Category Archives: immunotherapy

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.

 

Number 100!!!!

When I went to a consult about joining a clinical trial at UTSW back in 2013, I never, ever dreamed I would still be here, writing this blog!! Remember, I was only supposed to live 4 months. I had already outlived that prognosis by several months in July 2013.

When I first started the clinical trial in August 2013, the drug I received had only numbers for a name. I had no idea what kind of drug I was receiving. Immunotherapy was not a word I had ever heard.

As time went on, I participated in a number of surveys conducted by pharmaceutical companies. The companies were seeking feedback from cancer patients about upcoming advertisements. I began to connect the dots … and realized that the test drug I was receiving was the newest and latest therapy – immunotherapy.

Not everyone has the same results as I do. In fact, my medical oncologist has said that the biggest side effect of immunotherapy is disappointment. Because it is touted these days as the “cure-all,” patients whose cancer doesn’t respond positively suffer great disappointment. Sometimes, they also live with side effects they hadn’t bargained for, such as pneumonitis or impaired liver or kidney functions. No drug is completely safe and immunotherapy is no exception.

But, for me … and for many like me … immunotherapy is a true miracle drug. The drug I get is Opdivo, aka nivolumab. Another was introduced at about the same time, Keytruda (pembrolizumab). Both of these drugs received FDA approval for use against non-small-cell lung cancer like I have at about the same time. Both had already been approved for treatment of metastatic melanoma prior to being approved for lung cancer. Other immunotherapies have now been approved by the FDA for treatment of various cancers, including lung cancer. There are other drugs currently in trial. This field of research is exploding!!

That’s good news for those of us with cancer. Five years ago, immunotherapy wasn’t considered a viable option for treating cancer. Today, it is offering great hope to researchers, physicians, and most importantly, patients and their families and loved ones.

But, this is not really an advertisement for immunotherapy. I do encourage you to speak to your oncologist about the possibility of being treated with this miracle drug, though. It might not be the right treatment for you, but it just may be!

Plugging Along

Opdivo is infused every other week. That’s a lot of doctor-going, especially for a person like me who avoided doctors like the plague prior to being diagnosed with lung cancer.  Every visit required extensive blood tests. At first, I had to have CT scans every 6 weeks. As the years went by and my tumors remained stable, we were able to extend the amount of time between scans to three months. I had so many CT scans that I learned to drink barium without gagging. That’s too many scans!!

At first, no one knew what in the world I was talking about when I said I was getting immunotherapy. These days, I imagine most lung cancer patients, and possibly patients with other cancers, are familiar with the term, if not with how it works.

Opdivo gave me back my life. I was very sick when I underwent traditional chemotherapy. With Opdivo, I suffer a bit of fatigue on the day of the infusion and some minor tiredness on the day after the infusion, but that’s about all. (My thyroid no longer works properly, a common side effect, so I have to take levothyroxine every day … That means I constantly fight a weight problem, but that’s comparatively minor (and I do have to remind myself of that quite often!).)

When I reached treatment #75 or so, I began to look forward to a big centennial celebration!!! How many other patients are out there who can say they have gotten 75, much less 100, immunotherapy infusions? I wondered about that then. I still do wonder. How many of us are there who have basically been with the drug since inception?

When I finally reached treatment #90, it was a forgone conclusion that I soon would be joining the centennial club. And, I looked forward to it with relish. I’m not really quite sure why it seemed so important to me to get to that 100th treatment, but it was a goal I really wanted to reach.

A Bump in the Road

Imagine my shock and distress when I went to see my oncologist prior to receiving my 99th treatment and learned that I was being pulled out of the trial and I would not be getting any more Opdivo! After over four years, a tumor in a lymph node in my neck finally outsmarted the nivolumab. The drug was no longer controlling it. My doctor could not and would not continue the treatment.

What????!!! I cried. I rarely ever cry. But, I cried.

Most normal individuals would have cried because their cancer was once more on the move. Not goal-oriented me. Oh no! I cried because I was just two treatments away from reaching Infusion #100. My heart was set on it. It had been a foregone conclusion that I was going to be celebrating #100.  I was nearly frantic in trying to figure out how I could still get those two additional treatments (I never looked past Treatment #100. Treatment #101 held no awe for me … just that #100 was important.)

I’ve already blogged previously about this bump in the road. In short, after much consideration, I decided to have the growing tumor irradicated. I am slowly blogging about the process, if you’re interested in reading about the experience.

Sooooo … How did I Reach #100???

So, if I was pulled from the trial, a tumor was growing, and I went through a different course of treatment, you may be wondering how I managed to reach Infusion #100. Well, it is really simple!

My medical and radiation oncologists both agreed that I should resume Opdivo treatments after completing radiation. The drug has controlled the tumors in my lungs for about 4-1/2 years. The logic of the oncologists is that it would be foolish to abandon a protocol that I have responded to so well. The tumor that outsmarted the drug, the tumor I called Wayward Tumor, has presumably been killed with radiation so we only have to worry about the tumors in my lungs at this time.

I resumed Opdivo treatments at the end of September after a break of several months. My blood test results remain perfect. I continue to feel great after a treatment. We’re back in the saddle again!!!

Shine

Imagine my surprise when I arrived at the doctor to resume my Opdivo treatments and my oncologist, his nurse, and my nurse practitioner came in bearing a 100th Infusion gift. If I haven’t said it before (I have), I will say it now: I have the most awesome medical team ever!!!

Shine is perfect! The lady who designs the sculptures says this about Shine:
“Shine could be a congratulatory piece for a milestone reached, or a healing piece to show support and belief in someone. I wanted the form to be visually uplifting… a little reminder of personal goals, met. I embellished the surface with gold to suggest inner light and energy.”

Enough said! There’s absolutely nothing more I can add except, “Isn’t she beautiful?”

 

 

 

A Week in My Life

A Little History

Since I began the clinical trial for Opdivo back in July 2013, my life was returned to me. While I was on chemo, there were quite a few days when I wondered if the fight against lung cancer was really worth it.

Chemo made me so violently ill that I can remember being curled up on the bed with my Sheltie Barney wondering how in the world I could endure an existence that put me in such misery, time after time. I began to think that if this is what life is going to be like, let me off of this train sooner rather than later.

With chemo, I would feel good for a day or so after treatment (thank you, steroids!), but then the nausea and vomiting and fatigue would set in. For two or three days, I could get out of bed or off of the couch only to go throw up. I couldn’t eat or drink. It took every ounce of willpower and strength to walk 10 feet into the kitchen.

I couldn’t live. I could only exist … and it wasn’t a pleasant existence.

Fortunately, those horrid days lasted for less than a week. By the second week after a chemo infusion, I was feeling much better. I could eat and drink again. I could make myself live a somewhat normal life. By week three, just in time to go back for another infusion and begin the process all over again, I felt pretty good.

For the first infusions, I was able to keep my spirits high. I could look at the bright side and focus on what I could do, rather than on what I couldn’t. But, the longer the process went on, the harder it was becoming not to get depressed during that third week. I was knowingly getting ready to submit again to a treatment that was going to totally knock the wind out of my sails. Is that insanity, I wondered? Everyone knows Stage IV lung cancer patients don’t live long, I thought, so why was I making myself so miserable for at least a third of the time I had left on this earth?

Chemo treatments went on for about six or seven months. Finally, my doctor said we would take a break from treatments. He hoped the tumors would remain stable, but they didn’t. The minute we stopped treatments, they started growing. All of the headway we had made with the chemo was lost.

That’s when my doctor asked me if I wanted to begin a new regimen of chemo or start a clinical trial. The chemo was expected to be less effective while making me sicker. Ugh. No thanks. Clinical trial, here I come!

I didn’t expect the clinical trial to do anything for me. I expected to be a test subject so that decisions could be made for future cancer fighters.

I could not have been more wrong! From the moment I started the trial, I started feeling better. And my tumors were stopped in their tracks. And, now, 2-1/2 years later, my tumors are still stable and I still feel great!

So, I thought some of those reading this blog might get a little bit of hope from reading about my week last week. I think you will agree that it does not sound like a week in the life of a typical stage IV lung cancer survivor. The good and surprising news is that many other Stage IV lung cancer thrivers DO have similar weeks! Guys, there is HOPE … and lots of it!!

Fun, Fun, and more Fun!

It has taken me awhile to get this blog written. The reason? I’ve been too busy to sit down and write it! Don’t you think that’s a good thing?

