Another Day, Another Cancer Surgery   August 31st, 2011

Today marked my third surgery of the year.

The first surgery, almost exactly five months ago, was to confirm whether I actually had cancer (it did).

The second surgery, about four months ago, was to try and confirm whether the cancer had spread (it had), as well as try to remove it surgically (didn’t work).

Today’s surgery was not about verifying or fixing anything, however. It was to remove cancer tumors from my body and use them to create a cellular therapy, using my own cells to fight the metastatic melanoma growing in my body. This was explained a couple of blog entries ago.

What I did not discuss in that blog entry last week, because I didn’t know, was that the firm lumps immediately below my lymphadenectomy scar (surgery #2) were not scar tissue as we had believed, but instead were new, growing melanoma tumors. Three tumors, as best as we could tell via touch. That determination was confirmed via the CT scan I had taken last week while I was here at the National Cancer Institute’s (NCI) Clinical Center.

The impact of this new determination resulted in a change in my surgery today. Originally the thought had been that the 3cm+ tumor in my right iliac region, spotted during a CT scan a month ago, would be the tumor removed for harvesting immune cells. But now that tumor, along with other smaller ones in my groin lymph nodes, remains within me, to be used as references to determine whether my upcoming treatment has been successful.

So instead, this morning, around 10:30am, surgeons removed a chunk of biological material almost the size of a baseball from my upper thigh, consisting of the aforementioned three tumors and surrounding tissue which was of questionable state and use (like old scar tissue). They also removed the new melanoma mole that had been forming (which had achieved a respectable 6mm in diameter after only six weeks) near the original mole site.

The size of the extracted mass was intimidating when I learned about it. I have been told there may be a permanent “dent” in my thigh once healing completes.

But what’s really important is that the folks here at NCI now have sufficient amounts of my melanoma to try and harvest the immune cells they need to help treat and hopefully cure me of my cancer.

The next step is that we need to wait a couple of weeks to see if they were able to harvest the necessary lymphocyte cells from my tumors.

I am going with the assumption they will be successful with that step, in part because that’s the assumption here at NCI as well (though no guarantees, of course).

Once enough cells have been grown, I will come back to Bethesda, sign the agreement for the treatment, and then be randomized into either the normal TIL treatment or the one with radiation, as I discussed last week.

In the meantime, I will have a couple of weeks during which the wounds from today’s surgery can continue healing up (I haven’t seen them yet, but will soon enough). I am already able to walk around (albeit slowly), with only a small bit of pain from the surgical areas.

I will be released tomorrow so I can fly back to Boston with Linda in the evening. I must admit that the prospect of the flight is a bit unnerving, though, because I was only able to secure a window seat on the flight back (Hurricane Irene related flight cancellations resulted in very heavily booked flights all this week). I hope I’m able to work a deal with someone (either the airline or another passenger) for a left-hand side of the plane aisle seat so I can stretch out my right leg.

But even if I can’t negotiate a better seat, I’ll manage – it’s a small thing in the grand scheme of things. The really important thing is that I’ve taken another step – a very critical one – on the path to NED (No Evidence of Disease).

Please note I probably won’t post another blog entry until I have heard back from NCI about my TIL cell harvest results, which may be in the next two to three weeks. Until then: To NED!


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This entry was posted on Wednesday, August 31st, 2011 at 22:12 and is filed under Health. You can follow any responses to this entry through the RSS 2.0 feed.Both comments and pings are currently closed.

23 Responses

August 31st, 2011 at 22:28
Martin Says:

Hi Jake,

That is a good piece of material… I know you will show us all that staying positive will work and you WILL be able to get cured.

And until then: To NED!! (picture me holding a glass of cognac high up in the air)


August 31st, 2011 at 22:40
Carole B Says:

You are one hell of an amazing person, Jake. The way you are able to “explain” each process to us in laymans’ terms as well as using official medical terminology, etc. Will keep the prayers coming your way along with good vibes and positive thoughts. What an amazing journey we are sort of sharing with you….ayo. cb

August 31st, 2011 at 23:14
howard sobel Says:

To NED!!!

September 1st, 2011 at 01:31
Kathleen Dewhurst Says:

Yes, Jake, I agree you are amazing.

Samantha, Charlotte and Ted just left San Diego yesterday. We had a wonderful visit. Ted grew so much while he was here and he was using several new words every day. I miss my household being noisy.

I play Bridge with a retired Navy internist, surgeon and was telling him about you. I heard myself explaining some of the NCI plans that I’d read in your blog and realized that I must be learning more than I thought. The Dr. told that all of this cellular therapy is so far beyond what he had to work with years ago.

