"My lungs and body want to die," he said, sucking in air from an oxygen tank. "We get this stuff and it'll be a big U-turn."
The stuff is peptide receptor radionuclide therapy or PRRT. It's infusion treatment that uses a peptide protein and radioactive material, Lutetium 177, to target the kind of neuroendocrine tumors inside Carlson.
The therapy is offered in Houston through the state's Right to Try law that allows terminally ill people access to drugs not yet approved by the Food and Drug Administration. Carlson leaves Tuesday with his sister to undergo final tests and receive the first of four infusion treatments.
Each infusion will cost about $10,000 in treatment and other costs. Little if any of it will be covered by insurance.
Carlson paid for the first treatment with money raised from friends and family. He's trying to sell his high-powered bass boat for the second infusion.
He needs about $20,000 more for the final two treatments and hopes the money comes from fundraising efforts that include two GoFundMe accounts.
Doctors and therapists say the treatment carries no guarantees of success, but Carlson talks about the therapy without a flicker of doubt. He said it will extend his life.
"It absolutely will... It will give me three to five years of good quality life," he said, noting the extra years mean he could be around when researchers find a cure.
Fueled by hope
He is the ultimate optimist, the guy who declares a half-full cup as overflowing. He's always been like that and the attribute didn't disappear seven years ago when nausea, sweat and chills that emerged while he was fishing turned out to be symptoms of a malignant mass over his pancreas.
The cancer spread to the lining of his stomach. Carlson started a treatment path that would bring more than 500 days of chemotherapy. Once a quality systems auditor, the disease pushed him to pursue his dream of becoming a tournament fisherman.
He started a project called Fishing For a Cure, designed to raise awareness about pancreatic cancer, which is expected to kill 43,000 Americans this year. He helped organize a fishing tournament to raise money for the Hirshberg Foundation for Pancreatic Cancer Research.
The cancer spread to his liver and to his spine. Carlson kept fishing and fighting.
Two years ago, he and his partner, Mike McQuillen, were a few good-sized fish shy of winning the American Bass Association's regional anglers of the year award. They finished third.
The gradual slide turned into a free-fall. Carlson stopped fishing in December. The energy and gregariousness that defines him faded. It was hard just to breathe.
"I felt like I was carrying a linebacker on my back," he said.
The cancer spread to his right lung, then his left. Dr. Josh Roseberg, Carlson's oncologist and hematologist, called the disease a sinister mix of different types of cancer cells. He said Carlson has already gone through virtually all available therapies and survived longer than most people.
"He's an incredible man... tough as hell," Rosenberg said.
Carlson was told he probably has no more than six months left to live. He's still fighting, convinced PRRT will turn those months into years.
"He's the most persistent person I've ever known," said his fishing partner, Mike McQuillen. "He's still looking to tomorrow. It's not promised or guaranteed. He still believes it is."
He lives with his parents because he needs people to take care of him. His daughter, Raichel Lickver, visited him this month after hearing the cancer had spread to his lungs. They sat in a room decorated with the 14-pound largemouth bass he caught in Lake Casitas, looked at photos of his grandchildren and talked about PRRT.
"I'm very, very sure," he said of the effectiveness of the treatment.
"We are too," said Lickver, who lives in Illinois and has three children.
"We're fighters," she said.
Carlson's sister, Barbara Kingsbury, found out about PRRT on the internet. In the treatment, a small quantity of radioactive material is sent into the bloodstream, targeting receptors found in neuroendocrine tumors.
"It attaches to the tumor cell like a lock and key and then it destroys the cancer cell," said Susan Cork, therapy coordinator at Excel Diagnostics, where Carlson will receive the treatment.
The treatment is part of a wave of therapy that targets specific cancer cells. In theory, it is "sort of a holy grail," said Dr. David Dawson, a pathologist who runs a pancreatic cancer lab at UCLA.
The effectiveness of personalized therapy depends on the exact nature of a person's cancer, the way the radioactive treatment is delivered and its ability to target just the cancer and not normal cells, Dawson said.
Studies have stamped PRRT as "promising." Cork said there can be a very good response to the therapy, partial success and little or no success.
"We never know how a patient is going to respond," she said, telling of patients where the therapy didn't work and others where it helped bring new energy and extended lives.
Rosenberg, Carlson's doctor, said the treatment is his patient's best shot. He, too, stressed there are no guarantees.
"If he lives another five years after this therapy, he will be the poster child," Rosenberg said. "There will be papers written on his success. It will be an absolute home run."
Hoping to fish again
To Carlson and his family, the chance is his only one.
"It's the only way he can continue to live," said Paul Carlson, his 83-year-old father who's helping manage his son's GoFundMe campaign.
Doug Carlson will fly to Houston on Tuesday, his bag packed with a change of clothes that will be disposed of after the radiation infusion. His body will likely be wracked by vomiting and diarrhea caused by the treatment. When the infusion is over, he'll have to be isolated and tested with a Geiger counter.
He calls it an adventure.
His optimism could help with the therapy. His family says his ability to stay positive has helped him survive seven years.
It "even helps him keep his optimism," Kingsbury said.
Carlson said he knows he'll raise enough money for four infusions spread out over several months. The treatment will work. He'll fish again. He'll spend time with his grandchildren. He'll wake in the mornings feeling OK, maybe even better than that.
"It'll be like getting out of jail," he said.
Money is being raised for Doug Carlson's cancer treatment on two GoFundMe sites: