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Jul 26, 2022

This week Randall sits down with Robert Duran from Encinitas, CA. Robert’s inspiring story fighting pancreatic cancer while never losing his community and cycling spirit is lesson to us all to continue pedaling forward in life.

Episode Sponsor: Hammerhead Karoo 2 (promo code: thegravelride)

Robert's Links:

https://pancan.org
https://robertduranduran.com
https://www.pancan.org/stories/not-just-a-patient-a-survivor/https://youtu.be/fS9Q1BT8Za0

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Automated Transcription, please excuse the typos:

Robert Duran

[00:00:00] Craig Dalton: Hello, and welcome to the gravel ride podcast, where we go deep on the sport of gravel cycling through in-depth interviews with product designers, event organizers and athletes. Who are pioneering the sport

I'm your host, Craig Dalton, a lifelong cyclist who discovered gravel cycling back in 2016 and made all the mistakes you don't need to make. I approach each episode as a beginner down, unlock all the knowledge you need to become a great gravel cyclist. This week, I'm handing the microphone off to my co-host Randall Jacobs for an interview with Robert Duran Robert's of four times stage four, metastatic pancreatic cancer survivor. And the cyclist. I think his story is going to be an inspiration to anyone listening. Robert's been through the ringer, but never lets it get him down.

He's out there every week, riding his bike, regardless of whether he's getting chemotherapy treatments. Or some experimental drug he's pioneering for the benefit of all those who suffer from pancreatic cancer.

As a cancer survivor myself, I really enjoyed hearing about Robert's journey. I certainly drew some parallels to my own experience many years ago.

I've included some links in the show notes for how you can learn more about Robert's journey. And a fundraising link for his pan can purple stride campaign. He was the number one individual fundraiser and his teams have garnered over $31,000 in donations for pancreatic cancer research.

I hope you'll take a moment after learning Robert's story and donates to his fundraising campaign. Before we jump into rental's conversation with robert i need to thank this week sponsor hammerhead and the hammerhead Karu to computer

The hammerhead crew too, is the most advanced GPS cycling computer available today with industry leading mapping navigation and route capabilities that set it apart from other GPS options. Free global maps with points of interest, include things like cafes and campsite means you can explore with confidence and flexibility on the go.

I've had a bit of a funky schedule the last few weeks and only had about an hour or so to ride when I've been heading out. And I've really wanted to do something new here in mill valley

I've been exploring some of the lesser known fire roads and how they connect to the various paved road neighborhoods in the hillsides, across from my house. And I've been using the crew two's mapping feature, which I've always appreciated having that color screen and the ability to kind of pinch and zoom and move around.

Has been instrumental in me unlocking a few new pathways through mill valley, which has been a lot of fun. I remember at one point in my first ride thinking about exploring and I was about to pull out my phone to use that big screen, to find the road in the trail and how they connected. And I remembered the hammerheads got that same kind of screen resolution as a mobile phone.

So I was able to kind of pinch in, find the trail where it was going to connect and navigate through this neighborhood. I've never been in, it was a lot of fun. And while it wasn't the purest of pure gravel rides, it was a real fun adventure for me when I only had a small amount of time.

As I've said before. Hammerheads mapping functionality is really where one of the areas where it shines big time for me, I remember in the original device, that was what blew me away. And now that they've reduced the footprint in the size of the device. It's spot on exactly what you need. You know, you can customize it as much as you want in terms of what's on the screen.

You can set up as many different swipeable screens as you like. It also has the buttons on the side. So if you've got a glove that doesn't have any capacitive touch to it, You can still navigate. Through your hammerhead.

I encourage you to give the hammer head to look. It was Nanda, bicycling magazines. Editor's choice award for GPS cycling computers the last two years, and continues to collect accolades from many more people beyond myself. For a limited time, our listeners can get a free heart rate monitor with the purchase of our hammer. Head to computer, simply visit hammerhead.io right now and use the code, the gravel ride at checkout to get yours today. This is an exclusive limited time offer only for my podcast listeners.

So don't forget to use that promo code, the gravel ride, and that's a free heart rate monitor with the purchase of the hammerhead crew to go to hammerhead.io, add both items to your cart, insert that promo code, the gravel ride. And the price of the heart rate monitor will disappear.

Big. Thanks to hammerhead for continuing to sponsor the show. And with that, let's hand the mic over to Randall and his conversation with Robert Duran.

[00:04:37] Randall R. Jacobs: Robert Duran, welcome to the podcast.

[00:04:40] Robert Duran: Thank you, Randall. How are you?

[00:04:41] Randall R. Jacobs: I'm doing well. I'm really glad to be finally having this conversation. You're somebody who I've had the pleasure of interacting with in a couple of different forums. So far, both as one of our riders and then as a member of the, the ridership community. And as I've gotten to know your story, I've just found it really compelling.

And I thought it'd be a, a great story to tell here on the pod. So thanks for coming on.

[00:05:02] Robert Duran: Thanks for asking me finally get a chance to tell my story that that I'd been asked to tell over and over again for the past eight years, but,

[00:05:09] Randall R. Jacobs: Yeah.

[00:05:10] Robert Duran: glad I'm here.

[00:05:11] Randall R. Jacobs: yeah, I would imagine it gets it gets repetitive. You have kind of your, your canned responses or what have you, and, and, you know, today we'll just have a, have a conversation about, Who you are and how you got here. And maybe we can just start with just give us a little bit of background about yourself both in a general sense.

And in terms of your relationship with the bike.

[00:05:31] Robert Duran: Great. Let's, let's do this. I, I think I'll start top down. I think bottom line is let's see, I'm an old guy. Yeah, it's, it's really funny. I'll, I'll back into that later, but yeah. I I've, I, I live here in Encinitas and I've been here for about 16 years now, but I lived all over the world.

