If you can keep your head when all about you
Are losing theirs and blaming it on you...
Rudyard's Kippling's If

For those of you who know the entire poem; the poem epitomizes how I try to live my life. For those who are not familiar with it- Google it, is it a wonderful poem.

Whether you are diagnosed with stage 1 breast cancer, (a cancer that is reasonably treatable), or stage 4 pancreatic cancer (one that is a death sentence), it is very important to make peace with your disease- your diagnosis, your prognosis. This can be especially difficult if you are terminal. The depression, the anxiety, the sense of helplessness can at times be overwhelming and nobody understands this better than I.

I believe it is important to focus on what you have- not what you don't have or are about to lose, no matter how precious it may be, even life itself. Good things happen to bad people and bad things happen to good people. There is often no rhyme nor reason to what happens to us. Call it fate, blind luck or lack thereof.
It is important to be appreciative for what you have, not be unappreciative for what you don't have. Some people wake up, cross the street, get hit by a bus and are killed. They are not afforded the luxury of making peace with those that they love and care for the most.

Those diagnosed with cancer are given that chance, the time to spend time with loved ones. If you are fortunate enough to weather the cancer and beat it, great! Rejoice and continue with your life. For those with a less certain future, those still going through treatment or those who are terminal with mere months or years to live, embrace that time to spend with your loved ones. Thank them for their friendship, their love and, where necessary make peace with those whom one has offended- my personal list is long. If you are fortunate enough to survive the cancer, the renewed friendships, the mended fences will make you a better and richer person. 

By no means am I remotely happy with my diagnosis, my prognosis. If whining, complaining, or moaning would make my cancer disappear I would be the biggest whiner, the biggest complainer that ever lived. But it won't so I don't.

There are days I am exceedingly anxious and, on occasion, depressed. On those days I generally "disappear", not wanting to bother friends or family with my problems. I always try to remember that my best friends have their own children, wives, husbands, families and their own problems- they really don't want to hear about mine. Many of my close friends are amazed by my internal fortitude. I cannot imagine living my life any other way. No matter how deep or broad your support network, it is critical to get professional counseling. Be it a priest, a rabbi, a psychologist or a psychiatrist- you need someone who can be objective, someone emotionally "removed". I will address this further in a future posting.

In the end I want to be remembered for how I lived, not how I died. When one is forced to look into the abyss and there is nothing, that is when a person's true mettle is tested. I want to be remembered as one who understood the fight, took it on, did the best I could and never flinched in the face of adversity.

To say I led a blessed life is an understatement. I had two loving, caring and supportive parents. Parents who were always there when it mattered. I was given the best education that money could buy and my brain could absorb. I also worked for two of the largest and most successful software companies in the world. I earned more than my fair share of money. When I look at my life in it's totality, I have nothing to complain about. Although I did not go the traditional route, get married, have babies and raise a family, my life has been very full and I am amazingly grateful. I have no regrets, no recriminations.

At the end of the day, and at the end of our lives it is the friendships we have built that sustain us to the end. It is not the money, the house, nor all of the other "toys" we may have amassed. In that regard I am amazingly fortunate, many of my best friends, the ones I care for most date back more than 20 years, and, in some cases, more than 30 years. 

I am truly blessed and amazingly fortunate despite my disease.

The standard bell curve applies to all professions, whether it be a teacher, an accountant, a plumber,  or a Dr. 20% are top notch, 60% are  mediocre and 20% are sub par.  If you are re-grouting your bathroom and you choose a sub par handyman you are out a few hundred dollars and have learned a moderately expensive lesson.  If you have cancer and choose a sub par surgeon or oncologist the results can be disastorus.


I have spent the last 18 months assembling  a team of medical professionals that represent the best of the best- the top 20% in their respective fields.


