Category Archives: chemo

A Day in History

Five years ago today, May 8, 2013, I quit getting chemotherapy. I have to say, it was a happy, happy day for me to learn that I would not be getting chemo any longer. Chemo and I … we didn’t deal well with one another. No matter how many anti-nausea pills I took, no matter how long I took steroids, no matter what, I was sick, sick, sick from my treatments.

I’ve never been a sickly person. At all. I didn’t even have a primary care doctor that fateful day when I finally went in to see why I kept gaining weight … and we discovered that I had late-stage lung cancer. I hadn’t seen a doctor for 10 years or more (yeah, I’m one of those people who definitely didn’t take care of themselves with regular screenings or anything else).

So, when I was so sick from chemo, I didn’t deal well with it. I don’t know, maybe even if I had been more sickly, I still wouldn’t have dealt well with it! There were times, many times, when I wondered if it was even worth going through the treatments. I was spending way too much of my very limited time (my oncologist projected 4 months before I passed away) in bed, too sick to eat or drink or do anything except try to sleep away the misery.

At the same time as I was celebrating the fact that I was getting a break from chemotherapy, there was definitely some fear associated with quitting treatments! No treatments meant nothing was being done to hold those tumors at bay. Sure, they’d responded and shrunk some during treatments, but that was because we were bombarding them with poisons!

My doctor hoped that I could take a break from the chemo and that the tumors would stay stable or, if they grew, would do so slowly. Unfortunately, as we would discover when I had my next scan, his hopes were not realized. All of the progress we had made against the tumors was lost during the short time I was not receiving treatments.

As I sit here today, pondering my life and the fact that I am still here, I am grateful that I was diagnosed with my cancer when I was. It is sobering to think that if I had been diagnosed only one year earlier, I would probably be dead.

Stop and think about that for just a moment. It is hard to think about. And, many of us have friends and loved ones who have succumbed to the disease, even recently. They were diagnosed too soon to be saved. Why? Well, partly because lung cancer is a really tricky disease. You often don’t have symptoms until you have only months left to live. So, doctors are faced with an uphill battle because late-stage cancer is really difficult to treat.

Another reason why we are still losing way too many of those diagnosed with lung cancer is because it is so very severely underfunded. Researchers are making such tremendous progress in finding new ways to treat this insidious disease, but they are limited by the lack of money available to them. It boggles my mind to think about what they could be doing if they had the kind of money that breast cancer or prostate cancer gets each year.

So, the purpose of this post is two-fold. First, I want to thank everyone who generously gives to help fund research. You are quite literally lifesavers. If not for your heart and your help, people like me would not have had cutting-edge therapies to try when chemotherapy quit working. Thank you, thank you, thank you! From the bottom of my heart, thank you!

The second is that I want to encourage everyone to give to lung cancer research. It doesn’t have to be much. If everyone I know gave only $5 or $10, it would add up to a reasonable amount of money. If they shared with their friends and their friends gave only $5 or $10, the cost of a Starbucks and a donut, the funding would begin to snowball and just think of where we might be in finding … dare I say … cures … or, at least, therapies that could help treat this disease as a chronic illness instead of the killer it still is.

It hurts my feelings and boggles my mind that I have so much trouble getting people to give to this cause. It hurts my feelings because I take it very personally. It’s MY LIFE I am advocating for! Opdivo is keeping me alive right now. But, when it quits working, there is not another treatment for me to try. Selfishly, I want researchers well-funded so that I have some more options when that time comes.

It boggles my mind because even those who contact me and want me to pray for or talk to a loved one of theirs who has been diagnosed don’t give toward finding better therapies. If not those who either have someone living with or who has died from lung cancer, then who can we expect to help fund life-saving research?

Where can you donate? A few of the foundations that I support are:

Bonnie J. Addario Lung Cancer Research Foundation

LUNGevity (if there is a way to designate that you’re donating on my behalf, please do!)

Lung Cancer Research Foundation (where Free to Breathe merged) – I will be posting a link to a donation site on my behalf soon)

Lung Cancer Alliance (if there is a way to designate that you’re donating on my behalf, please do!)