My dad was in the United States Navy. He joined the Navy to escape from the Philippines. Know the country had invaded. His country in his village and did horrible things when he was child. So he knew he needed to get out to live in a better place. So he made his way to the United States and he had my two sisters and myself, I'm the middle child.

And and so basically I, basically was Had a very interesting childhood, but through all that and that's another story by the way. I I lived here in two thou. I got here in 2004. From the bay area, I lived in the bay area and I was doing a lot of.com, a lot of high tech stuff, and it was great, but I left the bay area to move to the beach, to just have more of a quiet, relaxing lifestyle.

But I still hung onto technology. But it was a good trade off. Right. So I got married, had two kids. And then roughly, I would say 10 years later, I was diagnosed with my terminal disease and I've been living ever since, and it's been eight years now. So that's kind of like me as far as you know, the beginning so we can take it wherever you want to, because this could be a really, really long story.

[00:07:09] Randall R. Jacobs: Sure. Yeah. And so this your diagnosis, what year was that?

[00:07:14] Robert Duran: 2014 It was 2014. A matter of fact the thing that I love the most is is what helped the diagnosis. I was losing weight and I had indigestion and I had bouts with nausea once a week or so this was roughly late 2013. And whenever I would overindulge. Food, so to speak. I would feel a little bit of heartburn, little pain in my stomach, and I thought, well, maybe it was too much habanero I live in San Diego.

They, they make really good breakfast burritos, you know? And and and so I, I just did what the normal person would do. Just go to two the pharmacy and just get semantic acids and whatnot, and didn't work. Sometimes it would get better, but it would progress. So one, one day a week I would feel nauseous and then it would go two times a week and it would go three times a week.

And so eventually it got to the point where I had to go see my GP. And they kind of did just the normal testing, which is what they normally do based on protocol, which is a good thing. Right. I could talk about protocol being a good thing and a bad thing, but it's necessary. It it's what moves the millions of people through the health system on a daily basis.

Right. And it gets us to where we are today. But after a month and a half of that just didn't work and A lot of testing, a lot of antibiotics, a lot of things, just take this, come back see how you feel. And, and by then, what we didn't know was I had a tumor in my, in my pancreas that was just growing.

It was doubling. I mean, it was, it was growing pretty fast to the point where it was closing my part of my upper Gira. So there's the, after the stomach, there's the Geogen and there's the, there's a duo num where it takes that first turn. And then there's the second turn and that's where all the food gets absorbed.

So to speed all the nutrients right after it comes down from the stomach, and that was closed off because the tumor was just getting too big and eventually I kept losing weight and they couldn't find it, but I was pretty heavy at that time because I had kids and I gained weight. Yeah. Yeah. I gained a bit of weight, so I was happy to lose weight.

I really was. And so I was riding, I kept riding and there's a local crew that I ride with on Tuesdays and Wednesdays. And we went on a, on a 30 mile ride and I was riding, riding, riding. I did really well was drinking water on the bike and I got home and I tried to rehydrate, like we always do.

Right. And And I ate again and tried to get the calories back in me that evening. I ended up throwing up and that's pretty much my life for three weeks was laying on the bathroom floor on my side, withering in pain until my body would force the food and liquids that I consum. The entire day out, and then I would feel better, but then it would just repeat.

So if you can imagine going on a ride and never hydrating yourself and never giving and never filling yourself back up with the energy in the calories and the nutrients. That's what put me in the hospital. I had double kidney failure. I had li I had liver failure. Sorry. I had double kidney failure. Yep.

And then I had liver failure. I, my body was just done. And that's when they found that I had a tumor after a few tests, the doctor at the, at the emergency room came back and said, Robert, your insides are kinked like an inner tube, and that's why you can't eat. And that was the first time I realized what was going on.

He put it to me in terms. Bike terms, like we all know what a kinked inner tube is, and we know what it looks like when you frame, when you pump up that inner tube, it's just it's kinked. And so that's why, when I was eating, nothing was going down, nothing was being absorbed. And at that point a few more tests later, they confirmed that I had adenoma carcinoma of the pancreas and it was stage three.

And yeah, that was the start of my journey.

[00:11:37] Randall R. Jacobs: And stage three is to clarify for those who might not know, what does stage three mean and how many stages are there?

[00:11:44] Robert Duran: Well, stage one through four four being its metastasized whatever you had inside you has now metastasized traveled, so to speak to other parts of your body and it's no longer local. And when that happens, That means that cancer has spread. In my case it was stage three, which means that it did spread outside of the immediate local area where my tumor was living, which was in my pancreas, in the middle part of my pancreas, but it actually sucked up part of my upper GI tract because of the way the GI is positioned near the pancreas.

The pancreas is behind your stomach, so to speak. And so. The tumor was growing and it was blocking my upper GI tract. So nothing was going down and my pancreas was inflame, stretching it stretching it, I would say, not vertical, but horizontally kinking, my upper GI tract. So, and yep. No, because it had spread outside of the actual immediate area.

Involved other body parts. It was stage three. So, yeah, and the sooner you catch any cancer, right? The better chance you have to, you could survive. But once it's later, stage three, stage four, you know, the odds drop. I was, I was told that the chance for me to survive at the time when I was diagnosed in 2014 was. 6% five

[00:13:17] Randall R. Jacobs: a five year survival.

[00:13:19] Robert Duran: five year survival rate was 6% with the majority of those diagnosed with pancreatic cancer pass within three to six months because pancreatic cancer is discovered out of all cancers pretty much late because it disguises itself. And so, yeah, I had a lot of work in front of me, but that's how it happened.

