Nine months on

Organic broccoli lemon soup in the sun with Jack outside Lebenskunst in Duderstadt must be doing us good – mustn't it – surely! Well, we explored and experimented and it tasted healthy! Then we had sorbet and ice cream.

Had third treatments and saw Dr Thomas Nessulhut yesterday for DC injections with 12 million cells – half IV and half subcutaneous. Mentioned the dysphagia/swallowing symptom and he seemed a little concerned so he has suggested adding Anti-PD-1 antibody to the treatment next round in four weeks time.

My simple understanding is that the Anti-PD-1 antibody is useful in boosting immune responses and enhancing t-cell activity with a particular intent to reduce tumour size. PD-1 is a protein found on the surface of T-cells (immune system cells) in our bodies; this protein binds with protein PD-L1 that is expressed in cancer cells, and together they protect the cancer cell from attack by our own immune system. Anti PD-1 antibody blocks that action and allows normal t-cell attack.

Dr Thomas has also increased my dose of Metformin to 2 x 1000mg per day.

Back in London and have an NHS appointment on Monday so will begin to get a fresh perspective on where we are. I have faith in the approach we've taken but I know this is not a simple process and the conventional opinion next week will be both interesting and possibly challenging I imagine – we'll keep an open mind.

Another small point is blood tests and scans seem to be something I need to organise which is fine – I think it reminds you that you have actually taken control of your treatment rather than simply turning up to oncology appointments when booked and following that particular defined path of 'palliative' treatment. Trying not being negative about that but it's a treatment that has been proven to, well be fairly negative in the old survival stakes...