Yes, I’m still here in Cologne. I wasn’t quite ready to return to California, and I really enjoy being in Europe. I also have cheap rent. More importantly, being across the ocean from almost everything I know provides more space for reflection and clarity. Even though Cologne is now familiar, I’m still surrounded by a different language and culture that invites an isolation of self. Somehow these dynamics have fostered a more fertile environment for me to continue creating a new life, and find myself in the process.

My priority has been work since my return to Cologne. I am working for several clients, and have a number of writing projects. One of them is for Alternative Medicine magazine. I’ve been hired by Alternative Medicine to write an article about my journey over the last year, including my experiences at the Medical Center of Cologne. In addition, I started a book proposal, and I’m considering applying for a media fellowship.

Along with work, my deepest priority is my health and healing. For now, I am exercising, eating a healthy diet, taking supplements, meditating, and enjoying not being in full-time treatment mode. I am scheduled for another dimension of cancer therapies at the Paracelsus Clinic for 3 weeks starting the end of March.

I have sent my MRI scans to Cedars-Sinai in Los Angeles for review with their brain tumor board. In my December 10th blog, I reported that the radiologist in Cologne told me I’ve had stable disease for the last year and a half. Unfortunately, he didn’t conduct a thorough comparison of my scans. I have since reviewed the radiologist reports from my scans conducted over a year and a half ago, and a year ago, and there was growth during that time period. As I also noted in my December 10th blog, low-grade disease is especially difficult to measure in MRI scans. I would like nothing more than to have stable disease, but there doesn’t seem to be a way to know that is the reality.

Since my scan results, I’ve been reflecting about definitions of treatment success. What defines treatment success? Is it disease shrinkage or eradication? Is it stable disease? Is it increasing survival time? Is it maintaining a high quality of life?

The mainstream cancer paradigm defines treatment success through tumor shrinkage and eradication. Sadly, this is sometimes achieved through cancer therapies with severe adverse effects that compromise the patient’s quality of life, and don’t always increase survival time.

What if the disease size could be controlled, and the patient lived with it for a long period of time with a high quality of life? Would that be success? I think so. However, for me, I would need to be one step ahead of my disease. I simply know I’m not there yet.

I have learned over the last nine years that most people do not understand the unique challenges imposed by brain tumors. For example, if my tumor grows more, some of my brain functions will be compromised. This explains part of my determination to receive cancer treatments that clearly elicit a tumor response.

Even though my personal definition of treatment success has evolved, I still believe that I will be tumor free someday. And if I’m proven wrong, so be it.