Gut Bacteria Could Affect How We Respond to Immunotherapy

Did you know that your gut bacteria might predict whether or not you will respond to immunotherapy? Three different studies have found that responders and non-responders can be predicted based on the composition of their intestinal microbiota.1

What do the studies show?

One of the studies, conducted by Laurence Zitvogel at the Institut Gustave Roussy, Villejuif, Paris, looked specifically at immunotherapy response by those with non-small cell lung cancer and renal cell carcinoma. The study found that patients with more bacteria from the species Akkermansia muciniphila had the best response to anti-PD-1 therapy.


Hydration and You. It is Important!

Hydration is important for good health and we need to be able to recognize and treat dehydration before it becomes severe. We, as cancer patients, are particularly vulnerable to dehydration, both from the disease and the treatments we receive. It is important for us to pay close attention to whether or not we are staying properly hydrated, even when we don’t feel like drinking water.



Staying Occupied When Energy Levels are Low

Treatments that we undergo for our lung cancer can really zap our energy. Someone recently posted a question on a forum on which I participate asking what kinds of things people do to occupy their time when they don’t have much energy. It was a popular question and there were lots of great responses. Below are some ideas that you might find useful.

Paint or color

Several people mentioned painting or coloring. Neither activity takes an inordinate amount of energy, but they are calming and enjoyable. One person is teaching herself to paint watching YouTube videos (is there anything you can’t learn on YouTube?). I personally bought some books.


Let’s Raise the Legal Age to Smoke to 21

I just arrived in Austin, Texas, which is the state capitol of Texas. Shortly, other delegates from all across the state and I will learn how we are going to approach asking our state lawmakers to (1) continue funding a cancer research and prevention program and (2) raise the legal age for buying cigarettes to 21.

Interestingly, far more lawmakers have already signed onto the bill that will pour billions of dollars into cancer research over the next 10 years than have agreed to support raising the legal age for smoking. A couple of years ago when I was here to ask for the same change in the law, my Congressperson argued that she could not tell a person who could legally join the military that they can’t smoke.

Isn’t that weird? They can’t legally rent a hotel room or lease a car at age 18. And, they can’t buy alcohol until they are 21. Is smoking less dangerous to a person’s health than drinking alcohol?

I always kind of wondered what difference it really makes whether a kid can legally buy a package of cigarettes at age 18 or when they turn 21. For the most part, teens that are going to smoke start long before they turn 18. I smoked my first cigarette at age 16. So did most of my friends, if they hadn’t started even earlier.

It didn’t occur to me that many 18-year-olds are still in high school. As a 16 or 17-year-old who wants to smoke and needs cigarettes, it would be easy enough to just ask one of the high school seniors to buy cigarettes. Most kids are going to help out a friend, even if they themselves do not smoke, especially if it means they might make a dollar for doing it.

Once I understood that rationale, it made it much easier to make the ask to raise the legal age to 21. It has been well established that most people who start smoking do so before they are 21 years of age. In fact, 95% of smokers start before they are 21.

Wow. Sit and contemplate that for a moment.

Naturally, we’re never going to keep cigarettes out of the hands of all kids under the age of 18 or 21. But, if it is especially difficult for them to get cigarettes, maybe a few will decide it just isn’t worth the hassle.

(I don’t know about you, but I wonder how anyone, but especially kids, can even afford to smoke these days. When I started smoking, a pack of 20 cigarettes cost $0.35. By the time I quit, they were closer to $3 a pack, I think, especially if you bought them by the single pack. These days, in Texas where they are less expensive than in many states, the average price for one pack of cigarettes is $6.70. I just shake my head at that. I used to smoke at least one and a half packs a day. I sure am glad I quit when I did. I would go broke buying cigarettes in today’s world.)

But I digress. The law we’re proposing isn’t about raising the cost of cigarettes. It is about changing how easy they are to get. I can’t be sure of it, but I think I might have been one of those kids who just didn’t want to go through all the trouble it would take to ask someone else to buy my cigarettes. I think that would have been especially true if I had to find someone who was not even a classmate to do it for me.

If the law prevented anyone under the age of 21 from legally buying cigarettes back when I was a kid, I might never have started smoking. And, that would have been the biggest favor legislators and the adult public could have ever done for me. I might not have realized it when I was a rebellious teen, but I sure understand it now.