The week I sat down to write about started with a Run As One agility trial. In order to have a trial, the barn has to be readied. Linda Lelak and I both start trial weekend on Friday afternoons, helping with set-up. It requires the lugging of equipment from place to place. By the time these pictures were taken, we were nearly finished emptying the stall where everything was stored and carrying it out to the barn.

 

 

 

 

Since the dogs came to the trial on separate days, we took the opportunity for a photo shoot on Friday after we got things set up!

 

Saturday and Sunday – 4 days compressed into 2

Cotton got to play on Saturday; Barney on Sunday. They both had a lot of fun! Barney finally earned his last Open Touch N Go title, so he’ll start in Elite at the next trial. We’ve been chasing that title for about two years so I was really excited when we had a clean run!

 

Here is Barney’s Touch N Go run. He had a good day. He was oh-so-slightly too slow (he missed making time by less than half a second) in Tunnelers to earn a qualifying score, but he qualified in Touch N Go and in his Regular run.

Cotton wasn’t quite as successful! She DID succeed in having a great time, though. And, in all honesty, that’s what it is all about. Just to be fair, here’s one of her runs. You can see that she runs very happy!

But, this is not so much about agility as it is a chronicle of my week. So, let’s move on.

Saturday, November 14th, was a busy date. As I mentioned, I ran Cotton in agility during the day. For the evening, there were three possibilities for activities.

First, American Cancer Society wanted me to speak at a semi-formal fundraising event they were hosting. I frantically looked for a way to get a cocktail outfit without spending a lot of money. I run dogs in barns; I rarely attend events where fancy clothes are necessary. My friends really came through with offers for help. It was heartwarming.

About the time I figured out what I was going to wear, I got an email saying that the event had to be canceled due to lack of ticket sales. I was sad on the one hand … and breathed a sigh of relief on the other. I hated that the event was so poorly supported that it had to be canceled.

I had barely relaxed from having that event canceled when I got a note from my doctor’s office wanting to know if I could attend a Dallas Stars hockey game on Saturday night. I was excited to get the offer to participate with Chris Draft’s Team Draft Foundation, mainly because a good friend and fellow lung cancer survivor was going to be there.

Now, there is another outfit dilemma. I have no Stars jersey to wear. And, once again, I don’t want to spend $50 to $100 (or more) getting one!

Just about the time we decided we would just bite the bullet and get something, I got yet another email saying the event was canceled for Saturday night and would be rescheduled. Ahhh, Saturday night is going to be a night of relaxation after all.

Oh wait! Here comes an invitation to a good agility friend’s birthday party – chips and salsa and nachos … This event did not get canceled! It was a lot of fun to see everyone. I am the only one of that particular crowd who runs NADAC agility. The others run in AKC and/or USDAA, two venues I eschewed after my cancer diagnosis, so it is like a reunion when we get together for a meal.

I came home from the party and did a quick load of laundry (quick = about 2 hours) and crashed so that I could get up before daylight on Sunday.

While I ran four runs on Saturday with Cotton, I only ran three with Barney on Sunday. I knew that I had another obligation to meet on Sunday night and I was afraid there wasn’t time for more runs.

On Sunday night, I had to be in Dallas by 5 PM for a Free to Breathe meeting. This is a foundation that was started by Dr. Joan Schiller, currently the head of oncology at UTSW, and a lung cancer expert. Like LUNGevity, they host a 5K walk to raise money for research.

They also do other events. I had previously worked at one of their tables at a Dallas Stars game doing lung cancer awareness. I’ve tried to determine the major differences between LUNGevity and Free to Breathe. From my own perspective, they both do great work raising funds for research. LUNGevity is also focused very much on lung cancer survivors. They are all about offering HOPE to those of us fighting the disease. They do a wonderful job of it.

Sherry and I have HOPE … and lots of it!

Free to Breathe, I have decided, has a primary focus, besides raising funds for research, of increasing awareness about lung cancer. You will find them at health fairs and other events.

I’m happy to be involved with both organizations because I believe offering survivors and thrivers (a term I learned from Free to Breathe and that I absolutely love) hope and information is incredibly important. Lots of us are living still. Our prognosis is not as dark as it was. This is vitally important information for people with lung cancer. Don’t give up. Never give up.

