The Courageous Podcast with Ryan Berman

Robert Duran - Navigating Life with Pancreatic Cancer

Episode Summary

Our guest today defines what it means to be courageous. Robert Duran is a father, husband and passionate cyclist. For the last decade, Robert has been riding through life navigating the rocky terrain that comes with being diagnosed with what many call a death sentence in Pancreatic Cancer. In this very open and raw conversation with host Ryan Berman, Robert opens up about how he has been able to survive and thrive despite the odds against him. Robert shares how cycling has been a lifesaver during his battle with cancer, but was almost the thing that killed him. The two also discuss how “cutting the cord” from most electronics has allowed Robert to take his life back and live every moment in the present. It’s a moving and inspiring episode with a tremendous human being in honor of World Pancreatic Cancer Day on 11/17/2022.

Episode Notes

Our guest today defines what it means to be courageous.  Robert Duran is a father, husband and passionate cyclist. For the last decade, Robert has been riding through life navigating the rocky terrain that comes with being diagnosed with what many call a death sentence in Pancreatic Cancer.  In this very open and raw conversation with host Ryan Berman, Robert opens up about how he has been able to survive and thrive despite the odds against him. Robert shares how cycling has been a lifesaver during his battle with cancer, but was almost the thing that killed him. The two also discuss how “cutting the cord” from most electronics has allowed Robert to take his life back and live every moment in the present. It’s a moving and inspiring episode with a tremendous human being in honor of World Pancreatic Cancer Day on 11/17/2022.

Episode Transcription


 

(Intro Music 0:26-0:43)

Ryan Berman  0:44  

Pancreatic cancer has been called the king of cancers. It's a cancer that begins in the organ lying just behind the lower part of the stomach pancreas. There are fewer than 200,000 US cases per year. And many call it the world's toughest cancer. Few effective treatments. No early detection method according to PANCAN, and some would say it's a death sentence. My guest today is an eight-year, stage four pancreatic cancer survivor. Husband and father of two kids. He's my neighbor, he's my friend; Robert Duran, you're more than that to me. You meet people in your life and it's like, “Okay, this is my people.” Let's get rid of the small talk, let's get to it. We got things to do. But let's get to the most important question is, did you get your bike riding today, and if you did, how long did you go?

Robert Duran  1:58  

(Laughs) I didn't get my bike riding this morning, but I did get one in yesterday, and yesterday was about 15 miles. So, that was a lot of fun. I got the trails all to myself. Today, I went to the gym, did a little bit of a workout. I did some things this morning, also went to the beach.

Ryan Berman  2:20  

When you say the trails all to yourself are you like, “Yeah, get these kids back in school already. Get these people back in work already. I want the trails.”

Robert Duran  2:30  

Yeah. The trails were good. If you go early in the morning, you get it all and that's the story of my life is, I get up early, and enjoy what has been given to me. The joke for Robert actually is, I don't know the coast of our hometown after 9:30 in the morning (Laughs) All of a sudden with my kids and whatnot, because I'm out there in the morning, and I'm done when everybody else starts trickling through.

Ryan Berman  3:00  

And 15 miles, that’s… From what I remember, you're 15 to 30 miles a day or two, or is that a week?

Robert Duran  3:11  

No, that's right. It depends on what bike I choose because there's a full-squish mountain bike, there's a gravel bike, which is similar to a road bike, and whatnot. And so, I always said If I go out for 12 miles on my gravel bike, or on my mountain bike, that's equivalent to 20 miles on the road. Because, I'm working a lot more, and I believe, for me, I get better anaerobic because the power of mountain biking and gravel biking is one that you're always on and off the power to the pedals, whereas your road biking, you just got a really good cadence and you can go for hours. Can go to oceanside and back and you're done, and that’s 30 miles. That's easy.

Ryan Berman  3:56  

Easy for you. And I think I want to go back to this. It's been eight years now. It was 2014, I believe when you were, I think, out on a 35-mile bike ride, and, I don't know what it felt like, I'd love to get your take, where you just couldn't hydrate or rehydrate. Can you take us back to that day?

Robert Duran  4:17  

Oh, sure. The thing that I love the most that puts me in my happy space is cycling, and that was something that almost killed me if I hadn't ended up in the emergency room the next day. To break it down, I went on a 35, 40-mile ride with the local crew. And there's a bunch of different mix of riders, and there are a lot of A-type personalities, and guys that just want to hammer and run the pace. And so, we were running pretty hard. And when you're going on a ride, you hydrate, and then, when you're done with your ride, just like working out, you want to get the carbs, and the protein, and all the nutrients back in. Well, I, at the time, did not know I had a tumor in my pancreas. And even though my doctors were on the ball looking for it for one and a half months, I didn't know that until the next day. I had severe dehydration, and I had to go to the ER. I had double kidney failure, I had liver failure. It was a culmination of two weeks of just losing a lot of weight, and just being nauseous pretty much every day. So, what I love the most, and I still love the most, was something that almost killed me, but opened the next chapter in my life.

