What  I have been diagnosed with is a rare and aggressive type of cancer.

Selfie outside the Precision Cancer building at the UCSF Mission Bay campus

It has scared the crap out of me, and I am just starting to call it out by name in order to face it directly. 

Cholangiocarcinoma. AKA Biliary Tract carcinoma. Or just bile duct cancer.  Its specific location earns another label, a Klatskin tumor.

It’s a nasty cancer. The general prognosis is dismal. 

But it looks like I could be among the few who are candidates for “curative” surgery, the only way to beat this thing. Tests done this past week at the University of California San Francisco Precision Cancer Building in San Francisco’s Mission Bay appear to have found no evidence the cancer has spread beyond the original location. That would seem to make a surgical approach in my case more viable.

i’m awaiting the “official” assessment of the surgical oncology option, which I expect to get soon.

Ths is, of course, only a very short version of what has been happening over the past seven weeks as the process of diagnosing and devising a treatment plan has been underway, initially in Hawaii and then in San Francisco.

The selfie was taken early Monday morning, April 13, as I waited for the building at UCSF to open so that I could check in for another CT Scan. I was probably looking more beaten up by the end of the week.

Please keep those positive vibes coming!

Some of you might find this of interest.

I found myself in a very immersive dream, probably somewhere around 2 or 3 a.m. on a night not long ago.

The dream was very much like a movie in which I was a first-person narrator.

As I recall, I had infiltrated a strange religious cult along with one other reporter. I remember walking through a group of flower-child types who were off in their own worlds, with an occasional hard character with a predator’s gaze, probably the flock’s keepers.

I have no recollection of why we were involved in an undercover investigation of this cult, but I felt vulnerable and a bit worried as we collected observations.

At some point, I was talking to a couple of cult members, and one showed me a flyer challenging some of the cult’s primary beliefs. I pretended to be shocked, but it was something we had written and dropped around in an attempt to cause some disruption of internal discipline.

Seeing the flyer made me realize that they were looking for the source, and decided it was time to get out.

I recall strolling over to the back exit, where it was necessary to go through a small obstacle course before leaving. I managed that task and tried to look casual as I walked away from the property, but within a minute or so I started running to get as far away as possible.

I found myself running parallel to a low berm to my left, away from that exit.

Then I noticed one of those predator-types running off to my right, cutting across the field that separated us as he tried to intercept me. He soon caught up and to evade him I threw my body to the side, over that berm.

And BAM.

It was a rude, startling, and somewhat painful awakening as I found myself stretched full length on the hard wood floor on the side of our bed where I had fallen.

I landed along my right side, right arm, elbow, and shoulder, and right knee, but then rolled over flat on my back as my brain caught up with my situation. A few deep breaths and I began a quick assessment. Lots of parts were sore, but nothing seemed broken. Meda was now awake and also assessing my situation.

Luckily, after a minute or two of self-assessment, I was able to sit up, get up on one knee, and then stand, before getting back into bed and going back to sleep.

Part of this is our own fault. During our entire marriage 55+ years of marriage, we have shared a double bed. Right. Not King, not Queen. A plain old double bed, usually shared with a cat or two, pushing the two of us to the sides.

Is that what they term “living on the edge”?

I’m not sure what psychological term applies to this crossover between dream and reality, where parts of the dream “break out” into real world movements.

Yes, I searched online. Most descriptions say there is usually no memory of the content of the dream. In my case, the opposite. A clear memory.

As far as I know, this was the first time I entered this particular space.

Now when I feel myself entering a similar deep sleep dream state, I try to escape toward the surface of consciousness, just in case.

This was the view at dawn from one corner of our room in the San Francisco Airport Marriott Waterfront Hotel. The room provides, as realtors might coyly say, “a partial bay view.”

That is a portion of San Francisco Bay out there. And it is visible from a part of the room. A chair has been strategically placed in that precise spot to emphasize the view. This morning, I enjoyed seeing it.

For those waiting with bated breath, my initial procedure yesterday at the University of California San Francisco medical center at Mission Bay was a success.

Its limited goals were to get a scope and some tools down my throat into my gut to examine the area around a small obstruction in my plumbing, which involved trying to get the tiny camera and tools into the lower end of a bile duct; relieve the immediate symptoms of jaundice the blockage has created; and get material for a biopsy for testing.

Two prior attempts at Straub hospital in Honolulu failed when the entry point to the lower end of the duct couldn’t be accessed.

The same thing happened yesterday. However, here at UCSF, there were multiple contingency plans. Plan B, which was to lower a miniature ultrasound tool down there as well to find an alternative path, did the trick. Plans C and D were unnecessary, but involved a radiology team standing by in case we needed to trigger those options.

What it means is that the immediate symptoms of jaundice, including my “Yellow Man” appearance, should fade over the next couple of days. That is a biggie.

And we have been cleared to return to Honolulu in a few days.

This isn’t over, since that biopsy could deliver bad news. But in the moment, it is a big relief.

I’m very fortunate to be covered by Meda’s insurance plan, a huge benefit she earned over 50 years of employment by the University of Hawaii system. Today, I’m appreciating that good luck in a very meaningful way.

We plan to be home by Saturday night.