Round 5

Lunch at the Turk's Head in Wapping with Jack – lovely apple pie and heaps of ice cream, just the thing to help rebuild the soul and weight! I know sugar is supposed to be the enemy but I liked it!

Lost a little weight over the past week or so and felt a bit crook but you know what sometimes you just are a little unwell and it doesn't have to be anything to do with the 'cancer' – Jack was also under the weather (that's the London weather for you) but of course you are always over conscious of every small change.

Heard back from Proton radiation in Prague – they are not keen to simply reduce main tumour whilst there is metastasis – "Please allow me to answer your question briefly: It is indeed a good idea to kill the primary tumour first and leave the remaining metastases to be managed by dendritic cell, i.e. to be killed by immunity. Unfortunately this assumption does not work at all. There is absolutely no sense to irradiate a primary tumour if there are multiple metastases. Despite a good theoretical basis of working immunity "abscopal effect" of radiation and anything else, the practical and wide experience indicates a bad outcome if only the primary is managed.  Thus I would never recommend to do as you mention.  I strongly advise to follow the recommendations of your medical oncologist."

Confused – I am, but at least I explored that possibility.

Back to Duderstadt this weekend for treatment 5 – with Anti PD1 and amended NFP2x7 – then a few days in Berlin with Jack for fun.

Hopefully the new treatment will improve the swallowing – it does seem slightly better following last round - there jinxed it again!

Hope to be back in Sydney in a month or so – save some sunshine for us!