[00:13:42] Randall R. Jacobs: What was, I mean, obviously that is a, a hugely traumatic thing to find out. And yet here you are. And one of the things that I have noted about you and, and that really made me wanna to, to bring you on was just your. The positive attitude you bring to life and your kindness towards others and your enthusiasm, and the fact that you are still going strong.

And in fact are probably a much stronger rider than many of our listeners despite the ongoing treatments that you have. So I'd love to hear a bit more about that. What was your, your, you know, emotional journey with this or spiritual journey with this?

[00:14:18] Robert Duran: You know, I I've struggled with trying to identify why I've been able to react the way I I did. And a lot of it is learned, right. Trials and tribulations. A lot of it was probably what. I was born with and how my dad, my mom, my parents brought me up. And so I, I think it's, it's a mental part that was ingrained in me since I was born.

And a lot of it was when my parents first came here, it was like, Robert, you are responsible for your life, your happiness, you create your world. Don't depend on anyone to give that to you, but love right. And will help. And so, I said, okay. And of course I didn't listen. Right. You know, you're a kid, your parents tell you all kinds of things.

Right? I can't remember how many times I didn't take the trash out. My dad would wake me up at, you know, seven o'clock in the morning. The trash comes at 7 0 5 on purpose.

[00:15:23] Randall R. Jacobs: Yeah.

[00:15:24] Robert Duran: up outta bed. Did you take the trash out last night? And he knew I didn't so I'm outed in my PJs, chasing the trash truck with the trashcans.

Trying to dump it in. So those things were kind of ingrained in me. And so when I was first diagnosed, I, I didn't really question, oh, woe is me. Why did this happen to me? Right. It was like, okay, news, Robert this is bad. You're in serious problem. You're you're in serious trouble. But put that aside.

How do you engineer yourself to get out of this? And that's the switch that, that had to turn on in my mental space to allow me to be in the space, to fight this and to be where I'm at today and to live my life. And I think a lot of it was just conditioning to the things that happened to you. And I think that's true in everyday life.

I've learned that I've learned to be able to vocalize how to, how to live. Now, when all these little things come at you, because with my disease, the trivial things don't matter anymore. , you know, every time things happen to me that are things that I cannot control. You know, whether it's the old lady or man at the grocery store buying groceries. And then there's a line five, 10 deep, and they're price checking every other item, and then it's time for them to pay. And they say, I'm gonna pay using a check

[00:17:07] Randall R. Jacobs: Yeah.

[00:17:08] Robert Duran: but I'm gonna split it. I'm gonna use two checks. I mean, who uses checks these days still? Right. But those are the things, right. And I'm like, you know, I love it cuz you know why?

Because every day that happens to me is every day that I'm alive, the day that I don't get that is the day I'm dead. And so those things automatically just go in and out the other and let that person have their day. I have no idea what they're experiencing. Right. They could be buying groceries for someone who just got COVID or who had COVID or has COVID.

I mean, you just don't know. So anyway, Long story show that's my mental space. And that's what I had to do to fight this. And and I think every day what do I say to my friends? I said, when I was diagnosed, I said, I made a deal. I said, you know what? I'll take the next five years. Cuz five years was the mortality rate they gave me.

I said, I'll take the next five years of my life at 150%. Then the next 50 years at 75%, because I don't want to be around with no regrets. You never know what tomorrow's gonna bring or, or, or take away. So, so do it.

[00:18:29] Randall R. Jacobs: When this seems to be a common theme amongst. People who have some sort of wake up sort of moments where it's my father was diagnosed with glioblastoma when I was 24 and he took a very similar attitude. And that's another one where it's caught very, you know, it's always caught very late.

He was stage four. He didn't have very much time. And he said, okay, well here, you know, like I don't have control over this circumstance other than, you know, I can go through treatments and so on. But I'm going to make the most of the time that I have, I'm going to let go of that need to try to, to fix this situation.

And I'm going to connect with my family and I'm gonna connect with my friends and I'm gonna spend this time getting my affairs in order. So that those that I love. Are are okay when I'm gone. And he had that, that clarity and that, that comfort when he was, you know, in his case, it was, there was no like Leo bus told me you don't.

You know, it's usually eight months or so, and the five year survival is next to di now you, as a, in, in part is, you know, probably a mix of attitude and genes and the particulars of your tumor and some good fortune of, of living in the age in which we do. You've managed to survive long enough to have access to some pretty bleeding edge treatments that have helped to not just prolong your health, but prolong your life, but also prolong your health.

I mean, I, I don't know what you go through every day, but just looking at you and hearing about how you ride and how you get out. I mean, it's, it's not obvious, it's not obvious that you have anything going. other than maybe the fact that like, you know, we both, we're both bald, but, but you know, I, you don't have eyebrows cuz of the, the, the, the treatment, otherwise you would never know. So I'm curious tell, tell me more about like what that journey has been like.

[00:20:16] Robert Duran: The So the journey, the journey has been interesting. And I've been, I've been lucky. I've been lucky to have friends in the medical industry friends and friends of friends who are in the position to actually speak as experts. You hear that nowadays, right? Who's an expert. And the experts I'm talking about that I've been so lucky to be just blessed to have in my life are, are ones that are actually pancreatic cancer surgeons nurse practitioners who are case managers for surgeons particularly in institutions that are, or were at one.

The comprehensive number one Institute for, for treating cancer in the United States. But I didn't go there. I was able to get advice and I wish this advice was just available out to everybody because there's just so much noise when you're on the internet, you know, you Google things and all you hear is things from experts, right?

