If you have time to read just one thing today, it really should be Oliver Sacks’ column in the New York Times. He learned that he has terminal liver cancer.
I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.
Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.
Apt. 11d 
Yes, I saw that essay this morning with my breakfast and like everything else from Sacks’ pen, it is beautifully written, as well as inspiring. Well worth reading.
One small correction though: he does not have liver cancer. Cancer is named after its point of origin, therefore he has ocular melanoma in his liver, although you could also correctly call the stage of cancer he has just plain terminal cancer. Do not feel bad about this, this is a very common cancer-beginner’s mistake.
What happened was, nine-plus years ago (for cancer is almost always present for a good amount of time before it is discovered), at least one of the cells in his eye tumor acquired the mutation that allowed it to break free and travel. It then made the perilous journey either through Sacks’ blood and/or lymph systems until it landed somewhere in his liver. Then it basically hibernated until conditions were right for it to begin dividing and to form a tumor. I call the journey perilous because it is — our immune systems destroy the occasional cancer cell all the time. And some cancer cells travel and land some place cozy but never begin dividing. For reasons we don’t understand at the moment, the normal cells around them keep them from reproducing. At the cellular level, our bodies are wild and crazy places.
It may seem like semantics, but identifying a cancer by its point of origin determines both the treatment protocol and the prognosis. Cancers have all different kinds of genetic and biological profiles. Lance Armstrong had testicular cancer that metastasized to his brain (and lungs also if IRCC) but he did not have brain cancer. He was treated with the chemos that are effective for testicular cancer (no matter where in the body the cancer cells may be) and because that is one type of cancer we know how to treat, he was cured.
Unfortunately, it appears from this essay that we don’t (yet) have effective treatments for the particular type of cancer Sacks has; he says it can be slowed but not halted. Other types of metastasized cancers can be halted, and for good periods of time. Some kinds of metastasized breast cancers, for example, can appear in the liver and be successfully halted for a decade or more, and with relatively mild treatments.
I’ll sign this Barbara but you can also call me NED (for you newbies, that’s an inside cancer joke).
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