Keep me on your list…and keep on with your perseverance toward NED! Kathleen

September 1st, 2011 at 04:08
Jan Says:

Thought you were planning to visit us in Ned(erland)
However: Ned is your primary goal.
We are praying that you will reach this stage soon.

September 1st, 2011 at 06:33
Tish Says:

Indeed you are amazing, Jake! Keep up the positive attitude and picture me along with Martin, toasting with cognac, to NED!!!
Love and hugs to you, Linda, Yana, and Bas,

September 1st, 2011 at 06:47
pat Says:

you inspire me jake. i have tried writing my experience but it’s babble.thanks for a clear voice. you are in my prayers.

September 1st, 2011 at 07:54
LaDonna Says:

hugs, big brother!!! To NED!!!

September 1st, 2011 at 08:32
Hannah Says:

Initial reaction.. Holy Moly.. No pun in tended!

Travel safely, and thankfully it’s a rather short flight. Heal quickly, and we all are embracing NED in our lives.

Hugs from here…h

September 1st, 2011 at 17:48
Tracy and Mike Griffin Says:

This is quite stunning information…. We wish you the very best in recovering from this third surgery. Quite a serious situation. We hope NCI creates your customized gene based CURE very quickly.

We are sending our love and healthy wishes to you from Lea’s boat in the San Juan Islands, WA. We all send our best wishes to you.

Hope you made it back to Boston safely and found a compassionate passenger to switch places with you on your flight.


September 1st, 2011 at 21:48
dara Says:

To NED!!!

You are on your way to adding “Cellular & Molecular Biologist” to your long list of proficiencies!!! although, I wish it were not so.

We can send you to the body shop later to have the dents bumped out and painted – right now, attack the rust!!!!

September 2nd, 2011 at 01:01
Mitch Says:

Nice! To NED!!

September 2nd, 2011 at 06:53
Denise & Teddy Says:

To Ned, with hugs and love.

September 2nd, 2011 at 10:46
Mercy Says:

May you and NED become the best of friends! As always, you are in my healing thoughts Jake.

September 2nd, 2011 at 18:00
Vince D Says:

If I were on that plane, I’d gladly give up my left hand side aisle seat for you, would order a scotch & toast NED!

September 2nd, 2011 at 18:03
Jake Richter Says:

I am pleased to report that the incredible and awesome agents at AMEX CTS Travel set me up with a wheelchair (thank you Ann D. for the idea!) and also managed to get JetBlue to find us seats on the left side of the plane together, so I got my left-side aisle and could stretch out my leg. Not sure how they did it on a sold-out flight, but they did.


September 3rd, 2011 at 08:03
Scott Says:



September 3rd, 2011 at 11:38
Carolynne S Says:

Hi Jake,

I don’t know if you remember me but I stumbled upon your blog as I was looking for NRAS info and I knew right away that you were the guy I met at MGH on August 3rd when we both going to have a PET scan We talked about our melanoma, and we both had Dr. Flaherty for an oncologist and we are both NRAS. I had to contact you as it is very odd indeed to me that your last name is Richter. That is my maiden name and now I am wondering if I am somehow genetically linked to you. I am on the ipi/bev trial at MGH right now- my scan showed spread of the disease to my adrenal glands. I will be following your progress very closely and wish you the best. All of this treatment can be quite difficult and I truly can understand all of your fears and hopes.

September 4th, 2011 at 10:39
Jake Richter Says:

Hi Carolynne!

So good to hear from you! I’ll drop you a private e-mail.


September 3rd, 2011 at 21:27
Carrie Says:


September 6th, 2011 at 20:49
Jan Klos Says:

Hi Jake, Would love to meet you and Linda for lunch while you are back in Boston. I had seen a post on Bonaire Talk a short while ago. Keep up the positive attitude…

Jan… Foxboro, Ma
(formely Hamlet Oasis)

September 7th, 2011 at 17:15
Cynde Says:


Well, that’s quite a bit of tissue they took out. I’m glad the surgery was a success, and that you secured a better seat on the flight on the way back to Boston.

You are in the thick of the battle melanoma warrior…and I think of you, Linda, Bas, and Krystyana daily….especially you.

As I was recovering from my most minor surgery compared to yours (they had to leave the 5 surgical incision sites open due to my severe allergies to surgical glue, tape, stitching)…every time I moved and it pulled or hurt, I thought of you and the drain tube…not even a comparison.

Keep fighting the fight Poseidon….we will be toasting to NED on your rooftop on Bonaire, and eating roasted pig from the spit soon in 2012 or sooner….

hugs and healing love,


September 10th, 2011 at 19:10
Barbel Says:

Hi Jake
Thank you for writing about your experiences. It is nice to read how you are doing. You are in our prayers. To Ned!!