But, I believe it is equally as important to get the word out to the masses that lung cancer attacks more people than any other cancer besides breast. It kills more than breast, prostate, and colon cancers combined. There are two reasons why I believe lung cancer is so deadly:
1. people believe it is a smokers’ only disease, which couldn’t be further from the truth and 2. it is usually without symptoms until it has advanced to stage 3 or 4.

I had a lot of fun meeting everyone at the Free to Breathe event. I hope I will have a lot of opportunities to work with them … as well as with LUNGevity.

Monday

I kept thinking that cramming four days into two over the weekend would not be a problem because I would just rest while I was at chemo. Chemo day (a misnomer, really, because I don’t get chemo, I get immunotherapy … but both require an infusion and it is just easier to call it chemo day!) is usually a long day. It begins with a blood draw. Then, I wait an hour or so while the blood is read. Then, I have a visit with my favorite oncologist in the world. He orders the immunotherapy. It takes an hour or so for the pharmacy to get the life-saving concoction put together. Then, the infusion begins. The drip only takes an hour. Still, even if everything is running like clockwork, which it doesn’t always, I am there for a minimum of 3.5 hours. Usually, it is more like four or five hours.

I love most everyone at UTSW so the time goes pretty fast. Nevertheless, it is a long day. I do not usually rest. Monday was no exception!

Tuesday

I actually had nothing to do on Tuesday. I usually have agility practice, but instead, we had rain. As much as I love my agility lessons, I was happy to have a day off. I did very little besides rest.

Wednesday

On Wednesday, I met a couple of friends for a movie and a late lunch. I never went to the movies until I met Anna. Now, I go at least once a month and often two or three times a month! It is a nice way to lose yourself in a world that doesn’t usually include cancer.

Thursday

Thursday was an exciting day! I say frequently that having cancer has opened many doors for me that would have never opened otherwise. I can’t exactly be happy that I have cancer, but I can tell you that I am enjoying my life. A lot.

So, Thursday is usually an agility training day so it is always a day I enjoy. But, this Thursday, was something different. Robert and I went back to UTSW, this time to do an interview with WFAA, Channel 8 news.

It just so happened that the interview took place on the day of the Great American Smokeout. So, instead of being on the news once, I should end up being featured twice.

http://www.wfaa.com/story/news/health/2015/11/20/great-american-smokeout-help-smokers-quit/76130726/

Advertising UTSW’s new initiative

 

Waiting on the reporter to arrive

 

Dr Gerber explaining what my CT scans mean

It is with mixed emotions that I was part of the feature above. I surely want people to know that they can and should quit smoking. But, I don’t want anyone to get the mistaken idea that only smokers get lung cancer. Because nothing is further from the truth and way too many people die because they think they are immune.

It only takes lungs to get lung cancer. That’s it.

We are anticipating that another segment will be aired on November 30, during the 4 PM news. I guess I will probably not see it live as I will be having chemo again. It would be highly unusual for me to make it home by 4, especially on a Monday after a long Thanksgiving holiday. Thank goodness for DVRs!

I had so much fun doing the interview. I love my doctor. I love the nurses and aides. It was especially fun that some of them got to be on TV, too! Sonia, the health reporter, was so nice. I felt like we were old friends! And, finally, I had an interview where my mouth didn’t get dry and I didn’t experience a moment of nervousness. Yes!!!!

RW and Kim had come in from New Mexico on Wednesday. They came over to watch the news story with us. Mom came too. Afterwards, Mom took us out to the Goldmine for dinner. It was a really fun day.

Friday

On Friday, Linda and I had agility class. We always have so much fun. Both Barney and Louie did an excellent job getting great distance and following our directions. I love to trial, but I love class even more.

After class, RW and Kim came over to help me clean house a bit before we went after Jimmy and Jonah. The kids are spending a little over a week with their dad … and were they excited!!!

Grandma … not the camera AGAIN!!

It is always great fun to have the kids, but it does turn our quiet existence a bit topsy-turvy! The boys have a lot of energy!! And, especially when they first arrive, a lot to say!

Saturday

On Saturday, we had a great time. Linda, Mom, and I were signed up to work a Lung Cancer Awareness table for Free to Breathe at a Stars ice skating rink in Plano. Genentech was sponsoring a Free Skate for kids and adults as part of the awareness event. So, we all loaded up and headed to the Dr. Pepper StarCenter in Plano.