My former internist, Dr. Monica Altman at New York  Presbyterian is the Dr. that  originally saw and knew the acorn snapped nodule was very serious. For all of her charm she does not have a poker face. When I first showed her the lump on my neck her eyes grew as big as saucers and immediately scheduled a biopsy for 10AM the next morning. Even before I got results I knew I was in trouble.  When I got a phone call the following afternoon around 4PM, I recognized the hospital's  phone exchange and I knew the news was not going to be good. Dr. Altman, always the consummate professional broke the news to me as gently as she possibly could-  the nodule was indeed cancerous, but it would require a full biopsy to determine the exact kind and the extent of the cancer. It took a full week to complete the tests and arrange my first appointment with my first oncologist at NewYork Presbyterian. Dr. Altman has subsequently moved on for personal reasons but I often think of her fondly from time to time, wondering, and hoping she is well.


My new internist, Dr. Cyrus Boquin also at New York Presbyterian picked up the mantle where Dr. Altman left off. His professional pedigree is without question he is indeed a  first class internist.  Aside from being a really nice guy with  a great bedside manner he is very approachable and I could not ask for Dr. - patient relationship.


Dr. Maria Ordonez at New York Presbyterian was my chief, and primary surgeon. It was Dr. Ordonez's responsibility was not only to remove my cancerous kidney but to make sure I survived the operation.To say she was a breath of fresh air is an understatement. From our first meeting when  she ushered me into her office, spent ten minutes reviewing my chart and medical records and then walked me through the entire procedure step by step. Even during the signing of the pre-surgery waivers, ( always an uncomfortable moment for me), she was very reassuring. Her follow through, her continued  dedication to my well being, her personal interest in my health and general well being in my health is touching. I am and will be forever be in her debt. Dr. Ordonez is a unique individual- she is in a word, an angel- my angel.


Dr. Darren Feldman at Memorial Sloan Kettering is my oncologist. When I first met Dr. Feldman I was apprehensive to say the least. Having had three oncologists in the previous ten months there was good reason to have a healthy dose of skepticism. Fortunately all of my skepticism was totally unfounded. My concerns, my worries were my own issues. Dr. Feldman's professional pedigree is above reproach but more importantly I trust him implicitly. Having cancer and being terminal comes with a large dose of anxiety and at times depression and a feeling of complete helplessness. Dr. Feldman's ability to explain my disease, to put me at ease, his willingness and ability  to address those feelings and  he never rushing me through door. If there is a Dr. that can add months to my life it is Dr. Feldman.


My therapist is Angela Lloyd Heller at New York Presbyterian. When I was first diagnosed with cancer my then oncologist recommend that I talk to her but I dismissed the idea outright. About a week later Angela called me directly offering me to come see her- again I dismissed the idea. One day, about two weeks later I was feeling especially vulnerable, I called Angela and set up my first appointment for the following week- it was without a doubt the best move I ever made. Those who know me best will all admit that I am not an extrovert, not gregarious and very often a curmudgeon. I am not a warm and fuzzy guy. I do not feel comfortable in opening up and talking about myself and my problems, especially to a stranger.


Angela has a "gift", a unique ability to put one at ease, to make one feel totally comfortable. There  is not a subject that I can't  or haven't discussed with her. I know that due in large part to Angela I am handling my illness as well as I am.


Dr. Burkhalter is a relatively new addition to my team, a he is a psychiatrist , his initial primary goal was to help me stop smoking, I have cut down, although not completely quit, some habits are easier to break than others. Those that know me best will attest to this. I can now go days, even weeks without smoking, but I still do love that occasional cigarette. I hope to include him on my permanent team. Much to my pleasure he has never asked me " and how does that make you feel"- a phrase way too often used by psychiatrists and also happens to be a personal pet peeve of mine. The last Dr. that asked me that question I was sorely tempted to punch in the nose and then ask: " how does that make you feel" - needless to say I did not, but rest assured I was  tempted.


No matter what hospital you are being treated at make sure you are 100% comfortable with each and every member of your team and their support team. If you are not, speak up immediately, and vociferously. Your personal well being is in a large part dependent on your mental well being. You and your Dr.s have to be on the same page. They may be brighter than you- all of mine are, thank God, but it is your health, your well being that is at stake.