And so one has to. Decipher that, but you don't know, you don't know. Right. So the, the one thing that I was told by a friend of mine was Robert. You want to go to the best surgeon? And my question was, well, how do I know who's the best surgeon? And he goes, well, That's the challenge, but I'll tell you who the best surgeon is.

because I'm gonna know, but, you know, if you stick with the major institutions the east coast, right on the west coast you will find them. And those are really easy to find, right. And again, but that's almost like self self-selecting, because if you are in the middle of the United States in areas, Just don't have access to healthcare.

Where do you go? Because there are different levels of medical I guess institutions that just aren't top notch. Right? It's almost like if I put this in bike terms, right there, there are some bicycle bike shops that right. Upset. Right,

[00:22:26] Randall R. Jacobs: Yeah. Throw, throw a leg over it. Oh, that looks about right.

[00:22:29] Robert Duran: right, right. Yeah. Right. Yeah.

[00:22:31] Randall R. Jacobs: the medical, the medical treatment equivalent of that of like, okay, well, this is what we got. And so this is what we'll provide you. I, I definitely have seen. And, and my sisters work in, in medical here in the Boston area at the Brigham which Dana Farber is part of.

So Brigham and women's hospital is a big teaching hospital associated with Harvard. And then Dana Farber is the cancer Institute within there. And just the. The access, the, the, the, the access that, that I have in that anyone connected with someone working there has, and the privilege associated with that is, is significant.

It is a major advantage having those types of people on your team.

[00:23:07] Robert Duran: It? Yes, it is. And so, frankly, I was told if you're gonna have a surgeon, that's gonna cut you open. You don't want to have a surgeon that opens you up and says, oh, bleep. Okay. I think we can fix this. Let me go out for consult or I don't know, but then you're already exposed. Cut. Right? And then they close you back up.

They say, you're not a candidate, but then now you have to endure. The recovery things that happen during the surgery that are high risk procedures. And so those are the things that I see often and sometimes, sometimes the protocol of just diagnosing first level, second level standard of care. Those are basic.

Any doctor could really do that, but having the ability to change on a dime, whether this particular treatment is working for you or not have the confidence level to say, we're gonna switch to a second line of treatment and then being able to manage that because often more times than not, well, I'm not a doctor.

I'm not gonna say that often. The chemotherapy and the treatment itself to kill the cancer treat. You will kill you right before the cancer will. And in this first world country, it's kind of barbaric and archaic. That chemotherapy has been around for a number of decades and it has not changed. But I went through first line in second line chemotherapy.

I went through all kinds of treatment and I've been able to exercise throughout and recover. And show my doctor that I'm a fighter and that I'm the type of patient that if they were to maybe extend the extra chance of maybe give him that treatment, because we know you're that type of a fighter and your body recovers really well. I don't know if that plays played a part of, of, of, of whether I passed through the two boards or not, but I got my surgeries and having surgery. When you are, have gone when you are metastatic, not once, not twice, three times is very rare. And so I think it's a combination. And now that I have a chance to move into a new cutting edge surgery, because I've been around so long for a lack of a better word, I failed first line, second line FDA approved treatment methods for my cancer.

I was able to. Get this new treatment called car T, which we could talk about later. And I just wish more patients were able to get this treatment, but right now it's the early stages. And now I have to be a Guinea pig. I don't know what's going to happen, but I'm gonna be a, be a Guinea pig for science to not only help myself, but also at the same time, help other patients.

And not only pancrea, we had cancer patients, but patients that have solid tumor. This can possibly change the way that cancer is treated in the future and chemo will be long gone. So we'll see. I, I don't know. I may be here in a couple years. I may not, but I'm gonna ride

[00:26:27] Randall R. Jacobs: yeah,

[00:26:29] Robert Duran: and do what I do. And it's been eight years.

So.

[00:26:33] Randall R. Jacobs: change the things you can accept the things that you can't change and Have the wisdom to know the difference and find serenity in that practice.

[00:26:39] Robert Duran: That's true because a sprained ankle only hurts when you think about it.

[00:26:44] Randall R. Jacobs: Yeah, it's I mean, what I hear and, and, you know, I've, I've also, you know, I have fortunately not experienced this myself, but I've seen it in live, in loved one's journeys with, with such a, you know, such an ailment is you know, there's the, the. The inner work that has to be done to remain resilient and to be compliant with treatment and to not lose hope and to keep, I mean, to keep the, the mental state healthy, such that you don't have further decline in the physiological state due to, you know, depression and stress and anxiety and all the things that that do wear you down.

And then this other element of, you know, there's a political element, right? Making making yourself out to be a strong candidate for a doctor or a researcher who has a lot riding on whatever this this treatments that they're, they're developing you know, and this, in this big money involved in this too.

And so if they're going to take that risk and have you be one of the statistics that they're going to use to hopefully get this treatment furthered and approved, you know, they want to know that they get the best chance possible. And that means. You know, being compliant with treatment, coming with a good attitude, remaining, healthy, doing all the right things.

And so like that two-sided element is, is something that I, I definitely see very clearly in you. And it's not, it's like a mix of good fortune, but then also you had to create the circumstances where good fortune could, could come to you where you'd still be around for it.

[00:28:17] Robert Duran: Yeah, no, no. I mean, you, you said it perfectly Randall. I mean, I mean, I did go through standards of care first line, second line, and I rode my bike to chemo the first, well, actually the first time I got chemo, I had some bad reaction to it. I had anaphylactic like shock. Reaction. But after that, we can control it with certain drugs.