Ryan Berman  5:46  

What did it feel like? I know you said you felt you were throwing up a lot, but were you so dry? You kept trying to drink water, whatever you were drinking, and nothing changed.

Robert Duran  6:00  

See, pancreatic cancer is a disease that comes on really fast, relatively speaking, compared to other cancers, because diagnosed late. But, the acute phase when I was on my ride, I was drinking water, and I came home and I drank… Well, I drank a lot of water during the ride. After the ride, I ate food. Some chickens, some broccoli, healthy stuff. And then, whatever I ate did not go through my system. It was blocked because the tumor was blocking my intestinal tract. And so, whatever I was eating was not being absorbed, so it came back up the next day. And so, imagine all the water that I drink, it never replenished. So, imagine going out on a hike, 30-mile hike, or whatever, 98 degrees, and then, you never drank water and you never ate. That's kind of like what it feels like. And then, you start getting lightheaded, you feel you’ve been breathing helium. Lightheaded, you get delirious, and you just can't think straight for yourself. And your body starts shutting down, and I ended up in the ER.

Ryan Berman  7:15  

Again, the pancreas, I am clearly not an expert in cancer, but I'm trying to read up on it. I know where pancreatic cancer sits in deaths in the nation. I believe it's the 11th most commonly diagnosed cancer, but it's the third leading cause of cancer death in the nation. You've been able to Matador this for eight years against stage four. It is directly behind the stomach. I think it's been called the hockey stick gland, and, as you said, it's essential for digestion. If it was blocked, I could imagine nothing getting through. Because it's such an obscure part of the body, this is why it's hard to detect, and why it's found, unfortunately, in advanced stages. When you got it in 14, when you learned that you've been living with it, the five-year survival rate was only 6%. 

Robert Duran  8:18

Correct.

Ryan Berman  8:18

So, take me to the day the news is articulated to you. Mentality-wise, where do you go? Were you there by yourself? Was your wife with you?  What's the doctor like?

Robert Duran  8:33  

So, what happened when I was diagnosed, Ryan, back in April. This is the culmination of two and a half months of slowly dying. I had to go to the ER. My neighbor down the street forced me to get into her SUV, because I was in denial. I knew something was wrong but, call me hard-headed. I don't recommend that, go to the ER. So, I ended up in the ER, and they gave me the initial blood tests, found out that I was dehydrated. They found out that I was low on magnesium, potassium. Just typical case of someone came in with dehydration. After they did that, they set me up for an X-ray. The doctor is doing triage, “What's wrong with this guy? Why are you here? What happened?” So, they're going through their progression. They found out that my insides... What did the doctor say? The ER doctor came back and said, “Robert”, he put it to me in bicycle terms. He goes, “Your insides are kinked like an inner tube.” And at that point, I knew something was wrong. He said, “It’s kinked, and that's why what you've been eating, and what you've been drinking these past two months has not been going inside you. You've been slowly starving to death.” He said there was something that was causing pressure that was not allowing any of the food to go in. And so, they had admitted me, and the next day, they set me up for a CT scan. And the T scan actually showed really nothing. The next day, they gave me an endoscopy, where they stick a tube down your throat with a camera, and they navigate around. The doctor said, “Hey, you know what? There's something really narrow in your stomach after the first turn, and it shouldn't be there. So, there's something externally causing your insides to kink and not allow you to digest your food.” The next day, they set me up with another CT scan with contrast, and they found it. A golf ball sized mass in the middle of my pancreas that had sucked up part of my intestine, and my pancreas was inflamed, and that was causing me to slowly starve to death. Two months.

Ryan Berman  11:03  

For two months, they said that it had been going on.

Robert Duran  11:07  

Yes, two months. Yeah. And so, this is over the course of two days, they were going through this diagnosis. And that's when the doctor came back and said, “Robert, we found a mass in your pancreas.” Right then and there, I knew in the back of my mind that it was pancreatic cancer. 

Ryan Berman  11:26

Wow. 

