Living with Cancer in Silicon Valley

Enso, a symbol of Zen Buddhism

My cancer returned Monday. In not exactly a subtle way. I have two tumors, one of which is 11×8 centimeters. They are messing with my left psoas muscle which explains all the back and leg pain I have been having.

Being the occasional idiot I am about ignoring pain, I waited too long to get medication. Now I am on an intense mixture: the morphine is the platform, the percocet dulls the spikes, and the neurontin is nothing less than a bomb going off, so thankfully it’s reserved for sleep, something I have not had for weeks.

This is my life. I am living with cancer, I have had three major operations — here comes #4, I have had a frightening amount of chemo, and I lost a year of my life right before joining Atlassian. I can struggle or I can embrace it. Those of you who know me understand I have only one option. Not because I consciously choose. I am just innately positive.

Lean into it. A shrink once gave me this wonderful Zen advice about facing challenges and problems: they aren’t going away, so you can choose to fight them or embrace them. Embracing them means finding the positive, and turning the badness into goodness. Cancer is an opportunity.

I sincerely believe cancer has been more positive than negative. Thanks to my first battle, I had time to focus on my son, who was struggling with teenage issues, and help him make a remarkable turnaround to a focused young man. It was in him, but I learned how to be a better parent thanks to cancer.

I learned how much love there is in this world. All you have to do is get in touch with it, and it’s everywhere. Even out here in the social-2.0-blogging-weird-o-sphere, the connections can humble you. People may be conversing in Seemingly Strange Ways like Twitter, but there are humans behind those electronic bits and the messages and meaning can lift my spirits. That was the lesson I learned about blogging about cancer and seeing the love come back. My blog inspired people, and the Awesome Karma came back inspiring me through a major surgery.

A friend reminded me: I have a blueprint for this journey. Getting the news Monday about the two tumors sucked. I was upset to say the least. I love my life. Four years ago, I married the most Incredible Woman on the Earth, I bought a new house, and I met this incredible little company called Atlassian. I just love my work. I love living here in California. I am the luckiest guy in the world. My blueprint starts with reminding myself that I do all these things — the ritual Sunday night family dinner, the sandwiches my daughter Brittany brings me while I am sitting here waiting for surgery… the list is long — because I love them. And yes, it includes the work I love.

The first priority on the blueprint is of course getting the right treatment and recovering. But the blueprint includes trying to work when you can. I called a customer Tuesday morning, just 20 hours after getting the news. Willie Doyle had read my blog and wanted to share their agile development story. I love talking to customers and learning what they’re doing. The point is: cancer is not going to stop me from learning new, cool things like this.

Surely I will have to cycle down and let things go during surgery. Right now my biggest challenge is managing this intense concoction of drugs so I can still do the little things I love: like blogging.

Awhile ago I chose to write about personal things in this blog, and not just talk about software, business, Atlassian, and the expected. That’s also part of my blueprint: people have complex, interesting dimensions, and sharing these opens up opportunities.

Cancer 2.0: the Killer App

Watercolor, August 2004, of Bing Gardens at Stanford Hospital I drew during one of my in-patient chemo treatments.

Soon I’ll be going in for surgery for a re-occurrence of my cancer. I have a 2 centimeter tumor where my left kidney used to be.

I’m a cancer survivor. The year before I joined Atlassian I battled cancer for a year. It started with surgery to remove my left kidney, when they discovered a nasty tumor attached to various important things. They removed part of it. My initial stunning prognosis was 3-5 years to live.

My cancer was eventually diagnosed as an unknown cancer: sarcomatoid carcinoma. Which means it looks and acts like sarcoma [very rare bone, tissue cancer] but it may be a rare carcinoma [organ based], which means, “we have no idea.” This was exhilarating news: no statistics meant I was a data set of one, and any prognosis was bullshit.

Chemo for 4 months followed. Which was a lot of laughs. Because they didn’t know what I had, they experimented with different regimens. I had the pleasure of having Cisplatin amongst other drugs. Cisplatin is as bad as chemo gets. Chemo assaults the faster growing cells attempting to kill them. Your hair and your stomach lining are fast growing, so they can be killed by some chemo.