If you live in a state where it is still legal to buy cigarettes at the young age of 18, please advocate for them to raise the age to 21. There is no good reason to allow 18-year-old teens to legally purchase cigarettes. If you live in Texas, please write to your legislators and ask them to support Tobacco 21 legislation.

Journey to Israel … St. Peter’s Restaurant

I think just about every tour to Israel makes a trip to St. Peter’s Restaurant. Our tour did … and every tour I have looked at does. My mother went on an Israel tour back in 1978 or so … and her tour group went to St. Peter’s, too. So, if you go on a tour to Israel, chances are good that you too are going to have the opportunity to visit St. Peter’s Restaurant.

Going to St. Peter’s Restaurant for lunch

This restaurant caters to tour groups so there is a very large parking lot that accommodates several buses at any given time. Reservations are taken so there is no wait – or, we didn’t have one. In fact, the day we went to the restaurant, it wasn’t very full at all, at least not when we first arrived. There was a bigger crowd by the time we left.

The restaurant sits right on the Sea of Galilee. It is a lovely setting. While I am not aware of how I have read that there is easy access to the water from the restaurant.
I saw very few dogs while in Israel. I was surprised to find this little Chihuahua-type dog right outside of the restaurant. Being the animal lover that I am, I not only had to photograph it, I feel compelled to share it with you!
The restaurant is set up to serve huge groups quickly and efficiently. Notice that the walls are all glass so you can look out on the Sea of Galilee as you eat.
Menu in January 2019. There weren’t many choices. I don’t know if that was true for every visitor or just for those on tours. 80 nis translates to $22.14 US. Given how expensive things are in Israel, I guess that is a fair price, especially since the somewhat-limited salad bar was all you can eat.

There are a couple of comments I have to make about the menu. When I saw “baked potato,” I expected what we get here in the United States: a big foil-wrapped potato onto which is slathered butter, sour cream, cheese, and maybe chives and bacon bits. Not so. You’ll see a picture of the baked potatoes below. You’ll see why I spent some time wondering when they were going to be bringing out the baked potatoes.

The same could be said about the coffee the menu says we will get. What we got was a tiny, tiny taste of coffee. A couple of small sips. For a coffee drinker like me who can easily drink a pot of coffee or more, that was just a tease!

The salad bar included hummus, some sauces with which I was unfamiliar, fresh veggies, and more.
This is the St. Peter’s Fish, eyes and all. It was mostly skin and bones. There was very, very little meat on mine. St. Peter’s Fish is tilapia, so it is a very mild fish. Notice the potatoes. Those are what were called baked potatoes! Perhaps they were baked, but they certainly did not fit what my mind saw when I read that we would be having baked potato with our meal!
I had a taste of my friend’s kebab. If I ever return to the restaurant, I will have the kebab. I thought it was really good and it would have been far more filling than the St. Peter’s fish was.
You can see the bar behind some of our tour group. The restaurant efficiently gets you in, fed, and back out.


Links to the Hope and Survive pages related to my 2019 trip to Israel:
Journey to Israel – The Beginning … Part 1
Journey to Israel – Getting There … and Getting Home … Part 2
Journey to Israel … Bethlehem … Part 3
Journey to Israel … Bethlehem … Church of the Nativity … Part 4
Journey to Israel … Bethlehem … Church of Saint Catherine … Part 5
Journey to Israel … Bethlehem … Shepherds’ Field … Part 6
Journey to Israel … Nazareth … Part 7
Journey to Israel … Caesarea Maritima
Journey to Israel … Mount Carmel
Journey to Israel … Sea of Galilee
Journey to Israel … Ginosar and the “Jesus Boat”
Journey to Israel … St. Peter’s Restaurant

Journey to Israel – The Jesus Boat

Located in the Kibbutz Ginosar is a museum featuring an ancient boat that was discovered on the beaches of the western shore of the Sea of Galilee in 1986. Dubbed the Jesus Boat because it dates back to the time of Jesus, this remarkably well-preserved boat is the ninth oldest boat yet to be discovered in the world.

Ancient Galilee Boat

The Jesus Boat was discovered on the Sea of Galilee between Ginnosar and Magdala by two brothers. Moshe and Yuval Lufan, fishermen from the Kibbutz Ginosar, made the discovery in 1986 during a drought that caused the lake to be very low.

The wooden boat is comprised of 12 different kinds of wood

The boat measures almost 30 feet in length, 8 feet in width, and 4 foot in height. While it was built primarily of cedar and oak, 12 different kinds of wood were used to build and/or maintain the boat: Christ thorn, carob, pine, hawthorn, cedar, oak, sycamore, laurel, willow, judas tree, plane tree, and Atlantic terebinth.