Robert Duran  11:29

Well, you hear about pancreatic cancer, you hear about all the famous actors. You hear about the Supreme Court justice. You hear about Patrick Swayze, and you hear about this. You hear about somebody who was diagnosed with pancreatic cancer, and, all of a sudden, three months later, they're gone. And that's what I knew about it. When someone says, “Mass in your pancreas,” the first thing that I went to was, “I've got cancer.” And so, that's what the diagnosis was, obviously, they did a few more tests to confirm that, but I had already knew what it was. The surgeon came in and said, “This is what we think it is, you have a 94 to 96% chance of dying first three months, to the first six months. And so, you should start thinking about things. Get your life in order.”

Ryan Berman  12:25  

So, clearly, this is in person. 

Robert Duran  12:27

Yeah.

Ryan Berman  12:28

Did you go alone? Did your wife go?

Robert Duran  12:30  

I was alone at that time because I had gotten admitted into the hospital two days prior, and this was during the day. My wife was going to work, my kids were in school, and I said, “You know what? Go do your thing. We're going to figure this out, and I'll give you an update later.” So, I was alone when the doctor came back and said this is what it was.

Ryan Berman  12:50  

I appreciate you letting me be direct on a lot of this because this is not a… I'm sure you've told this story a hundred times, but still, emotional to hear it. In 14, how old are your kids?

Robert Duran  13:06  

My kids are at 14 and a half for my son. He was a freshman at high school. And my daughter is in fourth grade, and she's 10.

Ryan Berman  13:12  

That's today, right? 

Robert Duran  13:15

Today, today.

Ryan Berman  13:16  

Eight years ago, you got a six-year-old...

Robert Duran  13:20

And a two-year-old.

Ryan Berman  13:23  

Okay. And you're told to get your affairs in order because of the data. Does that rattle you? How could it not rattle you? It’s like waves. The first wave is, “There's a mass, you've been starving to death for two months. It's cancer, by the way, it's not just cancer, it's pancreatic cancer.” Where's your mind in all this?

Robert Duran  13:47  

I had two lines of communication that were given to me. One more line other than, “Get your affairs in order.” The other one was, “Hey, there's things that we can do, and if you are able to survive after surgery and chemo, you can act like this never happened before.” But, when I hear that, you look at the percentage. There is some light at the end of the tunnel, so part of that did give me hope. And as a cancer patient with probably the… Wll be the most lethal disease coming up here in 2023 or 24 they predict, that gave me hope that I can beat this or survive with it. Does that make sense?

Ryan Berman  14:53  

It does. Let's cut to the chase here a little bit. It's eight years. Here you are, and so, that alone is awesome. It's amazing that you’re… You talk about hope, Right? And, I guess, the more you go through it, the more you're still here. Does hope grow with every day?

Robert Duran  15:22  

There's two ways to look at that. The longer you survive, the closer you are to death within the five years. And my cancer has come back three times since 2014. I haven't talked about all of the reoccurrences and all the surgeries that I've had that has allowed me to be here talking to you right now. In one sense, hope is good because everyday scientists and researchers are discovering new, effective therapy for pancreatic cancer. What comes with it is better patient outcomes, and so, that alone is hope. But, the other part of hope is being alive and doing what I do every day. Dealing with this terrible disease that 60,000 people this year alone in United States will be diagnosed with. If you know the percentage, not many of them will be left within five years, and the majority of them will be dead within three to six months.

Ryan Berman  16:34  

Yeah. One of the things I enjoyed about some of our past conversations. Yes, the data back then said 6% survival rate over five years, but you kind of looked a little bit deeper at that data. You ask some pretty smart questions to the doctors to get to your conclusion that, Okay. Hold on now. Wait a minute. Let me stay laser-focused on me, not on everybody else.” This is where I wish we weren't just doing audio, because, first and foremost, and I think it's better coming from you. If you are going to explain visually what you look like, tail to tape. How tall are you? What do you weigh? Is that what you weighed back in 2014? Have you always been consistently at this weight? Can you give a little description of the physical makeup of you?

Robert Duran  17:25  

Right now, I'm high speed, low drag, I don't have any hair, but that's because I haven't had hair in 25 years. 

Ryan Berman  17:34

Me neither, but the way. 

Robert Duran  17:37

(Laughs) So, I wasn't worried about, “Oh, you're going to lose your hair.” “Okay. What else is next?” You may go, “Well, how about eyebrows?” 
Do you need eyebrows?” And I go, “What else?” “Eyelashes,” and I thought, “Oh, wow. Those keep stuff out of your eyes, and I ride my bike a lot.” I'm thinking about things that are not what normally people think about when you get diagnosed with this, and you have to get this type of therapy. When I was diagnosed, I was 215 pounds.

Ryan Berman  18:11

What are you today? 