 

 

 

Neither the kids nor the dad had ever been ice-skating before. They did really well. By the end of the Free Skate, Jonah was skating on his own. Jimmy took off on his own from the start.

We all had a wonderful time. At the Awareness table, we got lots of interest and gave away many blue (LUNGevity) and white (Free to Breathe) bracelets. A few people took more information.

 

 

Sunday

On Sunday, I totally forgot that I am no longer young and did something I haven’t done in years. I got up at 1:30 AM to get ready to go to a dog agility trial in Oklahoma with Ed and Linda and five dogs (three border collies, a Sheltie, and a Pom/Eskie). I picked Linda up at 2:15 and we headed to Ed’s. Because there wasn’t much traffic, we arrived in record time! The house was dark and quiet!

Linda and I, like teenagers, were outside with the dogs, trying to be quiet, but also having fun. She shined the flashlight into the porta-potty so I could see and then we used the flashlight to take the dogs through weave poles. This, my friends, is what they call “agility addicts.”

We were on the road to Norman, OK by 3:30. We laughed and talked, talked and laughed … and had a great time! This trial was done “beta” style, which means you run the same course twice. While we had a great time, Barney and I didn’t manage to have a qualifying score. I had a few chemo brain moments (I get to blame things on chemo brain … it could also have been called “senior moment”) during our runs that cost us. Barney, on the other hand, had some pretty runs!

This run was Regular 1. Barney had a beautiful run. If only his Mom hadn’t forgotten a jump, it would have been one of the nicest runs we’ve had. Where was my head??? On the second time through the exact same course, I managed to include the jump, but Barney thought I really wanted him to do the dogwalk instead of the tunnel at the discrimination. We argued about it for a bit…

What a fun, fun day. We arrived back to Ed’s by 5 or so.

Sum it Up

So … while this week may have been a bit more active and filled with more unusual activities than normal, I managed to do it all. And, keep in mind, chemo (immunotherapy) was part of the week. Had I still been getting chemotherapy, most of the activities described here would have had to be put on hold. But, with immunotherapy, and the way I personally react to it, I had a very, very full week.

Here’s what I want to leave you with. Getting a stage IV lung cancer diagnosis can be devastating. But, it isn’t the end of the world. There is HOPE. There is more and more hope every single day as researchers find more and better ways to treat our cancer.

Don’t give up. Never give up.

 

 

My Story

I am often asked for my story. I thought I might write it out and post it here. It will be easier to find and then copy and paste elsewhere when needed.

Finding the Cancer

When my Stage IV lung cancer was discovered in October 2012, I was, as far as I knew, as healthy as I have ever been in my life. I was playing agility with my two dogs three or four nights a week and every weekend. For those who do not know, agility takes a lot of stamina and energy! (https://www.youtube.com/watch?v=OCFrUCu6F_g)

I went to the doctor because I kept gaining weight. No matter what I did, I couldn’t lose it. Since I had always been tall and thin, the extra weight was disturbing me. I self-diagnosed thyroid issues.

I am not a doctor goer. When I went to the doctor on that fateful October day, it was the first time I had been in 10 or more years. I chose the doctor based on her name  – I knew someone else who had the same name – and the fact that she took my insurance. This was the luckiest choice I could have ever made.

The doctor felt a very, very small knot on my collarbone. She sent me for a CT scan. That day.

She called in a few days to tell me that my thyroid was fine, but I had some strange cell activity in my lungs. I needed a PET scan, she said.

I had never heard of a PET scan. When we got off of the phone, I immediately began to research. And, what I found was scary. PET scans are used to determine malignant activity. Cancer????? Me????? But, I was as healthy as I had ever been.

Sure enough, I was diagnosed with cancer. Specifically, I was told I had Stage IV adenocarcinoma of the lungs that was both inoperable and could not be radiated. Chemotherapy was my only option.

I had watched my father die of lung cancer back when I was in my early 20s. His cancer was also discovered by accident, during a routine physical required by his place of employment. Six months later, at barely 49, my dad died. He went through hell during those six months after diagnosis, suffering through chemo and radiation. I had always said chemotherapy was something I would never, ever do.

Until it was my only choice.