Cancer Research Institute (not lung cancer specific, but cutting edge in immunotherapy)

 

Dealing with the Nausea and Vomiting Associated with Chemotherapy

When I think about my chemotherapy experience, I think of three things: vomiting my guts up, severe constipation and extreme fatigue. My chemo treatments were on a 3-week rotation. I suffered mightily during the first week, felt better the second week, and felt pretty darn good by the third week. The vomiting only lasted a few days, constipation lasted a bit longer.

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Save Your Life With a Clinical Trial…I Did

Have you ever considered participating in a clinical trial? If you haven’t, you are in the majority. In fact, according to Patient Advocate Foundation,“ less than 5 percent of adults diagnosed with cancer each year will get treated through enrollment in a clinical trial.”

I find this stat extremely sad for two reasons. The first is that without participants clinical trials cannot be conducted. If treatments cannot be tested in trials, they will never be approved by the FDA, so they will not be available to cancer patients. A study by Fred Hutchinson Cancer Research Center and the University of Washington found that nearly 20 percent of publicly funded clinical trials fail due to lack of participation.

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originally published 10/6/2016

A Man Called Ove and Other Audio Books

I am a latecomer to many things technology. I was once on the cutting edge, but that was now many years ago, I hate to admit. I can usually click my way around to figure out enough to be dangerous, but I am definitely slow when it comes to technology these days.

I was once active on Facebook. In recent months, I have decided a complete hiatus from it is healthiest for me. I signed up years ago for Instagram. I think I used it once. I signed up for Twitter so that I could participate in regular Twitter chats about lung cancer. Unfortunately, I find them difficult to follow and because I don’t know Twitter, difficult to understand.

Snapchat, nope. Pinterest and Google+ … well, yeah, but I don’t actually do anything much with them. (I do save some dog treat recipes to my Pinterest account.) There are other apps that I had never even heard of until recently that obviously haven’t made it to my list of favorites!

What’s all this have to do with anything, you may be asking…

Well, I am also new to audiobooks.

Chemo treatments gave me chemo brain. Chemo brain is a phenomenon that is real and that is different than anything anyone else experiences. Most of us who have it … and way too many of those of us who have had chemo do … hear friends and acquaintances try to commiserate by saying, “Oh! I have chemo brain, too! But, I never have had chemo.” Well, maybe, but doubtful.

One of the gifts of chemo brain has been the robbery of my ability to read. I used to love to read. I was a voracious reader from the time I was a young girl. I well remember my mom dropping me off at the Midland library, where I would wander the aisles for hours. She would come pick me back up and I would have checked out a big stack of books, all of which I would read before time to return them.

After the advent of chemo, concentrating long enough to read a page, much less a book, became difficult. Remembering what I had read was just not happening.

So, I quit reading. In the last year, I have managed to read a few books, but they have to start off very engaging. And, many may start off engaging, but I just can’t read them. So, again, I usually just don’t try to read much.

In the last few weeks, I have discovered a new way of “reading.” Audiobooks. I have now listened to two. One, by Greta Van Susteren, Everything You Need to Know About Social Media (Without Having to Call a Kid), taught me all about the social media apps I need to learn more about. It was a book I enjoyed a lot. I want to see the hard copy now.

Today, I listened to A Man Called Ove. It is a nine-hour recording. I listened straight through. I admit that I may have slept through a couple of parts. Not because it was boring, but just because I laid my head down … and when I did, I fell asleep!

No, the book wasn’t boring at all. It was so entertaining. I never thought that a “book on tape” could hold my interest, but I was wrong. My only problem with them is that once I start them, I don’t want to stop. I want to listen all the way through. And, nine hours is a long time to invest all at once! Of course, because I am a slow reader under the best of circumstances, nine hours is less time than I would have likely invested if I was actually reading the book myself, especially now, with my chemo brain.

A Man Called Ove had me laughing out loud over and over again. I was so absorbed in the book that I really never thought about cancer or disease or anything other than the book.

So, the point of this post is to encourage my friends who, like me, suffer from chemo brain to consider listening to books on tape. You can get them from your library. That’s where I have been getting mine. I am getting mine online so that I don’t even have to worry about returning them. When my time is up, the program takes them back. They’re never late!

My library offers books and more using two different apps. One is called Libby and the other is Hoopla. It is likely that your library uses these apps or similar to provide books and other resources to you.