Robert Duran  18:12

I'm 168 pounds right now. 

Ryan Berman  18:16

Wow.

Robert Duran  18:17

My lowest weight was 158 when I had gotten discharged from the hospital in 2014 after my surgery. I was only about my wife, Celine. She's  5’8”, 138 and a solid water polo player, but I was only 20 pounds heavier than her. Something like that. Right now, I’m sitting at 168. I had a lot of muscle, but I also had a lot of fat. My diet wasn't particularly the best, and I was the type of guy that I would have two breakfasts, I would have two lunches, two dinners. I would have a few beers in between, and maybe I would go out with the guys on the weekend and have more beer. I was always the last guy standing, which was great for bragging rights, but not really good for health.

Ryan Berman  19:06  

Well, maybe there is something to like, okay, the last guy standing, the irony. There is a mentality and a grit level of not saying you always want that when you're going out and having beers, but that mentality. And I think, again, the types of questions you're asking your doctors about the data. I’m trying to get to your version of the truth, I guess. Can you share a little bit about the questions you're asking? Again, you had to come to some conclusion that there was truly an opportunity for hope, versus a false version of hope.

Robert Duran  19:45  

Sure. That's a good question, Ryan. When the experts tell you these are what the numbers mean, they give you… At least, they gave me, from my experience. And this is similar to a lot of the experiences that I ever heard from other cancer patients that were recently diagnosed, is they gave me a blanket percentage. 6% chance that you're going to be alive, plus or minus, we’ll stay with that. And I had asked, “Well, can you tell me how did you derive that number?” And It was, “Well, that's just the general number.” And I go, “Well, can you tell me the age distribution? Can you tell me the types of people who passed away, and what condition they were in?” And they like, “Well, that's just that, and you can go here and read about it.” I'm just like, “Are you kidding me?” You're doing me a service for finding out what was happening to me, but you didn't tell me what that means to me ultimately, and how to fight this.” And that still is part of the challenges with diagnosis today, with at least pancreatic cancer. I had to break it down manually. I had to understand what the absolute truth was, and then, how I move myself from that percentage to a more safe percentage. To where I feel comfortable with my diagnosis, and I feel comfortable with attacking this disease. No one will tell you that, unfortunately. There is no third party. There's no nurse. There's no department in any of the hospital centers that I visited, or that I've learned about through other pancreatic cancer patients that will tell you exactly how to survive when you've got this terminal disease. It's just, “This is what we're going to do. Here's the standard of care. We're going to inject you with this, and we'll see what happens,” and that's it. For a first-world country that needs to change and it is changing.

Ryan Berman  22:18  

Well, some would say that I tiptoe into the self-improvement space, and yet, in this scenario, you had to improve yourself. You had to keep going. I try to imagine what most people would crumble or feel. It’s human nature, it's not one person's strong and one person's weak. If you're in a room with a hundred people, and 94 of you, which is what the numbers were... By the way, the numbers are up to 11% now, it’s almost doubled. That's progress report, right? And I'd love to hear what's changed over those eight years that's gotten us to 11% now. Didn't the doctor also say, or one of your doctors look at you... Let's call it what it was, a deliberate interrogation, but a necessary one, to get to the truth. He responded badly. One of your doctors was like, “Oh, you've got what it takes.” Can you share a little bit about that story?

Robert Duran  23:33  

Sure, thanks for remembering. I remember we had a chat one day, and I told you. This was earlier on in 2014 when I was initially diagnosed, I had to go through chemotherapy. I had met a doctor over at the clinic where I was getting my infusion. This infusion, if you imagine, you walk into a room, it's about a fairly smaller infusion center compared to the major infusion center at UCSD, which is, by the way, is where I'm being treated at. This is probably a 5000-square-foot facility. So, we're not large for a clinic of that size, and there's about 30 seats in there, and it's big, but small. And I asked the doctor, I said, “How do people do with this chemotherapy”, as they started to put the drugs into an IV that was actually connected to a port. When I say a port, it's not an IV in your arm per se, it's a port that's in your chest. And because they give you a port in your chest every week you go in, it's easier to hit that port and pour the chemicals in there, as opposed to searching for a vein. And that could cause problems because you might not be hydrated enough, and you can have problems. So, I asked him, I go, “What are the odds of beating this type of cancer?” He looked at me after about four weeks I was there, he said, “Robert”, he said, “You're going to be fine.” He said, “I see a lot of people come through these doors, and a lot of them do not have your…” What did he say, “Your demeanor, and your positivity. And you're healthy, and you want to take care of yourself, and you're taking charge.” I didn't really understand what he meant at that time, but he looked at me and said, “You're going to be fine.” And that's the hope that I got from that doctor, and that's really what a lot of us really need in life. Whether it's pancreatic cancer or not, it’s encouragement and hope that there is going to be a reward.

