologist to send over my parrafin tumour sample.

theni can see if my tumour expresses pdl1. alas i was given nivolumumab without this test, its supposed to be essential to my reading, so an expensive clincal risk in my case. on the brigghtsidei suspect i had a rise in the crp, so i suspect my tumour expresses pdl1.

these are exciting times we live in, even if we have this disease, so many wonderful clinical options.

i have hope, maybe i really am in remission, this very mild spike in temperature could be a really good sign.

asalways time and markers and imaging will tell, in the mean time I do my best to have a good quality of life here in germany.

I am a bit lonely in this clinic, the other patients are a bit standard offish, some are colorectals and pancreatics, a few miracles for what its worth, its wonderful to herethere stories and meet them.

no one here is into the ketogenic diet, not a ketone meter in the place. still i stick to the diet.

even reviewing the research on removab has been amazing, so many studies using it post surgery, for all the different epcam cancers, ie cervical. whati liked were the discussions about using ipilumumab and removab, which is what i have just tried.

i was really worried about things going very wrong with todays attempt.

we live and learn, i share the adventure, and it is at least an adventure, which gets my focus away from missing my family as i struggle to understand the underlying methods of operation of these antibodies, removabinparticular very complex.

theres probably the most comprehensible answer i have written on colonchat.

love to you all,

Pete

ITS FROM SO MANY WORLD FAMOUS LEADING INSTITUTIONS, THIS IS SO UNBELIEVABLE

so why oncothermia works so well, also explains how to mitagatethge hypoxia issue with taceembolisation, so many reasons why oncothermia essential

http://stm.sciencemag.org/content/7/277/277ra30
ntitumor T cells either avoid or are inhibited in hypoxic and extracellular adenosine-rich tumor microenvironments (TMEs) by A2A adenosine receptors. This may limit further advances in cancer immunotherapy. There is a need for readily available and safe treatments that weaken the hypoxia–A2-adenosinergicimmunosuppression in the TME. Recently, we reported that respiratory hyperoxia decreases intratumoral hypoxia and concentrations of extracellular adenosine. We show that it also reverses the hypoxia-adenosinergicimmunosuppression in the TME. This, in turn, stimulates (i) enhanced intratumoral infiltration and reduced inhibition of endogenously developed or adoptively transfered tumor-reactive CD8 T cells, (ii) increased proinflammatory cytokines and decreased immunosuppressive molecules, such as transforming growth factor–β (TGF-β), (iii) weakened immunosuppression by regulatory T cells, and (iv) improved lung tumor regression and long-term survival in mice. Respiratory hyperoxia also promoted the regression of spontaneous metastasis from orthotopically grown breast tumors. These effects are entirely T cell– and natural killer cell–dependent, thereby justifying the testing of supplemental oxygen as an immunological coadjuvant to combine with existing immunotherapies for cancer.

http://www.colonchat.net/forum/viewtopic.php?f=1&t=2505&p=6169#p6169
Dear Tony,
this is such an amazing paper and study, just when I was feeling really nervous, on the edge of remission or progression. 
well here is one paper that kind of backs up to some extent my crazy lifestyle of coffee enemas and excellent immune responses.
maybe its all the coffee enemas, at least in terms of liver clearance. of course i put this on my blog.
oh and the oxygen from exercise, re addressing hypoxia, seems like the explanations for why exercise helps is becoming clearer and clearer.
love,
Pete
ps this is absolutely amazing, thanks again, what a fantastic site, colonchat. for what its worth i emailed too scientists who invited me to this little seminar/conference in cyprus, this paper explains so much about holistic gcmaf immunotherapies.




http://www.ncbi.nlm.nih.gov/pubmed/22511343
for my friend with her2 pancreatic cancer