Update

I’ve been continuing chemo and finished radiation on my spine.
I am glad that the radiation is finished and I had a little surgical procedure, kaphoplasty, on my spine. It seems to have worked in alleviating some of the back pain, caused by my spine crumbling. I am able to function with less pain killers and I hope that the pain continues to decrease.
In the meantime, I am also scheduled for several CT scans and MRIs to monitor how well the chemo is working and I just had another liquid biopsy to see if I developed any new mutations that might help focus and personalize the treatment.
Please continue your good thoughts and prayers.
Those celebrating the High Holidays, have a Happy and Healthy New Year.

I have been on maintenance chemo the last month and I am tolerating it well. Everything remains stable and my next scans will be in August.
It is my birthday today and wanted to reflect on that.
Reflections on my birthday.
I have always celebrated my birthday month because one day doesn't seem like enough time to celebrate, but I would like to take a moment to thank everyone for their birthday wishes and to reflect on my relationship with all of you.

I have always felt lucky that God has always handed everything to me on a silver platter.
Until age seven, I lived in Tiberias, Israel, with my parents, a few minutes from the gorgeous Sea of Galilee and near my father's small and loving family. Even though I was very young I have learned so much from living in the Holy land, surrounded by true idealism.
We then came to New York, where I had a  wonderful home life growing up with my mother's extended family. I was came home everyday from school greeted by my grandmother and her delicious "Babbi Cookies".
There was nothing I lacked. As I grew up, I continued enjoying all that life had to offer. A fun loving extended network of multi-generational aunts, uncles and cousins in addition to my parents and siblings. Every day was a lesson in respect and kindness towards all, and if there was a problem it could always be fixed with a joke and a laugh.

As life continued, I got married to the love of my life, had seven amazing kids and at last count, nineteen wonderful grandkids. I am so lucky that they put up with me and my life long philosophy of "Partito, ergo sum" "I party, therefore I am".

My dear friends continue to make sure, I stick to that credo. Celebrating every occasion and non occasion and living life to it's fullest.

I am not saying I didn't have any bumps along the road of life. However, because of the bumps, (not in spite of them) I was able to clearly see and smell the roses along the road.
It is my family and friends that helped me realize all the blessings that I am bestowed with. Therefore, when asked "How are you?" It should be no surprise that I  have to honestly answer "Perfect".
I want to thank each and everyone of you all for the very important role you continue playing in my life.
I'd also like to thank you all for your continued prayers and good thoughts. It gives me great emotional high knowing that you are praying for my full and speedy recovery.

Connect the Dots

A quick update.
I'm continuing the chemo and was able to tolerate a substitute drug instead of the drug I was allergic to.
The new scans however showed that one of  the tumors on my spine is getting larger and pressing against spinal cord. It is also causing some pain. Therefore, I will have that area nuked next week. This week I went to get prepared for the radiation.
For those not familiar, before the radiate any body part, they mark the area with little tattoos dots. Since this is my third radiation, my body is beginning to look like a page in my grandkids 'connect the dots book'.
However, I am looking forward to getting the tumors to shrink and the pain to subside. They did warn me that the pain will get worse before it gets better, but as long as I know that it will get better eventually, I am glad to have this done.
I am still hoping for the blood biopsies to show a DNA marker that will make me eligible for either a targeted therapy or clinical trial, until then I will continue with whatever treatment is available.
Thanks again for all your prayers and good thoughts.

You may be interested in this article

My oncologist and I were interviewed about liquid biopsies that are used to find DNA markers that can help find a more specific treatment.
I've mentioned this before, but I think this explains it clearly. I've am currently having these blood tests every three weeks, but so far all the markers I've had mutated and disappeared. Hopefully they will identify a new mutation that they can treat.

https://www.mskcc.org/blog/some-people-cancer-simple-blood-test-can-be-lifesaver

Small change in Infusion

I went for my second treatment yesterday. Unfortunately, I developed a serious allergic reaction to the Taxol  (Paclitaxel) and had to stop taking it.
I will continue with the other three drugs and hopefully they will do the trick and help keep the cancer from progressing.
Keep up with your prayers and good thoughts.

A New Path

I am happy to report that the radiation killed the active cancer cells in my skull and hip.
In addition my lungs and brain are stable which means the clinical trial was working well on my lungs and brain.
However, I developed more tumors on my spine.
Even though they don't hurt me, I cannot continue on this clinical trial. With this much progression of disease, they kick you off the trial. Unfortunately, there is no clinical trial that I am currently eligible for. 
I have had several liquid biopsies to see if there are biomarkers that can be useful in finding a targeted therapy or clinical trial, but the latest only showed a slight EGFR mutation and the previous mutations disappeared. It appears that the cancer cells are smart enough and learn to resist the treatment drugs used.

Thankfully, I am not out of options.
Next week I will start a new chemo regiment of four powerful drugs.
Paclitaxel and Carboplatin which are system wide general chemo drugs. These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Avastin, which blocks a specific protein (VEGF) in the cells, since some cancer cells produce too much of this VEGF.  Blocking VEGF may prevent the growth of new blood vessels that feed tumors.
The fourth drug is Tecentriq, which is an immunotherapy drug. Which can help to reactivate the immune system so that it can recognize cancer in the body and destroy it.
 I am not an ideal candidate for immunotherapy. Immunotherapy is most successful when the patient has high levels of a certain protein (PDL1) in their blood. I don't, but since it can't hurt to try it, I will get will be immunotherapy as part of my new cocktail.

I will go in once every three weeks for the infusion. Hopefully this new treatment will work for a long while. I will keep u posted.
Please continue to keep me in your prayers and thoughts.

Brief update

I saw Dr. Jonathan Yang, a wonderful radiation oncologist.
I ended up with radiation to my skull and to my hip.
My skull, because of the pain and its proximity to the brain stem and jugular. It was also near my right cochlear, which will cause permanent hearing loss on that side, but other than using the phone with my left ear, the other side effects, pain and fatigue should abate within six weeks.
The hip was also nuked, because the tumor on my hip bone was growing and caused a hairline fracture on my hip, which they feared will grow and cause a larger fracture.
Other than that I am doing great.
Hopefully, the next scans will show that the radiation caused bone tumors shrink and that the chemo keeps working to keep me stable.
It's been exactly three years that I was diagnosed.
As crazy at it seems, I truly miss New Year's Eve in Times Square. It was an annual ritual I hope to resume. Perhaps, next year.
Keep up with the prayers and good thoughts, they are working.

To all those celebrating have a merry Christmas and happy New Year.