Ryan Berman  25:59  

Yeah. I am so not a doctor, at best I'm a brand doctor, a leadership doctor, I don't know. But I have to imagine if your body is already working against you, and then, your mind works against you. Your mind causes more anxiety, and more stress, and, “Poor me,” or… You are going the wrong way. I wonder -- again, I’m not the doctor -- the self-fulfilling part of it feels if you don't give yourself permission to truly fight. Did you feel that for your fight? You're still in it, but do you feel it every day? Are you still in it, and feel that? Like, you're just trying to stay positive, and stay in it, and stay hopeful. Is your mind working for you or against you?

Robert Duran  27:01  

That's a good question, Ryan, because… How do I even begin to answer that question? We could be here for hours. But I think the way to answer that question is, every day I wake up is a gift, and that's a gift that I've been given as a result of being presented with the worst gift that I got, that I never asked for. Almost to the point where I wouldn't even wish it on my worst enemy, it's just that debilitating. But my mind is completely opposite, so I've been told, than what a lot of people think where my mind is. And, you know how you can train, and you could face your fears, and you could rewire or remap the way your brain thinks of things. There's things that are very subconscious that are built into our minds that just work a certain way. There's a lot of people, let's say, first responders. They go through training to learn how to handle themselves, and civilians do that too. But some people are wired differently, and that's another discussion. But, for me, I've learned that dealing with the small things in life, using those things will actually prepare you for the heavy things in life. As opposed to, “Oh, Roberts got pancreatic cancer. He can beat pancreatic cancer, he can deal with everything.” It's actually opposite. It's dealing with the little things that control how your mind reacts that puts you in a mindset to do what you do, but if you can control that, you can deal with something that it's on a larger scale. Don't get me wrong, that person who hits the accelerator on the I-5 when you put your blinker on to prevent you from going in. Those little things, if you can handle those things, that will give you the tool to be able to be... At least, that's given me, in a nutshell, the ability to deal with this grave disease that I have every day. Does that make sense? It's a twist. It's completely opposite of what you would think, or most people would think.

Ryan Berman  29:48  

I love that, in some ways, when you make the world just small enough for you to get through the things you can get through, then there's an aggregate, there's a compounding factor to it. It's what I'm taking away. Which is cool because you've heard, “Get the big rocks first, and then, the sand is the last thing that goes in.” It's like, “No, actually put the time and the attention on the…” Shrink the world down, basically, to the little things. Question for you. Your kids are two and six in 2014 when they find this golf ball size mass in your Pancreas, and here you are. They’re now 14 and 10. This is a tricky one, you're Superman to them. They must be watching this Marvel or whatever they're watching, but you're defying odds. Is that a scary thought too? Because, their whole lives, you've always had adversity, and knock on wood, here we are having this conversation. Is that how they see it? Does this terrify you? Is this a good thing? Where's your mind on all this?

Robert Duran  31:11  

How deep do you want to go? That's a good question, and it's one of those things where… My daughter, for the majority of her life, she only knows me and what I've been doing. And my son, at six years old, how much do you really know? Remember at six? You don't remember much. Effectively, for most of even my son's life, he's 14 now. 14 minus eight, six, right? Majority of his life, they only know me as who I am. I face adversity every day. And do, my mantra, if you ask my kids, they get sick of, is “Adversity will give you the diversity to handle things that come your way that you never asked for or didn't expect.” But, on the other hand, this is where the deep part comes in, is I had to tell my son, again, last month, that my cancer had returned. Even though I'm at a one or 2% chance of surviving, because like I said, the longer you go, the more the cancer grows in you, and the more you got to fight, and you get collateral damage. I told my son that I was recently diagnosed, and I'm going to go through the same thing I went through the last time, and the time before that, and the time before that, three previous times. My son's a smart guy, smart kid, did a presentation on pancreatic cancer when he was in sixth grade. But I don't know, because he's not mature right now, doesn't have all the life experience at this age, I don't know if he really knows how dire of a situation someone with pancreatic cancer, late stage, could be. When I told him that I had to go through this again, he looked at me and said, “Dad, that really sucks, but, you know, you're superman, you're going to beat this, right?” What do I say to that other than yes? But, that is how much my kid is counting on me for not only going through my disease, but just that's how he sees me. My daughter, she doesn't know. So, I tell her things, I walk her to school. I tell her things for my benefit. We know your kids eventually separate and they are their own human beings. Just last week, my daughter goes, “Dad, I want to walk to school on my own. I can do it, dad.” And I said, “No, you can do it.” That was probably the hardest thing that I had to deal with recently because I'm not ready to let her go. Because every day I wake up, I don't know what the next day is going to be because cancer could turn on a dime. Yeah. So, it's one of those things where… The mindset is a battle, and that's what I go through every day, every day. But it makes me who I am, and that's what makes me want to do what I do.