I rode my bike, I rode my bike to my labs, and then I rode my bike to chemo and I would ride my bike after chemo, like Thursdays. I have chemo. It's a three hour deal. And after I'm done with chemo, my mind is telling me I'm tired, I'm tired. Right. But I have to recognize that and say, well, yes, you are tired. Fair enough. But you know, what's gonna not make you tired. Right. Moving your legs, getting some activity, breathing, getting aerobic activity. And so I force myself to ride. Then I ride and I get back, I feel so much better. And then that's my life. And if I don't have my bike with me every time I tell myself I'm tired, I go, oh, let me go for a walk.

And when I first was diagnosed, can only make it maybe 50 feet, 50 yards or, or after my surgery, 50 yards, 10 yards in back. That was accomplishment sense of accomplishment. Right. And part of that is probably my cycling mentality or whatever it is ingrained in, in us that just, just wanna keep going.

Right. And, and I think, I think someone could be, what's the word I'm looking for? Someone's attitude could maybe put them in a better position to accept those challenges, or someone can learn that, or someone may not ever learn that. But I'm lucky in that sense. That was my attitude. Just do it right?

[00:30:27] Randall R. Jacobs: There's a, I mean, for, for me. And I've talked about this before you. The bicycle is a rolling meditation and as a, a practice a discipline in the truest sense. And you know, the number, I mean, certainly my experience with the bike has been one of you know, in periods of, of, you know, difficulty with mental health.

It's like, okay, I feel depressed today. I don't want to get out of bed. Right. Everything feels dark. I'm gonna get on my bike and it's going to be, I expect that it's going to be hard. And in fact, I expect that, you know, over the course of this, this ride, I might feel miserable the entire time, but I'm gonna go out because I know that this practice will, will give it has rewards.

If it is, if it is adhered to. Just like other practices around this. And so, I mean, adding the element of, of severe physiological distress, if I would imagine with chemo like nausea and things like this, or, you know, that, that that's a whole other element. But I, I, I love how, how the bicycle offers this, this kind of vehicle for working through things.

And like committing to the bike is not simply about, it's not about the bike. It's not about even exercise or, or, or, or fitness or things like that. It's literally like the simple act of getting in the saddle and turning the pedals over is in a way proving to one's self that, you know, one is still board and, and committed to moving forward.

[00:31:58] Robert Duran: that's. That is true. The nausea, the pain, everything goes away, even when I'm on the bike it, your, your mind. Just transforms. Right. And it's the act of doing it, like you said puts you in that happy space. And I can't stress that enough. Even the neuropathy neuropathy is a side effect of chemotherapy it's you and your nerves are just over excited.

Whether, because they're being affected because of the drugs or the nurse are dying, whatever, right. You just, if. The reason why I don't surf anymore is because if I get hit with my surfboard it normally it's. Okay. Right. But it feels like I'm getting hit with a sledge hammer, everything hurts. And whenever you drink cold water, warm water.

I, I mean, it, it feels like you're swallowing shards of glass, but even on the bike, the wind seems to just go through my skin and directly into my nerves. And your whole body feels. If you're in the dentist chair, the dentist hits a nerve and it just feels like that big shriek of pain that your body just, it goes through your body, your mind.

At least my mind, it just forgets, especially on a windy day, if it's, it doesn't matter. My

[00:33:12] Randall R. Jacobs: it's just noise.

[00:33:13] Robert Duran: to just ignore. I think there's that mental SP the mind is very powerful. It, it causes you to do things and not do things and endure things. As long as you channel that for a positive objective, whatever it is, I think it's, it's fine to do that to reason

[00:33:30] Randall R. Jacobs: yeah. Yeah, of course. I mean the extreme pain may be very, very hard to block out, but it makes, it reminds me of if you ever like put a, a cup of vinegar under your nose, that really strong vinegar smell, but after like 30 seconds, you can't smell it anymore. It's just background noise, your body recalibrates and.

You know, in, in with regards to, I mean, you're describing physiological pain you know, psychological psychospiritual pain as well. There is some degree of a building of a tolerance and being able to have this thing that is so front and center. So like in the middle of one's attention and just be like, okay, this is here.

I accept it. But have it kind of off to the side a little bit, and being able to focus on other things like the right. And, and I think that the bike, you know, the, the flowing through the environment, the, the, the sinking of one's breathing and one's cadence and one's heartbeat as one is, is, is going and, and traveling, it really is, is very centering and very grounding.

[00:34:27] Robert Duran: Oh, no yeah, I can relate to that Randall. I, I mean, I, the words you had mentioned about just even just being aware of your heartbeat and your breathing and just, just being in tune in that space and being in that zone is, is, is, is, is a good feeling, but it's also dangerous but I mean, I was just up in Colorado, hiking up Was it saw wash, they call it mountain range up in the Rocky mountain park.

About before Estes park. I, I think it was up there a few days last week I got as high as 12,500 feet. And and I live here at sea level and I thought I had acclimatized and I have. Chemotherapy induced anemia. I just have low red blood cells. If you look at my red blood cells, they're below the lowest they're below.

I mean, this I'm dead. Right. But I can still bike and I can still cycle, but I left, I left the thesis at home. Okay. It was painful, but I left it at home and I said, okay, I can't ride a bike. And I go, well, I can rent one. I go, no, no, it was too much of our deal. Let me just hike. And so I got to. 12,500 feet.

And you know, you feel your heart, you feel your lungs, you feel your, everything just beating outta your chest. And then it's like, this is so great. Cuz I'm I'm so in tune with my body. and having that the endorphines right. And the do just all that is just, this is even more intense, but I realized I needed to get back down because I am immunocompromised.

I have comorbidity. And so I had to scramble back down to 2000 feet to, to kind of, to bounce myself out. But yeah feeling one with your body and just, just knowing that it's there and there's a way you can control it to a certain extent. You know, it's probably part of the reason why some people do, you know, I don't know.