The singular most important first step after being diagnosed with cancer  is building a team of health care professionals to assist you with your treatment . This team should include not only your oncologist, possibly a surgeon, depending on your type and stage of cancer as well as a psychologist or psychatryist and potentially others.

When I was first diagnosed with cancer I was at a word class hospital in NYC, I trusted my oncologist, and team of medical professionals largely because I did not know any better. The hospital after all was a world class hospital, my Drs.  all had advanced medical degrees and I was lulled into a false sense of security.  Although  there were some warning signs I ignored them- thinking they were aberrations and still blinded by the reputation of the hospital. Mind you, not  all of the Dr.s  on my team were bad- some were and are excellent, but there were enough warning signs that made me eventually change hospitals.

My first meeting with Dr. K, (one of the surgeons who was going to do the nephrectomy,  removal of my cancerous kidney), was less than comforting. I was ushered into his office and waited for him to enter. When he did he slipped behind his desk and asked " and why are you here today". He seriously had no idea not only who  I was or even why I was there. After I realized he was was not kidding, he honestly had no idea why I was there I suggested in my own not too subtle manner that he that he look in the computer and spend five minutes reviewing my chart, my medical records  and then we should speak. He did review the file and the balance of the first meeting went off reasonably well.

Mind you, at this point in my career I had been in business for 25 years and had 1000's of  business meetings  with potential clients and clients. Not once did I walk into a client meeting and start off with " OK gentlemen, why are we here". If I ever had I wold have been thrown out unceremoniously  and not invited back,  and rightfully so.

If how well Dr. K prepared for our initial  meeting was any indication of how well he was going to prepare for my surgery I was screwed. I am a firm believer proper preparation prevents piss poor performance.  Especially when it comes to a Dr. with a scalpel cutting into my abdomen. Fortunately the primary surgeon is a wonderful  Dr.- surgeon  whose attention to detail was flawless - but I will write more about her later, she deserves her own paragraph if not her own separate posting- I believe she is in fact an angel-  one of them anyway.

Unfortunatley due to my insurance plan I was not afforded access to the best oncologists at hospital A. With  the exception of my first oncologist, Dr. Kevin Becker, an amazing oncologist and human  being- one who I trusted implicitly. However  he left the hospital  only six weeks after my surgeryfor a new post  at a different hospital. I stayed at the hospital for another eight months, ten it total, during that time I had three  different oncologists each one worse than the last. My last oncologist Dr. L.  was the worst. On one occasion I went in for an appointment, sat down and asked a question, his response was " interesting question", got up and left  the room and only to  come back five minutes later with the answer.  Because of the nature of the questioning I had a follow up question, again I asked a question, he said "interesting question"  and he left the room again and came five minutes later  with the answer.  On one visit this happened  three consecutive times with three different questions. I honestly did not know whether Dr. L. was checking Google or asking another Dr.  either way I knew it was time to find a different hospital, one that the level of care was not dependent on my insurance plan.

Living in NYC has many advantages, one of them it has many of the best hospitals in the  world and I moved my care to Memorial Sloan Kettering Hospital in NYC and one of the three best  cancer hospitals not only in the US but in the world. It was not until I transferred  to Sloan Kettering that I found out that my first hospital misdiagnosed my cancer. Sloan Kettering insisted on doing their own pathology. Sloan Kettering informed me that I still had stage 4 kidn cancer, I was-and still am terminal, but rather than having papillary kidney cancer, the most aggressive form of kidney cancer with a prognosis of 2.5 years to live, I in fact have clear cell kidney cancer, a less agressive form,I am still terminal but rather than 2.5 years to live I my new Dr.s  have given me 3.25 years from date of initial diagnosis.  To adaquatley  atempt to  explain how I felt and still do,  would require a tirade of  four letter words that would take an entire paragraph and shock even the most seasoned sailor- suffice to say I was pissed.

If you look  at the two different type of cancer cells, papillary and clear cell they are as different as night and day,  how a seasoned professional pathologist  can make such an egregious error is beyond me, and this was from a world class hospital. What made matters worse it took an additional three months to finally meet with an oncologist from hospital A and then their only response, their only admission was yes we misdiagnosed you. No, "I am so sorry", no apology- nothing.