The Story of The Jesus Boat

Rather than reinvent the wheel, I’ll just let the museum tell you about how the boat was discovered and preserved. You can start and stop the little slide show if you want to read the explanations.

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Besides the boat, other artifacts were discovered. Radiocarbon testing showed that the boat dates as far back as 40 BC and the pottery and nails found with it from 50 BC to AD 50.

Cooking pot and nails discovered with the Jesus Boat. These items aided in the radiocarbon dating of the boat.Of course, no one knows whether Jesus or any of His disciples ever rode on this boat, but its discovery gives insight into the type of vessels that were used when He walked on this earth. Furthermore, boats like it played a very important role in Jesus’ ministry and are mentioned repeatedly in the Gospels.

Interestingly, Ginosar is the Hebrew pronunciation of the town of Gennesaret, a town mentioned in the New Testament as a place where Jesus taught and performed miracles.

34 When they had crossed over, they landed at Gennesaret. 35 And when the men of that place recognized Jesus, they sent word to all the surrounding country. People brought all their sick to him 36 and begged him to let the sick just touch the edge of his cloak, and all who touched it were healed. Matthew 14:34-36

Life in a Kibbutz

As mentioned, the Galilee boat was found by kibbutz members and the museum housing the boat is on Kibbutz Ginosar property. Many people do not know what a kibbutz (translation, “gathering”) is so this seems as good a place as any to discuss exactly what one is.

I didn’t see many dogs while in Israel, but every community seemed to have cats. This cat lives in the Kibbutz Ginosar.

I find the concept interesting, though I don’t know if I would like living in one. In a kibbutz, you live in a true democracy. Every decision is made by the vote of the people. But, in some ways, it seems like you are also living in a socialistic place because no one has more than his neighbor.

Everything is shared. The general manager or Secretary of the kibbutz earns exactly the same amount as the person who does the laundry or cooks the meals. No one has more than anyone else in the kibbutz.

Every person in the kibbutz works, but they do not earn a personal salary. All monies earned by kibbutz members go into the kibbutz treasury. For example, if you are a teacher that teaches in a school outside of kibbutz, your paycheck is deposited into the kibbutz account, not into your own personal bank.

Many years ago, all kibbutz communities were dedicated to farming. Today, though, they are involved in all kinds of businesses. For example, in Kibbutz Ginosar, where the Jesus boat is, part of their income is earned by running a hotel.

In Israel, there are over 270 kibbutzim. The average size of a kibbutz is about 700 people, though some are as small as 500 or as large as 2,000.

You may apply to join a kibbutz, if you like. You must be no older than 35 and must have skills that are needed by the kibbutz to be considered. For the first year, you are considered a candidate. After the year is up, the community will vote on whether to accept you as a member. If accepted, you have a lifetime membership, no matter what. You may leave, but they cannot kick you out.

The influence of the kibbutz in Israel is great. During the 1960s, only 4% of Israeli citizens lived in a kibbutz, but about 15% of the members of Israel’s parliament, the Knesset, were kibbutzniks.

Some people may be familiar with the name David Ben Gurion. He was Israel’s first Prime Minister. When he retired, he moved to Kibbutz Sde Boker, a community founded in 1952, and helped develop the Negev Desert in Southern Israel. Ben Gurion, despite his status, lived in a hut that looked exactly like that of every other member of his kibbutz.

Interestingly, not everyone who lived on Kibbutz Sde Boker wanted Ben Gurion to join. He was an old man when he applied for membership and most are not considered unless they are 35 or younger. He was accepted into the kibbutz by a one-vote margin!

We saw many different kibbutzim while we were in Israel. We visited several, but only to eat (or, as we did at Kibbutz Ginosar, to see their museum). I find their way of life fascinating, even if it is a bit incomprehensible to my Western mind.