Ryan Berman  34:54  

I moved in city five years ago, so I  never knew the 200-plus pound Robert. I can't even picture a 200-plus pound Robert, This version of you, like you said, the reprogramming your brain, and getting you ready, and getting you here. 

I love that we get a chance to spend some time together. And one of the things that I hope is, you're memorializing, or you're documenting, you're putting down your point of view, and not just for your kids. I know, they know how you feel, but I think it's critical, because when we talk about pancreatic cancer, it's called the king of cancers. And you look at the data, there aren't a lot of examples of people who are living today with pancreatic cancer. Is it important to you to let people know survivors are out there? That it is getting better? That you can make it? Is that critical to you, or are you laser-focused on your fight, and that's that, and your family? Where is the line on that?

Robert Duran  36:15  

I've learned that throughout my, I would say, I guess, battle, that the most critical thing for me to do is give back, and by faith, is what's kept me aligned. Whether you're spiritual, whether you have faith, whether you live the Word, whatever it is, helping others overcome their challenges is what we are here to do. And that gives me the fulfillment to continue living and helping those who have been recently diagnosed with pancreatic cancer, or going through their cancer treatment, to, at least, tell them my experience. Because, I have, oh, my goodness, I've had so many different treatments, so many different experiments done to me. I had to recover after each one, and I continue to get surgeries, which typically, is unheard of for pancreatic cancer patients. Typically, when you're metastatic, stage four, if it’s spread to other parts of your body, the doctors look at you and they say, “Sorry, we're not going to give you surgery.” But I need to reach out and tell my story as it pertains to me. And, if I save one person, and if they find what I say beneficial, then I have to memorialize this. And that's what's been slowly happening, Ryan, is typically I'm quiet, unless I talk about something that I'm very passionate about. This is something that I found very, I would say, therapeutic, but it's also something that I feel I should do based on my faith.

Ryan Berman  38:26  

So, I believe you're 55? 

Robert Duran  38:29

Yeah, I'm an old guy. 

Ryan Berman  38:30

You're an old man. Me too, I'm 45, 46. I stopped at 45. See what I did there? I was like, “No.” So, one of the things that I find fascinating is that, the older we get, the more we do things that remind us when we were younger assuming there was joy when we were younger, not for everybody. I got lucky, I had a good childhood. The older I get, the more I can return to my happy place, which is, I think of myself as a little boy. I'm trying to create those moments as much as possible for myself. It's not selfish, it just keeps me young, and I guess that's where the term comes from. Riding your bike, I think it is what it is for you. Is it just your version of a time machine that takes you back to you at eight? Is it a meditation opportunity? Where did this come from, and how important is it to you?

Robert Duran  39:33  

Good question. I think how I would answer that is, it does bring me back to my happy space, as I mentioned earlier, and you had just confirmed that you have a similar experience doing things that brings you joy, especially as a kid when we had no responsibility. (Laughs) So, yeah. I cut the cord in 2014 when I was diagnosed. Gave me a digital antenna, because the analog didn't work anymore. I cut everything. I got rid of all the electronics in my house, all the things that were there to fill something that I felt that I needed, all these new shiny objects. “Hey, look at, you can do this app, or you can do this, it's going to allow you to be in control of your life this much, even be more control of your life.” But 24 hours is 24 hours. I wanted to get back to the basics of just who am I as a person, and what makes me thick. To this day, I still don't have cable. Okay. Hold on, I might have Netflix for my kids, and a few other things, but that's it. I have a 53-year-old car, I drive it every day. It's because, in my professional career, I'm a Solutions Architect for a cyber security company. What we do is, we do a lot of things that are underneath the layer of the internet that nobody ever sees anymore. I see all that stuff, but I don't want to adopt all the technology. I just kind of want to take my life back. I want to be in control and I want to be pure. So, yeah. Cycling for me, it brings me joy, and it reminds me of the time my parents drove us through Europe in the back of the 72 Westfalia Van, going through France, the Pyrenees, everywhere. And, I think those days, it's good to remember, because now, in 2022, everyone's just, “Hey, we're on the go.” There's something beeping, there's something coming at you, there's an app telling you you missed this appointment, but you've got this latest app that tells you what's your next appointment. It's like, “What's going on?” One app is telling me to do something, I don't know which one’s that one. I had to get back to basics, and that's kind of what helped me deal with what I'm going through.

