Fifty (50)

“Birthdays are good for you. Statistics show that the people who have the most live the longest.”—Reverend Larry Lorenzoni

I’ve never been a big birthday person. However, I have enjoyed celebrating some of my more significant age milestones so far—16, 18, 21, 30, and maybe even 40. But somehow approaching the big 5-0 tomorrow seems different; more momentous.

It may sound morbid, but my first thought was “at least now I won’t die in my forties.” Making it to 50 somehow sounds better. At my worst in the summer of 2017, Lorie and I were convinced that I’d never even see my 49th birthday.

I’m not sure what makes turning 50 so unique. Perhaps it’s because I’ve finally settled into my skin, even if I have a hard time recognizing my reflection in the mirror these days.

Or maybe after reading and reflecting on mortality during the past three years, it is comforting to see progress in breaking down the cultural silence around death and dying. For example, in recent years, there has been a slew of books authored by “expert patients.” Doctors, scientists, and writers who are reflecting on their departure and have sought to show us different, kinder ways of ending (Atul Gawande, Paul Kalanithi, etc.).

This is encouraging. Most popular cultural conversations around cancer focus on survivors and miracles. Their stories should be celebrated, but we don’t hear from terminal cancer patients as often—perhaps they are too sick or too busy to tell them. It’s their stories that may help inspire big questions and positive change.

“There are only two days with fewer than 24 hours in each lifetime, sitting like bookmarks astride our lives: one is celebrated every year, yet it is the other that makes us see living as precious,” writes Kathryn Mannix in her book, With the End in Mind.

Between those bookmarks is where life takes place. When dealing with a terminal condition, some people decide to focus on quality versus quantity of life, rejecting medical options that might negatively impact their body image, cognitive functioning, mental health, fatigue, sleep problems, physical functioning, pain, and more. They have made their peace—if not with cancer, then with their living and their dying. They want their remaining valuable time to consist of more than a war against cancer.

This is where I have been since March 2018, with no systemic anti-cancer treatments, such as chemotherapy, during the period. My only therapy has consisted of externally targeted radiation to several painful metastatic sites on my spine and a bisphosphonate infusion to help strengthen my bones. Also, I’ve had radiation aimed at the tumor on my spleen as well as a few mediastinum/thoracic nodes to alleviate coughing.

The good news is that radiation mainly addressed the pain originating from my spine. However, destruction of the bone by the tumor left little remaining support for the L5 vertebral body, which subsequently progressed to a compression fracture and resulting pain. In a few weeks, I have an appointment with a neurosurgeon at Memorial Sloan-Kettering Cancer Center (MSKCC) to discuss options for stabilizing the spine. I’m also meeting with my oncologist to review recent CT scans showing growth in the pulmonary and thoracic nodes.

That’s the rub with cancer. There is always something going on; something else to be done. Another fire to be put out. Fortunately, the majority of my issues have been manageable with palliative treatment thus far. Indeed, nothing to stand in the way of some upcoming speaking opportunities or tomorrow’s quiet birthday celebration with Lorie and the girls (and our small petting zoo).

Steak on the grill

We even started my birthday celebration a little early last night. The November evening was cold and dry, which made it possible to use the barbeque one more time this season. So, I grilled some steaks Lorie got from the store, and we had a delicious homecooked meal that everyone seemed to enjoy. Despite my stomach upset and taste issues, I was able to eat about half my usual serving (par for the course these days).

Hopefully, last night is a good omen for what life has in store for me after turning 50. Until then, I’m just going to keep enjoying each day as it comes.

Thanks in advance to everyone for the birthday thoughts and wishes!

22 thoughts on “Fifty (50)

  1. I greatly enjoy your blog posts…they keep me in a reflective mood and appreciative of the time I have left, and also help me keep my spirits up for the continued treatment. Here’s to one more birthday…may it be happy for you. .

  2. A sensitive, wise and compelling insight on your health issues and feelings on your birthday. Congratulations on your 50th birthday! You have many admirers and I am one of them.

  3. Great to learn that you have reached 50 and continue to live each day as fully as possible. I turned 69 on Nov. 11. Where have the years gone? Four years since external beam/brachitherapy treatment for prostate cancer and all seems well. PSA very low and strength has improved, although lower body functions are sometimes a nuisance. Went for a trip to northern BC coast, Alaska and Yukon in summer. Am in China now. So grateful to have the opportunity to explore life while I can. Some very interesting developments are coming along now, related to treatment of metasized cancer. I hope you will be with us for a while yet.

  4. Happy Birthday Michael, and thank you for taking the rest of us along on your journey. You have done so much to teach and encourage. I hope you enjoy a great sense of satisfaction from all you have accomplished as you celebrate the big 5-0.

  5. Happy 50th Michael! I finished your book last night. I am trying to learn everything I can about head and neck cancer as my husband is recovering from his second bout of tongue cancer. We are waiting to hear from Ma. General Hospital as to when they will start radiation since cancer cells were found in a nerve in the tongue when a final biopsy was done. Our grand daughter works at Moffitt in Tampa and she has been most helpful with information.

    My best to you and your family. Kathy


  6. As always Michael a wonderful read. You are incredibly insightful and inspiring. I hope with all my heart you enjoy many more days to come.

  7. Happy Birthday!!! I wish you and your family the very best and a great Thanksgiving. It was great seeing you recently. When do you want to schedule that lunch with me?

  8. Happy Birthday Michael. I once read that a birthday is just the first day of another 365-day journey around the sun. I’m glad to see that you are embracing the ride.

    – Rich

  9. Happy Birthday Michael from your old Chicago Kemper friends, Mark and Elise! You are making such a difference. When a friend of ours recently asked if I thought her daughter should be vaccinated, I knew right where to send her and of course she did vaccinate. Thank you!

  10. Happy 50th Birthday Michael I agree Everyday is a gift I am on the downhill slide with ALS but I try to maintain my sense of humor and live one day at a time I PRAY for cures for cancer and ALS No one deserves to suffer like this God Bless You

  11. Happy belated 50th! Thank you for your courage in sharing your cancer journey. You have the support of many people. May your days be blessed!

  12. Dear Michael I work in the development of immunotherapy and I read your blog regularly as it makes things more concrete for me. Thank you for sharing your personal journey. You motivate me to work harder every day to bring meaningful new therapies to cancer patients. Am hoping that you have a wonderful birthday with your friends and family tomorrow

  13. Michael, we wish you a Happy Birthday! It seems almost like the wrong thing to say with all you are going through. We still CARE deeply and think of you every day (not an exaggeration). The best wish we can send is the gift of hope and healing! You certainly have inspired and touched many, many lives.

    I was just thinking yesterday how you made such a difference in Vern’s (our) life back in the Cytogen day.

    May blessings find you!


  14. Hang in there Michael. My wife is going through this exact same thing at age 43, it’s been devastating for us but she doesn’t let it bring her spirit down. I think I’m more devastated by this than she is. Anyways I just wanted to say I enjoy your blog and I wish you the best, cheers.

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