Libby allows library card holders whose libraries participate to borrow ebooks and audiobooks. If you have a library card, see if you can find your library among those that participate. You can use Libby’s built-in e-reader or send books to your Kindle. The Libby app, which is part of OverDrive, includes an audiobook player.

Hoopla’s Web site explains its service options:

hoopla is a groundbreaking digital media service offered by your local public library that allows you to borrow movies, music, audiobooks, ebooks, comics and TV shows to enjoy on your computer, tablet, or phone – and even your TV! With no waiting, titles can be streamed immediately, or downloaded to phones or tablets for offline enjoyment later. We have hundreds of thousands of titles to choose from, with more being added daily. hoopla is like having your public library at your fingertips. Anytime. Anywhere.

Even if you can’t get out of the house, or out of bed, for that matter, a book on tape might be a really nice diversion for you. I stream mine on my cell phone and wear an inexpensive pair of earphones to listen (I did run the battery out of the first pair and had to change to the earpiece I bought to talk on the phone). No holding the book, no energy taken at all. But a nice way to forget your situation and lose yourself in a mystery or love story or comedy that makes you laugh out loud. (Try A Man Called Ove for laugh-out-loud fun.)

 

 

Genetic Mutation Tests. Get Them Done!

Mutation testing is a subject near and dear to my heart. I can’t say how many people I have met who have lung cancer but know nothing about genetic testing. As a matter of fact, not so long ago, I didn’t know much about it either. (And, to tell you the truth, I’m still far from an expert. But, I know enough to tell you that the testing is very important and it can be a life or death test.)

So, What is Mutation Testing?

Mutation testing has a bunch of different names: molecular profiling, molecular tumor testing, biomarker testing, genomic testing, testing for gene mutations, genetic testing, genetic mutation testing, and more. It can be very confusing, for sure. But, here’s what you need to know – if you have lung cancer, especially nonsmall cell lung cancer (NSCLC), you are doing yourself a big favor if you ask your oncologist to get mutation testing, by whatever name, done.

Why is mutation testing important? Our cancer is unique to us. Each tumor cell is made up of specific proteins and molecules. According to American Cancer Society, normal cells do not have mutations, cancer cells do. Genetic testing allows doctors (pathologists) to take a detailed look at tissue from your tumor to see what mutations exist in its DNA and exactly what proteins are present.

 

How is Mutation Testing Done? Does It Hurt?

No. Or, it doesn’t hurt if you have tissue available from your previous biopsy. The pathologist will just use some of that tissue to do further tests.

If you do not have enough tissue left from your biopsy or the tissue is old, it will be necessary to get more tissue. Depending on where the tumors are located, the procedure could be simple or a bit more involved. I had a tumor on my supraclavicle lymph node (collarbone) so it was very simple to take tissue from it for further testing.

Why is It Important to Have My Tumor Tested?

Your tumor was already tested to a certain degree. The pathologist took the tissue from your biopsy and used it to determine what kind of cancer you have. If you have nonsmall cell lung cancer (NSCLC), then the pathologist looks at the tumor a little closer to determine what subtype it is. Generally, you will learn that you have adenocarcinoma (about 40% of NSCLC cases) or squamous cell (epidermoid) carcinoma (25-30% of NSCLC cases), but you may have one of the less common types, large cell (undifferentiated) carcinoma, adenosquamous carcinoma, sarcomatoid carcinoma, etc..

Your oncologist uses the information from the pathologist to determine a treatment plan that will be the most effective against your tumor type. Recently, it has become more affordable to provide the oncologist with even more information about your tumor type so that he can hone your treatment plan further.

Depending on the characteristics the pathologist finds in your tumor, your oncologist may decide that there are targeted therapies or immunotherapies that likely will be most effective against your tumor(s). In (very) simple terms, targeted therapies attack just your tumors, instead of all of your cells like chemotherapy does. Immunotherapy works with your own immune system so that it can see and destroy the cancer cells.

According to Memorial Sloan Kettering Cancer Center, about 60% of adenocarcinoma lung cancers will have specific mutations. Many of these mutations may have targeted therapies or immunotherapies available to treat them.