Links to the Hope and Survive pages related to my 2019 trip to Israel:
Journey to Israel – The Beginning … Part 1
Journey to Israel – Getting There … and Getting Home … Part 2
Journey to Israel … Bethlehem … Part 3
Journey to Israel … Bethlehem … Church of the Nativity … Part 4
Journey to Israel … Bethlehem … Church of Saint Catherine … Part 5
Journey to Israel … Bethlehem … Shepherds’ Field … Part 6
Journey to Israel … Nazareth … Part 7
Journey to Israel … Caesarea Maritima
Journey to Israel … Mount Carmel
Journey to Israel … Sea of Galilee
Journey to Israel … Ginosar and the “Jesus Boat”
Journey to Israel … St Peter’s Restaurant

Journey to Israel … Sea of Galilee

We spent our second and third nights in Israel in Tiberias, which is on the shores of the Sea of Galilee. Our hotel, the Ron Beach Hotel, was remarkable and there was just something about being at the Sea of Galilee that filled my troubled soul with peace. Even today, just revisiting my photos and reliving the time I spent there is calming.

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You don’t have to be a Bible scholar, which I am definitely not, to know that the Sea of Galilee played a significant role in the ministry of Jesus. This is where He chose disciples, where He walked on water, and where He calmed the angry seas.

The beautiful Sea of Galilee. You may also hear it called the Sea of Tiberias, the Lake of Gennesaret, or (in Hebrew) Lake Chinnereth or Kinneret.
Notice the fertile, beautiful land on the Sea of Galilee. I didn’t expect such beauty when I visited Israel. Flavius Josephus, the first-century Roman historian, said, “One may call this place the ambition of Nature,” when writing about the Sea of Galilee and its surrounding countryside.

Logistics of the Sea of Galilee

Of all of the sites in the Holy Land that we visited, the Sea of Galilee is probably the least changed from when Jesus walked on earth. It is a beautiful, heart-shaped lake found in the hills of northern Israel. I didn’t realize that it sits almost 700 feet below sea level, making it one of the lowest-lying bodies of water on earth.

Though it is called a sea, the Sea of Galilee is actually a very large freshwater lake. At its widest point, it is about 130 miles long and only 8 miles wide with a depth of 141 feet. By contrast, Lake Michigan is 307 miles long by 118 miles wide, with a depth of 279 feet.

 "Astronaut photograph ISS020-E-31066 was acquired on August 15, 2009, with a Nikon D2Xs digital camera fitted with an 400 mm lens, and is provided by the ISS Crew Earth Observations experiment and Image Science & Analysis Laboratory, Johnson Space Center. The image was taken by the Expedition 20 crew."
This photo is from NASA Earth Observatory. The Jordan River is visible flowing in at the northern end of the lake and out at the southern end. Image of the day for September 14, 2009.

While I was unaware of it while I was there, Israel is currently very worried about the state of the Sea of Galilee. An ongoing drought and overuse are responsible for the fact that the lake is shrinking significantly.

The Sea of Galilee, which is both fed and drained by the Jordan River, is Israel’s chief water reservoir.  It is also a major source of income as it draws tourists from around the world.

The lake also played an important economic role in the time of Jesus. Then, it was filled with fishermen whose catches were sold all across the Roman empire.

Palm Trees in Israel

I probably should not have been, but I was surprised and fascinated by all of the palm trees in Israel. These trees do not produce coconuts, they produce dates. Unfortunately, I recently read an article that laments the disappearance of Israel’s date palms. Apparently, an epidemic of red palm weevils is wreaking havoc across the nation. I hope they get the pest under control. I hate to think of Israel without its regal palms.

These stately palm trees lined the walkway to where we were going to take our boat ride on the Sea of Galilee. I don’t know that I completely agree, but I read recently that palm trees provided the sweetness described in the Bible when God promised the Israelites a land of that flowed with milk and honey.

The National Bird

The bird below is a hoopoe. It was voted as Israel’s national bird in 2008. The chosen bird had to “represent Israel’s character, be a permanent resident of the country and appear in Jewish tradition.”

As I was doing my Bible studies recently, I was surprised to find the hoopoe listed in Leviticus among the animals that God’s chosen people were not to eat. It was in good company. Other birds that God told Israel not to eat because they were considered unclean included eagles, hawks, and owls.

We were fortunate to come across a hoopoe as we were walking to the pier on the Sea of Galilee. His crest opens, but while we were watching him, he kept it closed. This bird was completely unintimidated by a tour bus full of people ohhing and ahhhing over it.

Crown of Thorns

Before Jesus was crucified, his captors made mocked Him. After flogging Him, soldiers crammed a woven crown of thorns onto His head. See John 19. They didn’t know how right they were when they deridingly called Him “the King of the Jews.”