I don't know, but, but I think that's the space that I get myself into and it allows me to deal with the triggering mechanisms of every day life to realize that that, you know, those things really don't matter. What matters is, is, is your body your mind? Than others. Right. And you could be very hardcore and you could be very, very, very, very strong when it comes to just defense be very physical, but you can also be very caring and loving and you can also be very empathetic to others.

And to have all that in one package is, is, is, is, is what I strive. That's where my community service and just giving back to the community too. All those that have helped me just helps. I just, I love if there's any way that I can help others. I always. Thought that maybe I could show up at a beach here, you know, in Southern California with a bunch of these bikes that you can ride on the sand.

Maybe you have balloon tires. I don't know. And just invite survivors or cancer survivors or anybody who's dealing with something just to ride these bikes and just forget their trials and tribulations for just that one. 15 minute, 30 minute ride. Right. And if you could just trick your mind to be in that space cuz you remember what you felt like, then you don't really need those apparatus to get into that happy space.

But now I'm talking really crazy stuff here, but

[00:37:54] Randall R. Jacobs: Yeah, the the context switching, being able to view whatever it is that one is struggling with or ruminating on, or that seems overwhelming from a different, from a different perspective, like getting out of that, that, that doom filled head space and into like, oh, this is still here. Like this head space is still here.

Feeling of connection with my body is still here or feeling what connection or purpose or meaning is still is still available, but I have to actively choose it.

[00:38:26] Robert Duran: Yes. Yes. Yes. And. Yeah, I, I have this thing I might be by, I might digressing here a little bit, but

[00:38:40] Randall R. Jacobs: Digressions are very welcome.

[00:38:43] Robert Duran: I, I, I discovered this thing when I was first diagnosed and it's actually a really simple thing that I, that I did that I was, I as driving down the I five in Southern California. I had a doctor's appointment to go to see my oncologist and I just plotted myself in the right lane, cuz I had nowhere to go.

I mean, I had taken disability. I was no longer working. All that mattered was me just fighting my terminal disease. And I just stuck in the right lane. I wasn't in a hurry anymore. go figure. Right. And and people were getting into my. and people were trying to, yeah, they were trying to get into my lane from the freeway entrance on the right side.

And they were trying to get into notice how I say my lane from the left lane from the left side. And I, I constantly had to like break or let them in or switch lanes. And I said, you know what, Robert, you have nowhere to go, just let that person in. Right. And so I just did that. And when I had to go to the left lane, I put my left blinker on and, but someone else would speed up and not let me get in.

And it be, it became a game to me and it was like, oh wow, every time this happened, cuz this was almost like rush hour traffic. My brain was telling me, you know, that's a obvious, I know Dick move.

[00:40:17] Randall R. Jacobs: Yeah.

[00:40:18] Robert Duran: right. And

[00:40:19] Randall R. Jacobs: there's aggression there. There's there's my uh, there's a violation of, of, of expectations of the rules of, of my boundaries or what have you.

[00:40:28] Robert Duran: yeah. And they're out to get me. Right. I need to protect myself, but I thought, well, Robert, you've got other things to worry about. You're dying. nowhere for you to go. I mean, you just gotta get to see your doctor. And, and so I said, okay, fine. And so from that day on, I kind of realized that I recognized those little trigger mechanisms.

I said, just let it go. And so I tell my friends, just drive the right lane, just ride it, just do it for one week. You'll learn a lot by others. And and then you will now know that triggering mechanism. And if you could just trade away to change the pathways and how you react and to that, and stay in that happy space.

I guarantee you anything that happens in the future after that one week experiment, you'll be able to deal with things with things a lot. You'll be more equipped to deal with things a lot better than you have been in the past. If you learn something from that experiment, something as simple as that, it's just amazing.

[00:41:37] Randall R. Jacobs: Well, and the reality is like, you know, take that experiment and apply it to say somebody who is really like actively intentionally trying to cause harm. And maybe they're causing harm in a significant way, in an ongoing way. Right. You know, we've you know, the, these, these sorts of situations they occur in life.

Somebody is, is vengeful. Someone is spiteful. Well guess what? That person is dying too. all of us are dying. None of us are getting out of this alive. And, you know, I, I tend, it's really hard. It's particularly hard when you know, it's, it may, I think it's easier when it's something small and you just like, let it go.

But when it's something big, being able to recognize the humanity of other people, like what is it that leads somebody to behave in such a hurtful manner? Well, you know, hurt people, hurt people and, you know, do I have some of those impulses within me? Do I have the good fortune of being aware of those impulses and not having, being able to actively choose not to act them out, laying on the horn or trying to retaliate in some way.

You know, that saying that like, holding onto anger is like picking up a hot cold to throw, you know, at the, the, the the party you're angry at,

[00:42:49] Robert Duran: Yes.

[00:42:50] Randall R. Jacobs: you both get burned

[00:42:51] Robert Duran: Yes, yes.

[00:42:52] Randall R. Jacobs: and, and the grievance, the grievance cycle continues. And I think that, that I mean, oh, the, the humbling element of being confronted with, with an an illness, like what you are, what you've been you know, living with this whole time.

I would imagine it's immensely clarifying. It's not an experience that I have had but it, I, I had. I admire, I admire how you go about it immensely. And I think simply that example is something that is, can, you know, is helpful to others unto itself. And here we have a self-selected audience of people who have gravitated towards the bike for whatever reason.

And you know, this is called the gravel ride podcast, but honestly, I, I don't really care all that much about bicycles as much as I have a bicycle company I'm involved in the bicycle podcast. I, I have done projects in the space at the end of the day. Actually, all of this is really about you know, creating vehicles for people to live better.