Fortunately the misdiagnosis did not have a negative impact on my treatment, my new oncologist at Sloan Kettering said he would have done nothing differently based on the new diagnosis- but I was very, very lucky. I can not stress the importance of finding and building a team of health care professionals you trust. Having cancer, being diagnosed with cancer is very serious business- choosing the right team can mean the difference between life and death or it can mean adding potentially months if not years to your life.

The three top cancer hospitals in the United States are Sloan Kettering in NYC, MDAnderson in Huston Tx. and Dana Farber Cancer Institute in Boston- I cannot impress enough on my audience the importance if at all possible of getting an initial proper diagnosis. If you are fortunate enough to live within a reasonable distance of any of these hospitals they should be your first choice. If not choose a hospital that specializes in cancer treatment.

If for what ever reason you are uncomfortable with any of your Dr.s whether it be an Internist, a surgeon, an oncologist or psychologist or psychatryist  do not hesitate to speak up. However you decide to address the issue make sure you are 100% comfortable with your entire team of Dr.s.

My next segment will  focus on my team.....

Quote: Embrace each day of life  for tomorrow is not guaranteed- Anonymous



This blog was born out of my personal diagnosis of stage four kidney cancer on  Februrary  8, 2010. To say it came as a shock is an understatement. With the exception of an acorn shaped nodule on the left side of my neck , ( a swollen lymph node), I felt fine. There were no outward discernible symptoms. It was, and still is to a certain  degree surreal. To know that there is something growing in ones  body, something that the best  Dr.s  in the world have no way of stopping is disturbing to say the least.

This blog is intended for those people diagnosed with cancer and their families. It is designed to be  in part, my story, from the initial diagnosis, surgery,  on going chemo and  living with cancer as well  as "best practices" resource guide. There are a multitude of cancer based resources- orginazations offering assistance for those with cancer and their families. Some of them are  excellent, some to a lesser degree. The orginazations listed under the "resource guide" on the right side of this screen are the best of best. Receiving the diagnosis " you have cancer", whether it be stage 1 or stage 4 terminal- the diagnosis is life altering. The last thing one wants, one needs  to do is find the best resources- especially by trial by error. All of ones energies should be spent on a cure if possible, and if not enjoying life as best as possible.

After recieving the initial diagnosis, "you have cancer" whether it be stage 1 or stage 4, terminal cancer one's  life is never really the same. Even if one is fortunate enough to survive the initial diagnosis and treatment regiment and be in remission the fact is one is only one Dr.s visit from the cancer coming back, those dreaded words, "the cancer has returned". Every pain, every little anomaly  in ones body, however minor and ones heart skips a beat and a lump forms in your throat and you wonder "is it back"? That is a reality that every cancer survivor lives with.

In addition to having and living with a terminal diagnosis I lost my father to prostate cancer nearly four years ago.  This gives and allows me a dual  perspective, not only one as one living with cancer, but one who has had to deal with the anguish of losing a loved one to cancer. Hopefully others will learn and take comfort from my story and realize they are not alone.

There are over 12 million people living with cancer, affecting not only them but their friends and families, in total there are over 60 million touched by this disease , either directly or indirectly and the number is growing each and every day.

Whether you or a family member was diagnosed with cancer yesterday or if you have been battling the disease for years I hope that my story, my experiences are not only useful but insightful.  The best way to follow my blog is to become a follower, click on the follower link on the main screen and updates will be automatically pushed to your inbox.

Future postings will include but not be limited to choosing, finding a competent oncologist, the importance of therapy, how to "live" and cope with the disease no matter how dire the circumstances,  how to reinvent your life, the importance of embracing life, embracing old friends and more,  as well as a much detailed outline of the resource guide.

For those that know me best, know that my approach will be an unvarnished look at the disease and life. If you know anyone with cancer, ( and who doesn't) I ask that you forward this to them and sign up as a "follower".