Crown of Thorns tree
These thorns on the Crown of Thorns tree are immature. They are green and have not reached nearly the length they will when mature. Still, they give you an idea of how sharp and long the thorns were in the crown that was crammed onto the Savior’s head before He was crucified. In addition to the pain caused by the long, sharp needles, GardeningKnowHow says that the plant is poisonous and its sap causes skin irritation.

Sailing on the Sea of Galilee

This man was playing the most soulful music as we approached the boat that would take us for a ride on the Sea of Galilee. He stopped playing just as I turned on my camera to record it. I wish he hadn’t. His music, played with such a simple instrument, gave me the chills it was so hauntingly beautiful.
Green and fertile – the gorgeous Sea of Galilee. You can see the pier in the distance where we will board our boat, the Matthew, for a trip out to “sea.”
The totem pole stood alongside the looooong dock we walked down to get to the boat. I’m not sure what the significance of the totem pole was, but I thought it was interesting.

These two boats, the Matthew and the Mark, take thousands of tourists for a short ride on the Sea of Galilee.Notice the American flag flying on the Matthew boat. It was raised while they played the Star Spangled Banner as we left the dock. For me, that was a very moving, meaningful and much-appreciated gesture.

Here is a video I took while riding on the Matthew. I’m certainly not a professional videographer, but hopefully, you can begin to feel the experience. Notice the song playing in the background, “He’s Got the Whole World in His Hands.” Yes, He does and that never feels truer than when you’re cruising on the Sea of Galilee, remembering all He has done for you personally and the world in general.

Always the animal lover, I thoroughly enjoyed the seagulls that follow the boats as they “go out to sea.” Apparently, my enthusiasm for the birds was noticed by our tour guide. He brought me (and several other tourists) some old bread to throw. I was suddenly in heaven … and the birds couldn’t have been happier.

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Another wooden boat carrying tourists on the Sea of Galilee

The Sea of Galilee in Scripture:

Jesus calls four disciples: Matthew 4:18-22; Mark 1:16-20

The miraculous catch of fish: Luke 5:1-11

Jesus calms the storm: Matthew 8:23-27; Mark 4:35-41; Luke 8:22-25

Jesus walks on the water: Matthew 14:22-33; Mark 6:45-52

The Sermon on the Mount: Matthew 5:1-7:28

The Parable of the Sower: Mark 4:1-9

The miraculous feedings of the crowds: Matthew 14:13-21; 15:32-39; Mark 6:30-44; 8:1-9; Luke 9:10-17; John 6:1-14

Paying the Temple tax: Matthew 17:24-27


Links to the Hope and Survive pages related to my 2019 trip to Israel:
Journey to Israel – The Beginning … Part 1
Journey to Israel – Getting There … and Getting Home … Part 2
Journey to Israel … Bethlehem … Part 3
Journey to Israel … Bethlehem … Church of the Nativity … Part 4
Journey to Israel … Bethlehem … Church of Saint Catherine … Part 5
Journey to Israel … Bethlehem … Shepherds’ Field … Part 6
Journey to Israel … Nazareth … Part 7
Journey to Israel … Caesarea Maritima
Journey to Israel … Mount Carmel
Journey to Israel … Sea of Galilee
Journey to Israel … Ginosar and the “Jesus Boat”
Journey to Israel … St. Peter’s Restaurant

Managing the Costs of Prescription Drugs

According to the Natural Conference of State Legislatures, prescription drug transactions in the United States make up ten percent of total healthcare spending.1 Because of this, states are beginning to enact legislation related to the pricing, payment, and costs associated with prescription drugs. In most cases, states are anxious to shift the cost burden away from patients.

In the meantime, there are ways that we can help mitigate our drug costs by becoming informed consumers. There are a variety of resources available that might help us reduce our copays or the cost of the drug itself.


Making Sense of Insurance Appeals

I recently attended a presentation on managing cancer costs. It was chockful of helpful hints. I share some of what I learned here.

1. Keeping track of costs

While the Explanation of Benefit (EOB) form you receive from the insurance company can be very confusing, it is an important document. Be sure to monitor it closely because, while it is not a bill, it details the services for which you will be billed.


Wayward Tumor. What Do I Do Now?

It was almost exactly a year ago that I was faced with some hard decisions. After four years of complete stability, one tumor in my supraclavicular lymph node had decided to go rogue and quit responding to the immunotherapy I was on. I named it “Wayward Tumor.”

From one clinical trial to another

When my oncologist told me that I was being taken off of the clinical trial because of tumor growth, I wasn’t particularly worried. That’s just how much confidence I had in him having something else for me to try.