Side affects vary, but nausea is popular. A common cycle for chemo is once every 3 weeks. The reason is you need 3 weeks to recover from the bombing your system takes. I would lose 10 pounds in the first 5 days when I tried to eat a scone for breakfast or have a bite of a sandwich at lunch. Dinner was impossible. Smelling food was disgusting. Then on about the 6th day I would stroll down to this local French bistro and wolf down a steak and have a martini. Your taste buds get assaulted, so good wine was a waste on me. Then I would return to the clinic with my 10 pounds back.

One of the regimens required 3 days in the hospital because I had to be hydrated so my remaining kidney survived. I would gain 10 pounds of water weight in eight hours; Boy, was I attractive. They gave me a PICC line which is a tube inserted into the back of your bicep and then threaded close to your heart where the blood flow is strong. The reason is grim: the chemo is so toxic, it will burn your veins unless there’s good blood flow. Having a toxic warning to the nurses on my door was also a lot of laughs. God forbid they spilled the chemo on themselves.

Eventually my MRIs showed only modest shrinkage in my tumor, so I was sent to the largest cancer hospital in the world, MD Anderson in Houston, where a specialized team removed the remaining tumor. That surgery went extremely well as the contingent plans for a graft on my aorta and some other things-down-there-you-need never were invoked.

I was cancer free. That was a very wonderful moment after all the crap I had been through.

I then underwent 3 more months of chemo to make sure there were no bad guys hiding out. At least now I could count the weeks. December 18, 2004 was a Wonderful Day: my last treatment. I could eat on Christmas day.

The day I got my (wrong) prognosis of a few years left to live, I faced the biggest challenge of my life: not cancer, but what to tell my children? I got a copy of Lance Armstrong’s book and I remember setting it down on the table in front of Brittany and Mac and telling them the one difference between Lance and me is that I didn’t have to win the Tour de France. I only had to beat cancer.

Cancer never broke my positive attitude. Sure, for a few hours or a day I would be an emotional wreck. But I had an uber focus. I worked out almost every day. Chemo made me feeble compared to my old self but I was relentless about exercise.

I discovered I was an excellent surgery patient. I could withstand a lot of pain. I would be walking all over the hospital after surgery. I ran 2 miles 11 days after an 8 hour surgery. Slowly. I asked my surgeon when I could start lifting weights and he thought I was out of my mind. During my 3-day in-patient chemos, I asked Stanford Hospital if they had a gym. They looked at me like I was nuts: “Mr. Walker, this is a hospital.” They did get me a treadmill so I could run in my room while the chemicals dripped into me. I was on a mission. Get the fuck out of my way, thank you very much.

Prior to my second surgery, they had to stop chemo for several weeks, so I had full strength. I used this opportunity to bike the famous “loop” near Stanford University and my home. I biked every single day focused on going to Texas, getting through the surgery, and getting out of there as fast as possible.

At MD Anderson in Houston I snuck out of the hospital on the 4th night and went to my hotel across the street because I hate hospital beds. The nurses on my ward were really pissed. But they let me get on a plane home 5 days after a 4-hour surgery.

So where does that leave me now?

In preparation for this upcoming surgery, I’ll be working out every single day. I’ll be leaving work at a reasonable hour. I need to point my Type-A personality at Atlassian at something more important right now.

This re-occurrence is nowhere near as brutal as what I went through three years ago. Will I have to go through this again in 3 years? Perhaps. The way I look at it: I will certainly live 5 more years, based on currently available data. Will I live 15 more? I didn’t know the answer to that question one year ago, so nothing has really changed. In fact the behavior of the cancer is better known now: it seems to stay local.

I read fellow Atlassian Chris’ incredible blog the day before my MRI that detected this current tumor. These problems make you face your mortality. Everything gets put into play, up for grabs. Jump ball.

I have the same attitude from three years. I am Cancer Dude and I am going to kick it’s ass. Here’s my secret cancer-fighting outfit… 🙂