Starting Treatments

I began chemo – a cocktail of Avastin, Alimta, and carboplatin – in early December 2012. I was one of those people who had a difficult time. No matter what nausea medicine we tried, I was incredibly sick the first week after an infusion. Fortunately, my health improved by leaps and bounds during weeks two and three. I was feeling pretty good when it was time for yet another infusion.

1st day of chemo … let’s get this show on the road!

I underwent four infusions of the three drugs. My tumors responded. They didn’t go away, but they shrank. After four treatments, my oncologist decided to change the treatment. For four more treatments, every three weeks, I received Avastin. I am one of the unusual ones. Avastin made me as sick as the three-chemo infusions had.

However, my tumors had responded. They shrank. They didn’t spread. My oncologist was happy. He decided to give my body a break and stop all treatments for awhile. He expected my tumors to remain stable. But, a CT scan revealed that it wasn’t to be. The tumors had grown back to nearly the size they had been prior to beginning treatments.

The oncologist told me that I basically had two choices. I could begin another line of chemo, with a drug that wasn’t as effective and that had worse side effects than those I had already had. Or, I could participate in a clinical trial. It was not a difficult decision for me at all. I chose to go into a clinical trial.

Clinical Trial

I really didn’t have great expectations for extending my own life, but I wanted to help others coming up behind me. So, I went to the UT Southwestern Medical Center, one of 69 NCI-designated cancer centers, in July 2013.

Nearly immediately, I was fortunate enough to get into a Phase III clinical trial. In this Phase, the drug or treatment is given to many people to confirm its effectiveness, monitor side effects, compare it to other treatments, and collect information that will allow the drug or treatment to be used safely. In my trial, the efficacy of the experimental treatment, immunotherapy, was compared to a known and common chemotherapy, Docetaxel. I was happy that I drew the straw that allowed me to receive the experimental drug.

Entering the clinical trial was the best thing that could have ever happened.  I now have been in the trial for over two years. I responded to it immediately. Since I began the trial, my tumors have been completely stable. I have very, very few side effects. The worst happened early on – my thyroid quit working properly, so I now take a little pill once a day.

I go every two weeks for blood tests, doctor visit, and treatment. The treatment itself takes an hour to drip. Until recently, I was required to have CT scans every 6 weeks. However, the drug company amended the trial plan and I now have scans every 12 weeks.

Sharon, my Nurse Practitioner

Grace, the nurse who usually accesses my port

How much more is there?

The Present

The clinical trial and the immunotherapy gave my life back to me. I am able to live fully and completely – at a time when no one expected me to still be alive, much less living well!

October 2015 with Barney

Feeling Blessed … Again … and Always

Fair Day!

There are actually very few days that I wake up and do not feel blessed. And, for that, I am very thankful. My nature is to look on the bright side of life, which makes me a much happier person than I could be!

But, today’s entry has to do with just how fortunate I really am to still be here among the living.

We know the stats … only 17% of the 221,000 people diagnosed with lung cancer in 2015 will still be here on earth in 5 years. Get a stage IV diagnosis and that percentage drops into the single digits. Scary stuff, lung cancer.

Consider me lucky because I happen to know several people who are 5+ year survivors. I hope to know more and more as those I know pass that milestone. I have 2 more years before I celebrate 5 years. Every day that passes, I get closer!!

I entered this immunotherapy trial I am in back in July 2013. It was, essentially, a last ditch effort to stay alive. Last week, I sat for my 55th or 56th infusion. 26 months.

My doctor and my immunotherapy clinical trial have been in the news this week. My doctor is a co-author on a major international study … which just happens to be covering the trial I am in.

This article, http://www.dddmag.com/news/2015/09/bmss-nivolumab-opdivo-extends-survival-rate-lung-kidney-cancer, has a paragraph in it that really brings home how special it is that I remain among the living.

At one year after treatment, 51 percent of the 292 patients treated with nivolumab, a PD-1 immune checkpoint inhibitor, survived, compared with 39 percent of the 290 patients treated with docetaxel. At 18 months, survival was 39 percent among those treated with nivolumab and 23 percent among patients treated with docetaxel, the study found.