Ryan Berman  42:17  

And I know you ride now to raise funds for cancer research as part of Pancreatic Cancer Action Network community, PANCAN. I want to go back, I know we're coming to the tail end here this conversation, but you had said that there's now 1% chance, is that what you said?

Robert Duran  42:36  

No. if I did, I misspoke. Oh, no, wait a minute. As cancer comes back… Let's say, you have cancer, they resected. You have no evidence of disease. You're in remission. When it comes back, it's angry, and it's pissed off, and it could have developed some sort of a adaptations, or it could have adapted to be resistant to the drugs that you were taking previously. So, they give you the drugs that you got previously, and it doesn't have an effect. And so, now it's taking over your body. So, when you go metastatic, that's the point where, “Oh, crap.” That's 6% chance of living, you're now that much closer to the edge. Because they can't give you surgery, in most cases, they won’t because it's already spread. So, from a workflow perspective, it’s like, okay, you have cancer, you beat it one time. It's come back, it's already spread. We know that if we do surgery, the chance of you surviving is low, the risk for surgery is high. What quality of life are you going to get? The protocol says, “No surgery if you're metastatic.” That's just the system, that's the protocol, that's designed to get millions of people through the day, through the system a day, It's good, but on the other hand, it may not be what you want. But it came back not only a second time, a third time, and it's now my fourth battle. So, when you look at it, it's like how many hits can someone withstand? You're taking hits underneath the water line on the ship, and you're getting torpedoes. Or NFL player, ACL gets blown out, things start happening, and eventually, you go down. So, it's just a matter of staying ahead of the curve and being the best patient, and taking care of yourself, physically, as well as, mentally to be able to receive the treatment that they give you. So, that's what I meant by 1%. It's a challenge, but I still have gotten treatment, and I'm still battling it like I did three previous other times.

Ryan Berman  45:10  

You're not going the traditional chemo route, you're part of a new trial, is that correct?

Robert Duran  45:19  

Correct. I am. I'm in a clinical trial. So, if you can imagine a world where anyone with cancer no longer has to get chemotherapy, which has been around for multiple decades. It kills good cells, and it kills bad cells, and often enough, the chemotherapy itself, the side effects are so bad than the actual cancer, and then, there's nothing… Unfortunately, the patient can't deal with it, and it just goes downhill from there. And so, for me, I was lucky enough to participate in a clinical trial, and I was one of the very few patients in the United States ever to get this type of treatment. And that’s where they take your white blood cells, and they genetically modify them like spider-man, and they...

Ryan Berman  46:14  

I knew you were a superhero. I knew you were a superhero.

Robert Duran  46:17  

(Laughs) Genetically modify your white blood cells, or your immune system to recognize the cancer that your body previously was ignoring, and hopefully, it'll jumpstart my immune system to recognize the cancer in my body and destroy them. So, that's just one tack, one option that I have. And I've been very lucky to actually get that therapy because they only give it to very few, and it's still on early trials.

Ryan Berman  46:47  

How many in the US?

Robert Duran  46:49  

I think I was lucky patient number 13 for pancreas cancer. So, it's something that's new, and a lot of patients are asking me about it, so I have done some videos and put up a website to let them know, “This is what I'm going through, and if you survive first-line, and second-line therapy,” that's another discussion, “You can get advanced treatment. And these are one of the treatments that scientists and researchers are coming out on a daily basis that could save your life.” So, part of what I do is educate cancer patients on treatments that are coming out, and, other than that, just awareness and early detection. That's why the survival rate is higher because you can catch it at an earlier rate. People are more aware of what it is.

Ryan Berman  47:39  

Look, again, there's been a lot of smiles coming from you during this conversation. And for someone who has battled pancreatic cancer four times, and to still find the smiles and the joy, I’m sure there…  How much did you talk about faith, because I believe in that too, like, the universe. The universe has decided for some reason that we were supposed to meet. The universe decided that you are going to take it on four times, and here you are. And so, I'm sure you've thought a lot about this experiment called life. And I'm sure it forces you to think about this experiment called Life. So, I’d love to know -- again, this is a courageous podcast -- so, what's the lesson? What do you want people to walk away from? And I want to set up the second one because the second question is harder. What about for your wife and your kids, what do you want them to take away from this? The answers I imagine could be slightly different, but I'm curious, what's the lesson first for the listener as they go about their day, what do you think it is?

