FYI - not for public dissemination, but for your information. ----- Forwarded message from Greg Newby <gbnewby@pglaf.org> ----- From: Greg Newby <gbnewby@pglaf.org> To: pgww@lists.pglaf.org Subject: Greg's medical status Date: Mon, 7 Apr 2025 15:06:50 -0700 Hi WWers. A few of you have already a heard a bit about this, but not everyone. This message has more detail than was previously available. Here is an update on my medical status. Share as desired internally and with family & friends, but this is not intended to be public information. I've been diagnosed with pancreatic cancer. Specifically ductal adenocarcinoma (PDAC). I am not in immediate mortal peril, but it's a serious situation that I will be addressing for at least the rest of 2025. Next steps for me are to start chemotherapy, hopefully by the week of April 28. The current plan is approximately 6 months of FOLFIRONIX, followed by major surgery called the Whipple Procedure, a.k.a., pancreaticoduodenectomy. My medical team is based in Vancouver at Vancouver General Hospital and BC Cancer. Chemotherapy will be closer to home, at the Whitehorse General Hospital. According to my main doctor at VGH, Dr. Michael Bleszynski, completion of chemotherapy and the surgery will give me another five years of life. Of course, I'm hoping for more. That's the news. I'll include some further medical detail below, for the curious. What this means for my organizational roles and work: Firstly, I'm working on simplifying what I do, and lessening my commitments, to allow me to focus maximally on health & treatments. Generally, I'm looking at reduced time and time off from work and other commitments, and am striving for an orderly transition. I hope to someday return to full health and energy, and in the meantime will be focused on beating the cancer. I expect to mostly maintain my role with Project Gutenberg, with some absences of up to a few weeks. A number of people, as well as the Distributed Proofreaders organization, will be helping to bridge any gaps. DP is also in a key role for succession, in cooperation with the PGLAF Board, if that becomes necessary. ~ Greg Medical synopsis: Following a week’s or so's illness, I first contacted my physician then visited the hospital on March 20. An initial diagnosis of gallstones was ruled out, and by March 20 I was checked into the hospital with an initial diagnosis of cancer. During the following 12 days of hospitalization, I was given extensive testing and diagnosis (MRIs, CT scan, ultrasound, laparoscopy, endoscopy, daily bloodwork, urinalysis, and more). I had pain in my abdomen and developed jaundice. I got a stent in my bile duct to regain bile flow. The initial symptoms of a blocked bile duct were what got the doctors looking, and the discovery was a golf ball-sized cancerous tumor on the head of the pancreas. It impinges on the superior mesenteric vein (SMV). A key consideration for treatment is whether the tumor is resectable. This means, can it be surgically removed, including removing enough of the organ that all cancer cells are gone. The involvement of the SMV means my tumor is borderline resectable since the vein will need to be bypassed or bridged. I'm still a good candidate for surgery. This is relatively early detection. The tumor had been growing for at least several months, but cancer has not yet spread to nearby organs or to the abdominal fluid. The pancreas is an organ near the liver, stomach, gallbladder and small intestine that is important for blood health, digestion, and other functions. Pancreatic cancer is particularly deadly because it's often not discovered early and is hard to treat. The tumors are resistant to immunotherapy and other treatments that work for other cancers. Chemotherapy before surgery with FOLFIRONIX is the recommended treatment for people who are healthy and have Stage II or III PDAC. This shrinks the tumor and lessens the likelihood of spread (metastasis). I'm speaking with my oncologist at BC Cancer about adding additional treatments or experiments alongside with FOLFIRINOX. My reaction to chemotherapy is yet to be seen. Many people get sick during it, and get sicker with repeated treatments. My treatment plan is to get two days of infusions in the hospital, followed by two days of infusions at home. Then to repeat the treatment every two weeks for approximately 6 months. Surgery would occur within a month after chemotherapy ends. If I don't tolerate chemotherapy, I may get the surgery sooner. The surgery requires 7-14 days of hospitalization followed by multi-week recovery. My reaction to chemotherapy is yet to be seen. Many people get sick during it, and get sicker with repeated treatments. My treatment plan is to get two days of infusions in the hospital, followed by two days of infusions at home. Then to repeat the treatment every two weeks for approximately 6 months. Surgery would occur within a month after chemotherapy ends. If I don't tolerate chemotherapy, I may get the surgery sooner. The surgery requires 7-14 days of hospitalization followed by multi-week recovery. ----- End forwarded message -----