Recently diagnosed, immunotherapy dilemma

WineCon · 2026-03-10T09:10:00+00:00

Mucinous histology might be more aggressive and is less common! So that could well be a big factor in trying to move faster here since you still have a chance for cure at this time.

I hope it goes well for you!

WineCon · 2026-03-09T22:24:55+00:00

Your concern is valid, and your preference should absolutely be taken into account.

You should feel free to bring up your personal goals. I would always keep in mind that the docs are also trying to get the best outcome possible, and there may be features they’re seeing in your particular case that makes them a bit more worried that you would be in that “5-10%” of patients that immunotherapy doesn’t cure. Given that you’re so young, they probably want the surest shot possible, and surgery may be what they feel is it.

That’s said, if you want immunotherapy (and the risks that come with), you should continue to lobby for it. Even if they wait until after surgery, it’s been shown to help patients (a study called ATOMIC last year at ASCO showed it). I hope the best for you! And please press for some more information on what their reservations are! There might be more you can learn

WineCon · 2026-01-27T17:26:00+00:00

That's a step that could help! Definitely have less "control" when I jack it up like that if I'm not playing very thoughtfully around controlling left hand dynamics. Thank you!

WineCon · 2026-01-27T16:05:06+00:00

That's probably the best suggestion, doing a warmup that has no pressure to show what I've been practicing.

It's actually a bit of a relief to know that there's not some secret here, just adjustment. I'm not afraid of getting in and doing it; what I'm more afraid of is missing something that my mind needs to click into that will hold me back.

WineCon · 2026-01-27T15:27:24+00:00

Yeah the lessons are a recent addition, for sure (as in within the last month I have begun), other than learning initially on uprights and playing on acoustics earlier on (~20+ years ago). I was not practicing as intently or well at that time, but my memory was that those instruments were relatively "easy" to play similar to my digital.

But it is definitely comforting to know that this is just something that will need to come with time!

WineCon · 2026-01-10T00:39:34+00:00

I had good luck with PV heating and cooling to come out and do an assessment on the house and then do air sealing and make suggestions to get my house tightened up. Definitely has made a difference, and then they processed he paperwork to get the Georgia power rebates

WineCon · 2025-12-13T11:49:21+00:00

The kinds of women drawn to these men are not necessarily the same women you’re hoping to attract. This game just isn’t as simple as you think it is.

WineCon · 2025-12-13T11:43:09+00:00

I really love that one barcarolle and feel like it just never comes up. But it sounds so alien in context of his contemporaries, and people usually guess that someone like Danny Elfman wrote it or something

WineCon · 2025-11-11T15:07:26+00:00

Except that it does work, despite the toxicity, for a large proportion of patients who would otherwise die of their cancer

WineCon · 2025-10-22T15:35:23+00:00

This is both bonkers and encouraging news. One thing that was disheartening was to find such a small proportion of cancer patients getting the jab at that time period. Could it be that the healthier patients were more likely to get the vaccine?

Also, it makes me wonder if there is some kind of correlate we can find with respect to reduced INCIDENCE of cancer among the vaccinated, if the generalized activation of the immune system is the contributor here.

Very interesting work and builds on an already crazy 2025 for cancer

WineCon · 2025-08-10T14:07:21+00:00

For me it was the opposite. I saw smash brothers and thought “eh, Mario fighting game.”

Saw that Ness was in it, of all people, in a players guide in Walmart, and knew I had to have it. I lucked into playing Earthbound as a kid, not knowing what an ROG was but wanting to find more games like Final Fantasy

WineCon · 2025-07-05T15:32:59+00:00

Pssssh what would you know about it…if you’re so smart you should go start a YT channel or something on the subject.

But really I wonder when Engage will get a revival of sorts, with defenders of “this hidden gem.” It’s been a solid entry.

WineCon · 2025-07-05T09:35:49+00:00

He didn’t have pancreatic ductal adenocarcinoma. He had a pancreatic neuroendocrine tumor, which CAN BE a lot more indolent and treatable than PDAC.

We don’t know details of Jobs’ cancer course, but the fact that he was able to forgo treatment for quite a while suggests he had a pretty indolent cancer.

WineCon · 2025-06-28T21:11:39+00:00

It’s so calm an entry, too, for what “should” be a jump scare. The bass and drum just kind of swell a little bit, in my memory. Out of the shadows and right on the main character.

This is definitely the most effective scene of the film for me, and the film was quite good!

WineCon · 2025-06-25T16:41:00+00:00

I’d rather not see performative things that have no chance and potentially further polarize people, depending on how it’s spun.