And so, Yeah, I am glad that, that we got to have you on. And I would like to have a follow on you know, downstream after your treatment and actually before you know, let's take a little bit more time here. Tell, tell us a little bit more about what you have ahead of you.

[00:44:09] Robert Duran: All right. After the multiple surgeries that I've had to undergo after the multiple chemo treatments that I've had to undergo the multiple recoveries I am now. Getting this treatment and it started yesterday where they are going to now say, look, it, chemo has worked in the past, but it keeps coming back.

So it's basically failed as far as the cure is concerned. Cuz chemo is never really a cure. It's just kind of a treatment, right?

[00:44:51] Randall R. Jacobs: Suppression suppressing the, the multiplication of cells, but at the same time, doing that across all of your cells, it just so happens that your cancer cells are replicating more quickly. And so it kills more of them. Isn't that

[00:45:03] Robert Duran: Yes.

[00:45:03] Randall R. Jacobs: the high level of chemo.

[00:45:05] Robert Duran: Yes. And, and, and it's, it's good that one of my oncologists has said that I actually do have some T-cell memory. T-cells are the hunter immunity cells that kill all of the foreign objects in your body. Right. It's just one of the white blood cells. Right? You have others. And my T-cells has the ability to fight my cancer.

Everybody who has cancer, your body just basically reco does not recognize it is just a UN unchecked growth of cells that just keep growing and just affect other organs or crowd other good cells. So they can't do the good things to your body. And and so what's happening is. Like you said chemo was systemic.

It goes through your kidneys. It's goes through your, I mean, I made it it's bad. It, it, I mean, my fingernails are finally recovering, but they were all black. Like I had black,

[00:46:00] Randall R. Jacobs: Hmm.

[00:46:01] Robert Duran: Nail Polish

[00:46:01] Randall R. Jacobs: and, and you didn't have cancer in your fingernails, but the treatment goes there because

[00:46:06] Robert Duran: that treatment goes

[00:46:07] Randall R. Jacobs: nature of these types of boot force treatments.

[00:46:11] Robert Duran: chemo kills cells that are, that are, that are alive and it's, and, and, and, and it, it, and if you think about it, your, your hair, right, your digestive system has cells, your bone marrow, your bone marrow, and a lot of things come from your bone marrow, right.

And your fingernail, everything. And so everything slowly dies. And so we're gonna go and try for the first time ever treat. My cancer, chemos, so to speak, they are going to modify my white blood cells. They're gonna edit reengineer engineer, modify the DNA, whatever you wanna call it. My Tcell and they took my Tcells out a month ago.

My white BLIS cells and the scientists in the. What they did was they actually inserted a gene that would give my T-cells an artificial receptor. Right. Like imagine a lock in key. Right. That would actually attach to the spike. That is to my cancer cell in my body.

[00:47:21] Randall R. Jacobs: So they had to biopsy your, yeah, they'd take out those T-cells and biopsy the tumor and hopefully they have, it ha those, it will be effective in hitting that particular cell, but then also, hopefully there aren't any EV evolutions of that, that it would not be able to tackle that it wouldn't have the key for in a way.

[00:47:41] Robert Duran: Correct? Yes. So, I was able to, they were able to get to my liver to actually biopsy it. Right. And and so it just happened to match a targeted protein which is the antigen that the biopharmaceutical company based in China was studying. It's called CLA 18.2 is the actual protein they're looking for.

And so what they're doing. In a nutshells, like you said, they're going to train my immunity system to recognize the specific cancer that I have to amuse my immunity system to just kill it. And so that's the treatment that I'm going to undergo next week? Right now they are killing my immune system. So when they put my own car cells back into me, car being chimeric, antigen receptor these are the modified cells that my immune system won't kill.

They want just these car T cells to actually compete for the cancer cell and they wanna suppress everything. So they want these cells to actually target it. So that's, what's going to happen. And eventually, if this does work then who knows how long of of immunity or cancer free? I will be it's possible that I could be cancer free for one year, two years, five years, eight years, 10 years, but it won't be systemic like chemo.

I'll be able to ride. I won't have low blood cells. I'll get my eyebrows back. My fingernails will be fine. I won't have all the, the bad side effects and anybody who gets cancer in the future. Initially, if you can just call up the bot principal company and say, this is what I need, you get it shipped over.

Right. And then they inject you via IV. Right. And then you get maybe the flu symptoms for two, two or three days, and then you're. That's the future. We'll see if we get there,

[00:49:24] Randall R. Jacobs: Well, and if, and if it does work long enough for the next wave of, of advancement in that domain, then all of a sudden, you know, you, you think about what's happened with HIV, HIV used to be a death sentence, right? It was a terminal illness. Now it's a chronic illness. And in fact, it's a very livable chronic illness that you can even get to a state where it's suppressed, where you're not likely to transmit it to another person.

[00:49:47] Robert Duran: We don't even need a cure as long as you can treat it chronically and have quality of life. Right. Then that's all really cancer patients really hope for and hope is all we got. And I hope that I can help.

[00:50:00] Randall R. Jacobs: Is, is this particular I'm curious, is this particular treatment, a derivative of CRISPR CA nine technology? Is that how they're doing the, the editing of the

[00:50:09] Robert Duran: I'm going to ask that question and I'll get back to you on a side channel, but I believe it's one of the techniques that they're using to insert the gene, edit it, and then they're also gonna grow it as a second component. So I know there's that portion of it, but this actually came from treating certain types of leukemia.

[00:50:25] Randall R. Jacobs: Hmm.