Among the most common mutations for which there are targeted therapies are Epidermal Growth Factor Receptor (EGFR), Anaplastic Lymphoma Kinase (ALK), ROS1, and T790. Scientists are discovering more and more mutations every day and finding treatments that work effectively against them. Immunotherapy works best when there is a large amount of a protein called PD-L1 in your tumor.

I’ll take this time to make a brief plug: more, more, MORE money is needed for lung cancer research. We’re talking lives here!!!!

Take a look at the Don’t Guess Test Web site. Among the vital information you will find there, you will find a PDF that you can download and take when you see your doctor.

 

 

 

FIVE YEARS!!!! Yes!!!! FIVE YEARS!!!!

You guys!!! This girl just passed her FIVE YEAR cancerversary!!!

When I was diagnosed back in 2012, my first oncologist thought I might live four months. And, yet I recently celebrated FIVE years of life after diagnosis!!!

Donna, December 20, 2017

The year 2017 was an eventful one for me. After four years of immunotherapy treatments with every CT scan showing tumor stability, a tumor in my supraclavicle lymph node (on my neck, near my collarbone) outsmarted the drug and began to grow.

I had to quit my clinical trial after treatment #98. I was so looking forward to getting my centennial treatment. I wonder how many people in the world have received 100 infusions of nivolumab (aka, Opdivo)? I wanted to be among the first.

There were decisions to be made after we got that fateful CT scan back. Initially, I was going to just move into another clinical trial. But, by the time I completed all of the requirements (ie., a biopsy to see how much PDL-1 was present), someone else got the spot I was hoping to fill.

My oncologist suggested that I go on chemotherapy for a time while we waited on something better to come along. I had done chemotherapy. I wasn’t anxious to do it again. To say the least.

I pondered on the idea for several days. I cried … and I rarely cry. I started getting depressed … and I am rarely depressed. I thought, I prayed, I researched other options, including potential clinical trials available in Dallas or Houston or anywhere within driving range.

And, one day I decided radiation might be a viable option. The tumors in my lungs were still stable. Only the one tumor in my neck was growing. It seemed to me that it would be an easy thing to radiate that bugger. (I wasn’t a candidate for radiation when I was first diagnosed because of the location of my tumors in my lungs.)

I spoke to my nurse practitioner about the idea. She said if I really thought that was the route I wanted to go, she would make a referral to a radiation oncologist.

My radiation mask and a wonderful
“lung cancer”
cross my cousin sent me.

My husband and I had an immediate connection with the radiation oncologist. We liked him a lot. And, we completely trusted that he would get the job done on that errant tumor, that I had nicknamed Wayward Tumor.

I had fifteen treatments. I will be blogging about those treatments if I will ever sit down and finish them. The treatments were easy enough. I was a little surprised by the severe fatigue that came around after the treatments were complete. It has taken several months to begin to regain my energy and even so, I tire and stay tired very easily.

Nevertheless, when I had my first CT scans since the discovery of the growing tumor, we got great news! Not only was the tumor in the supraclavicle lymph node gone … yes, for the first time in five years, that baby was no more!!!! … the one tumor in my lungs that the radiologist doesn’t call a scar shrank by half. That tumor had been completely stable for over 4 years, not shrinking or growing, just being.

I have been okay with those results … I’ve often said I was completely willing to carry the tumors around with me as I live my life as long as they just sit there nicely and don’t interfere. So, I wasn’t prepared to hear that it had shrunk significantly. Wow!!! You gotta love a CT scan like that one!!!

We didn’t do anything special to celebrate my five-year cancerversary. In a lot of ways, it was just another day. But, in my mind, crossing that magical line in the sand – it seems many stats are done for one year and five-year survival rates – was special. Very special.

I am well aware that people can and do get to fight the beast again after crossing the five-year mark. The fact is, I am still in active treatment. I have been in active treatment for the entire five years that I have known I had lung cancer. But, it is still celebration-worthy to cross a milestone that has been looming in front of me all of this time.

Next milestone in sight? 10 years, of course!!!!

Lung cancer is a bitch, y’all. It just is. But, it isn’t stronger than we are. If we keep a smile on our face, a song in our heart, and let hope consume us … we beat it. Every moment we do not dwell on cancer, we beat it. I am resolved to be happy and content every day that is before me. In that way, no matter what happens, I have beaten the beast.

Merry Christmas, Y’all.