Well, unfortunately, my lymphoma has returned.

This time it appeared in one of my testicles. I had that removed in early April, and now I am starting treatment. For those of you interested in the medical details, you’ll find them below.

Last time I went through treatment, I know a lot of you were interested in updates. So this time, I’m going to try to post regular updates at this web page: billonthecamino.com/cancer. I don’t want to fill up your mailboxes, so you won’t get email reminders when I add updates, but if you check the page occasionally, you can keep up with how I’m doing.

Thanks for the support that I’ve received from many of you already. It’s appreciated.

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Q: What’s the prognosis?

My oncologist says “our plan is to cure this.” And that’s very possible, but there are high recurrence rates, which means I could find myself doing more treatment in the future. At this point, nothing is life-threatening, it’s just a lot of treatment with plenty of bad side effects. So, we just have to go through this and hope for the best. If it permanently cures it, hurray! If not, we go down the next treatment path later.

Q: What treatment are you getting?

Since my lymphoma returned in my testicle, I have an increased chance of the lymphoma emerging in my brain, spine or other testicle. Those are locations that many cancer treatments have difficult reaching, so it means a multi-faceted response is necessary. Radiation and chemotherapy will be used to address the testicle, spine and brain. Then, immunotherapy will be used to address the rest of my body.

Here’s the down and dirty on all the activities planned:

1. MRI of brain to make sure lymphoma is not there.
2. Lumbar puncture (spinal tap) to make sure lymphoma is not in the spinal fluid.
3. While they’re in the spinal cord, inject some chemotherapy (Methotrexate) into the spinal fluid. This way, if there is lymphoma in the spine, we avoid having to do another spinal tap right away.
4. Use radiation on my remaining testicle. This will be 3-4 weeks of daily appointments. This should kill any lymphoma that may be there.
5. Go through 2-3 cycles of chemotherapy (High Dosage Methotrexate). This would help ensure there are no lingering lymphoma cells in the brain, spinal cord or testicle. I will probably have to be in the hospital 1-3 days for each cycle.
6. Go through CAR T-Cell therapy. This treatment takes a few months and it will attack the lymphoma across the rest of my body. This is a complex process. First, they take my T-Cells from my blood. Then, they genetically modify those cells in a lab. Finally, the modified cells are re-introduced into my body. The new modified cells are designed to attack the cancer cells, but unfortunately, they attack some good cells too.
7. Reaction to the modified T-Cells can be fairly severe, so for the first 30 days, they will monitor me very closely. For the first 7-10 days, I will need to be an inpatient. For the next few weeks, I will likely have to visit the hospital daily to be checked.
8. My immune system will be highly compromised so I will be isolated for much of this treatment. 3-4 months after the CAR-T treatment, I should be able to live a pretty normal life, although my immune system will be weak for quite a while.

I’m already done with #1 through #3, and things are going well.

I expect all of the treatment to be complete by end of summer, and hopefully I’ll be fully recovered by the end of the year.

Q: How are you holding up emotionally?

It was a bit of a gut punch when I first learned about the recurrence. I knew it was possible, but didn’t expect it to be back just one year after I finished treatments.

I find that my attitude improves as the plans for treatment solidifies. When you have cancer, your number one priority is getting rid of it, so you’re anxious to get started. Now that I have everything scheduled and underway, I’m more positive.

That said, the next 3-4 months are going to suck. Looking at the whole list of treatments is overwhelming, so, like the Camino, I need to take things one day at a time. I try to do that, but still find myself with some anxiety.

One thing that is brightening my spirits… three of my loyal blog followers are walking the Camino this summer! Beth from Wisconsin is walking the Camino Frances right now with her husband Jay. Sarah from New York just started walking the Camino Portuguese. And, Kari from California will be on the Camino Frances in a few weeks. I can’t walk the Camino myself this year, but I love following my friends as they walk.

Oh, and one more thing to celebrate. On February 22, our first grandchild was born! Emily Kay Wrobleski. My son, his wife and Emily live only about 3 miles from us, so Grandpa will be doing lots of spoiling. Photos below.

Q: When you are healthy again, what are your Camino plans?

I had plans to walk Caminos in California and Cornwall this summer. Unfortunately, those plans have had to be cancelled. I hope to be back on the trail in 2027. No concrete plans yet, but I am feeling a strong pull toward Santiago de Compostela. I’d really like to walk back into the square in Santiago again, free from cancer.

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Ladies and gentlemen the newest pilgrim in the family… Emily Kay Wrobleski. (I’m already her favorite, btw.)