[00:50:26] Robert Duran: Yeah. So car T has been around and it's the first time they're jumping to a solid cancer. And this is actually a really great time. I'm actually lucky patient number 13 in the United States to get this and the bike, your thesis Randall

Has allowed me right to be in my happy space to fight what I've got to allow me to get, to be receptive to the therapies, to be that person.

And You know, hopefully there'll be more of me in the future.

[00:50:54] Randall R. Jacobs: I suspect that if someone had given you a shopping cart to ride that you would probably have made the best of it. But I, I appreciate the I appreciate the appreciation, but can't really take any credit for you know, for what you've been doing.

[00:51:05] Robert Duran: well, let me tell you, I was excited. What I got it. I, I wrote, I wrote every day I wrote things that you shouldn't be writing, you know, on a non suspension bike. Let, let me tell you

[00:51:16] Randall R. Jacobs: Which is, which is what it was designed for to, to, to get into trouble.

[00:51:21] Robert Duran: Oh, yeah. In trouble I did get into, and my doctor was like, Robert, you have look at, you know, you can't fight these infections as much as you can. You've been on chemo. What are you doing? I go, well, let me tell you what I got. And then, then I got, then I geeked out. Right. He's like, oh, well, okay. But no, thanks for the kind words.

I, I really appreciate you giving me the opportunity to at least, you know, share my story. I hope I hope this was worthwhile and, you know, I hope

[00:51:49] Randall R. Jacobs: You, it was certainly worthwhile for me. So it helped one person. And I would imagine that the rest of our listeners will enjoy it as well before we hop off. So how do people get in touch with you? Follow you? What organizations you know, would you recommend people check out.

[00:52:06] Robert Duran: You know, the easiest way to get ahold of me is through my website. And it's website is really easy to remember. If you're old like me it's Robert Duran, duran.com.

[00:52:23] Randall R. Jacobs: So.

[00:52:23] Robert Duran: And you could, there's a contact form there. If you wanna get ahold of me, that's fine. I I'd be happy to share any of my stories with you or, or any tips when it comes to fighting cancer in general. But that's, that's how to get hold of me. And I know I'm also affiliated with a nonprofit, by the way.

It's it's called pan. Pancreatic cancer network every year we do. A fundraising 5k run and I think it generates anywhere between 20 to 30 million a year annually.

[00:52:57] Randall R. Jacobs: Where

[00:52:58] Robert Duran: It's every major city in the United States, but of course COVID had a damper the last two years. And so we did a lot of virtual walks in fundraising, which put a damper on the funds that we generate for cancer research, grants, patient services, things like that.

But. We had it first time last year after a two year hiatus. And we have it in San Diego at mission bay park. And I, I had a team and I generated $30,000 in, in a month. For cancer research and patient services for this nonprofit. So, anybody's diagnosed with pancrea cancer because you have a one in 67 chance, by the way, everybody male or female to get it in your lifetime.

Remember that or if you know, a loved one or a friend, right. Pancan.org. And that's really the only website you really need to go to just to grasp the gravity, you know, of the situation, and they will set you in the right path. And they're one of the big organizations that is one of the reasons why I'm still here and I've met so many people from that organization who are doing wonderful things to help the community.

And they've. They've been, they've allowed me to be able to come out of my shell and just tell my story. And I just try and follow the footsteps of those people who are, are trying to help the community in, in that particular segment of life. And I just follow the footsteps of giants. That's what I do.

[00:54:23] Randall R. Jacobs: Well, and I'll mention that we'll get these links in the show notes too, and that you are a member of the ridership which is actually how I became aware of this aspect of your life. And so we'll be publishing the episode to the ridership and there'll be some discussion around there. So, you know, if you want to, you know, connect with Robert, then that can be a good place to do so as well.

And then before we sign off, I just wanna ask. Whether it be pancreatic cancer or some other major life challenge. What would be your advice to somebody listening today?

[00:54:53] Robert Duran: That's a good question. I, I, I think, Hm.

I, I think my, my, my key to my key to life me, right. What works for me, I think is, is there's, there's an absolute truth mechanism. That's there. Okay. And that's the absolute truth. And then there's the convenient truth. Try to recognize the absolute truth because when you recognize the absolute truth, then you have a way to deal with it. And these could be little things in life or big things where that's trauma, things like that instead of hiding it, right.

I have a terminal disease and I can do what some of others have done hide it. And it just makes things worse and some of these diseases could be manageable could be very simple and they can turn into things that are very drastic. If you do not get help. So seek out organizations that can help you with the trauma that you have.

And then one thing that's helped me. I've been to give back give back to others and help every time I help those I feel good about myself. Not because I can post it on the internet and say, Hey, look what I did. Right. And here, you know, look what I'm doing. I'm doing this. No, it's just the act of just being a human being kindness and just having empathy and, and, and being, being, being there for, for, for your fellow man.

And I think that goes a long way because, because it doesn't matter what I have. It's what I can give and I'll give until I die. And that's what makes me alive.

[00:56:54] Randall R. Jacobs: Robert. Thanks for coming on. This has been wonderful. And I look forward to following up with you, a few months down the road, hearing how things went.

[00:57:00] Craig Dalton: That's going to do it for this week's edition of the gravel rod podcast. I hope you enjoyed that interview with Robert Duran. It was great to hear about his journey. We wish him the best of luck. He's a valued member of the community. And as you've heard an amazing and valued member of the Encinitas cycling community, , as well as the pancreatic cancer community.

As I mentioned before, I've got a bunch of links in the show notes to help you support Robert's journey and those others fighting this terrible, terrible cancer.

Robert's a valued member of the ridership community. So if you're interested in getting in touch with him, simply visit www.theridership.com. That's our free global cycling community. A great way to connect with gravel cyclists from around the world.

With all that said. Here's to finding some dirt under

your wheels