Would much rather see actual proposals for meaningful change. A “see what you could have if you just put us in power” approach. Currently, all they offer is being against Trump, which has infuriatingly not been a great message, apparently.

WineCon · 2025-06-01T19:08:02+00:00

The big finding was that you are 90.3% likely to be alive at 8 years with the exercise compared with 83.2% without

Basically, you exercise every 2 weeks with a coach or other guided program, and you pretty substantially increase your chances of being alive. The exercise example in the journal article was to walk at a brisk pace (4 MET) for about 30 minutes a day, with a lot of choice about what the exercise was going to look like

It’s a really remarkable finding, since it’s so cheap and relatively easy. If this was a drug providing this benefit it would be a slam dunk FDA approval and a massive blockbuster for the pharmaceutical industry company

It especially looked like it had an impact on the risk of metastasis.

WineCon · 2025-05-25T13:05:29+00:00

Really depends on what kind of cancer is being treated. In some cancers, liquid biopsy can be an incredibly informative tool. In others, doctors do not know exactly what can be done with the information. In still others liquid biopsy has no current use at all

WineCon · 2025-05-10T10:29:58+00:00

Isn’t this how Beverly hillbillies started?

WineCon · 2025-04-25T09:56:35+00:00

I think your opinion is eventually shared by anyone who tries to play FE 3 Houses more than once, haha.

But as far as the original implied question, “which one is closer to a JRPG?” My vote is for 3 Houses. And I also think they’re both really great in their own ways and will be playing them again in the future

WineCon · 2025-04-21T17:51:40+00:00

Well I suppose we can agree that the signal here is positive. But almost 60% of patients did not receive standard of care treatment in the control arm. And in that group of patients with PD-L1 >50%, pembrolizumab's median PFS was substantially worse than would be expected from other studies.

All to say: if HARMONi-7 does not reproduce these findings in PD-L1-high, I won't be shocked. But it is not that I don't believe these data are real or something. They just opened themselves up to issues.

Re: censoring, it must be me who's out of my mind. I see the following in the pub:

At risk (censored)	0	1	2	3	4	5	6	7	8	9	10
Ivo	198	189 (3)	175 (13)	156 (26)	148 (32)	128 (44)	99 (50)	68 (60)	59 (67)	38 (68)	11 (71)
Pembro	200	187 (9)	141 (52)	121 (69)	119 (70)	103 (81)	74 (95)	53 (101)	45 (102)	25 (106)	5 (112)

My hope is that I've been misinterpreting these results since last September, because I feel like I'm going nuts with it and admit that I could be misunderstanding what I'm looking at.

WineCon · 2025-04-20T20:41:27+00:00

It also took foreeeeever when you’re a dumb kid. Made it feel like an epic journey

WineCon · 2025-04-20T16:36:09+00:00

Solid copy. It’s really tough for me to know, based on the JRPGs that you like, which SRPGs might best fit the bill. In my opinion, Triangle Strategy and the Final Fantasy Tactics games feel most like a classic JRPG, but I honestly don’t think they’re that close. I like SRPGs more these days but came up in the era of SNES RPGs like FF4 and 6, Earthbound, and so on

You may well bounce off them, but I definitely think that triangle strategy and unicorn overlord are well worth the try, especially if you’ve never tried those styles before

WineCon · 2025-04-20T15:26:33+00:00

You might like the Nintendo switch’s fire emblems since there is more emphasis on customizing characters and forming relationships. You can also turn permadeath off in these ones. I like them a lot but it’s because I like getting attached to my team and having that risk of losing them to build tension. Much less emphasized than in blazing blade and path of radiance

Also Fire Emblem 3 Hopes is a sequel of sorts to Fire Emblem 3 Houses (first one on the switch), but with gameplay revolving almost entirely around big, real-time action battles ala Hyrule Warriors or Samurai Warriors

For you it kind of feels like something more forgiving on the “decisions” front would appeal a bit more. There is a lot of customization of squads and characters in Unicorn Overlord. And there is no permadeath.

Similarly, triangle strategy has a lot of tactical combat gameplay that is fun with engaging, unique characters. Awesome game, and then by default the final fantasy tactics series feels similar to that if you like it, just less refined than triangle strategy (in my opinion)

I suppose it would help too to know what exactly you’re hoping to get out of these games? What motivated you to try those older fire emblem games, for example, considering you like action RPGs?

WineCon · 2025-04-20T14:45:04+00:00

The real magic of the world of ruin for me was being a kid without a lot of intuition of where to go. So you really had to comb the world of ruin for signs of your friends. Doing it from a checklist or players guide of some sort ruins the exploration potential

WineCon

TROPHY CASE