Robert Duran  48:53  

The way I would answer that question is, the lesson for the learner… It's not my place to tell people what to do, but it is my place to share my experience and how I've been able to deal with it. Whatever the takeaway is from my experience, however they want to use it, or not use it, is up to them because you are in control of certain things. There are things that you're not in control of. And I think my takeaway is this, because of my faith, because of my belief in why life is not truly my life, I no longer have to think of the inevitable of waking up maybe tomorrow when I've got this big pain in my stomach, and all of a sudden they say, “Robert, things have changed. this is bad.” That can happen tomorrow. Right now I'm okay, knock on wood. I could deal with that not knowing because of my faith. So, control what you can control, and roll with the things that you can't control, and that is what I would say about, that's the secret. Because when you worry about things that really have no bearing in what your mission, your objective is supposed to be, that's just noise. And there's a lot of mental, I don’t know, CPU cycles that’s making you be inefficient. And in reality, if you can block the white noise out, then you would enjoy the things that are in front of you. The present. Living in now. Because, again, it goes back to, “What's going to happen tomorrow?” And, every day I wake up, I live that. I don't just say it in passing. Do today because you don't know what's going to happen tomorrow. Well, you know what? When I woke up this morning, I'm lucky to be here, and that's what makes me who I am. And I just want to go out and share my experience with others, however that ends up. I have way too much to say based on my treatment.

Ryan Berman  51:43  

I love ‘control what you can control, and roll with what you can.’ It makes a lot of sense that you cut the cord when you did. We have stories being told to us, and we're just sitting there, marinating in other people's stories, versus cutting the cord and going on a 30-mile bike ride every day. Or, finding your happy place, and whatever it is that reminds you of you when you're happiest. I appreciate that, and I wish more people would be part of this is, how do you design the story for you? There's been many things that have happened in my life, not at, to be honest, at the extent of your eight-year spar, but I call them negative blessings. It’s the moments that have happened to me. And almost every time a negative blessing has happened to me, when I've chosen to look at it that way, that's the optimist in me, there has been good that has come of it. And as we get ready to wrap, I do want to hear, if you feel comfortable sharing, what's the lesson for your wife? What's the conversation like? What's the lesson for your kids? What do you want them to take away from this experiment?

Robert Duran  53:16  

That’s a good question. That also comes up to my absolute truth mantra. The truth is, I live life to the fullest every day. 150%, 125, whatever the number is. And I would say that I would live that way for five years, and now, I'm living eight.  I would live that way as opposed to living 20 years at 75%. So, the absolute truth to the other side of that equation would be, my kids and my wife would probably want me around for eight years, 10 years, that's 75%. And that is something that I cannot control. So, the only thing that I control is to spend time with them, and be a dad. I'm human, so I make mistakes, and I'm learning to be a better dad every day regardless of this pancreatic cancer. I want to let them know that, “You know what? The adversity that I face will give you the diversity right to live your life.” And that is the words that my dad spoke to me when I was growing up, little. And, hopefully, they can see by example. And, hopefully, they can see that even though I have this terrible disease, I'm still going out there and helping others. I do it because it's the way it should be, not because I have to do it, or because I have to repay all of the doctors and nurses, my neighbors that have been so comforting in my time of just fighting this disease. It's because it's the right thing to do. And, sometimes you do what you do, and that's what I try and do.

Ryan Berman  55:43  

Control what you control and roll with what you can, I love that. If you wanted to follow Robert’s story -- and Robert, man, you're an inspiration. I love that the world brought us together, and I'm happy to let the world know all about your story. You can follow his story at robertduranduran.com. I wish I can come across to you here on the Zoom call and give you a big hug, man. But I know I'll see you at the school, assuming your daughter will still let you walk a few steps behind her on the way to the school.

Robert Duran  56:19  

Yeah. (Laughs) I'm trying to figure out how I can do that without... You’re right. I don't know how I'm going to deal with it, but we’ll get there when we get there.

Ryan Berman  56:30  

Hey, adversity, right? Adversity brings what…? Got to figure it out.

Robert Duran  56:34  

Diversity. In a different stance, not the diversity that we hear about nowadays, that's good as well. But my diversity is you've got a different tool set, and you've got all these experiences that you throw in there. And that's what you bring out when you decide to face your fears. Hopefully, I get a bigger toolset to deal with this moving forward.

Ryan Berman  57:07  

Robert, keep battling, keep cycling, keep burning man. Thanks for joining.

Robert Duran  57:14

All right, Ryan. See you later.

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