Wow. Only about 119 of the nearly 300 who started this study were still alive after 18 months. I wonder how many remained after 24 months? I know that I am the only person in the Dallas area that remains in my trial. That’s been true for at least the last 12 months. I never really considered the fact that the others may have died. I just thought they got out of the trial. I hope that’s all that happened.

The press release featuring my doctor (with a little quote from me!) can be found at http://www.newswise.com/articles/immunotherapy-superior-to-chemotherapy-for-lung-cancer-in-international-trial-involving-ut-southwestern-cancer-researchers.

I don’t know why God has chosen to leave me here on this earth. I am glad He has. I am not really ready to die. I am having a great time here. But, heck, the alternative is surely not something to dread when you believe like I do. Streets of gold and living in the presence of Jesus … not a bad gig at all 😃😃!

Still, every day I am made more and more aware of just how fortunate I am to still be alive. And, I resolve to be even more diligent in bringing to the attention of everyone I know, whether they want to hear it or not, the fact that lung cancer happens – to anyone with lungs – and it is deadly. We need more research funding. Lots and lots more research funding. For me … and for everyone who comes behind me.

Wow!! Washington, DC … Here I Come!

Lately, my life has taken some strange twists and turns. And, in the process, I have gained memories that will last a lifetime.

I am certain I should not say that I am happy I have Stage IV lung cancer. And, the reality is, that I would give up all of the experiences I am about to tell you about NOT to have lung cancer. But, as long as I do … what a ride it has been!!!!

The Beginning

About a year ago, I decided to participate in the Breathe Deep DFW 2014 walk in Arlington, TX. It was an event sponsored by LUNGevity … I had never heard of LUNGevity and I had never before participated in an event similar to this one. But, I made myself go, despite the fact that I didn’t know a soul who was going to be there and had no one to go with me.

 

 

 

I got there early. I walked around and took some pictures … and generally felt a little ill at ease. I am not a person that goes to events like this all by myself. Why I did on this November morning, I will never know. God was directing me. That’s the only possible explanation.

While I was at the event, I met some awesome people. One was Katie Brown, who was responsible for the entire event. She is also a VP with LUNGevity. It was through Katie that I learned about a Regional HOPE Summit that would soon be held in Irving and a National HOPE Summit that would be held in Washington, DC.

The summits bring together lung cancer survivors. They have food, speakers, food, and fun. As the names state – the summits are all about HOPE. Because, as deadly as lung cancer is, there are quite a few survivors out there. Some of us are making it! HOPE!!!

The Irving summit was free. Once again, I stepped outside of my comfort zone and attended. Robert went with me … at least for a little while. I had an enjoyable time, meeting other lung cancer survivors, hearing what the guest speakers had to say, eating some good food…!

I learned more about the National Summit that is held every year in Washington, DC. The Foundation pays for first time attendees to go – airfare and hotel room!! Last year, there was a small $50 fee to attend. I wanted to go!!!

I had so much fun at the National Summit. I met so many other survivors there. Some had been recently diagnosed; some have been surviving for many years. Some were young, some older. Some smokers, some not. A diverse group of people brought together by disease. So, we shared one thing in common – the burning desire to fight – and to fight HARD – to beat this formidable foe.

There was a lot of laughter and plenty of good times at both Summits. There were super people everywhere. And great food. And informative speakers. Very informative speakers. We have lung cancer, but we also have lots of reasons to have hope. That’s the message … and that’s the truth.

So. The journey begins! A walk in Arlington, TX. A HOPE Summit in Irving, Texas. An annual HOPE Summit in Washington, DC … a connection to LUNGevity.

Immunotherapy

As anyone who reads my blog knows, I have been getting immunotherapy for over two years. I asked the nurse yesterday how many treatments I have received. Yesterday was number 56. Which might actually only be number 55 in reality. I had to miss one treatment because I broke my arm and had to have surgery just weeks after beginning the clinical trial. Either way – a lot! I am nearly certain I am the only person in the trial in the Dallas area and that that has been the case for at least a year. Maybe longer.

You will never meet a bigger proponent for immunotherapy or clinical trials. I have gained my life back because I took that step and joined a clinical trial. I am so lucky because for some reason, I am that person that the immunotherapy really, REALLY works well for.

Well, the fact that I am in a clinical trial and doing well on immunotherapy has opened some big doors for me. BIG doors! Some of them, scary doors!

Katie Brown … of LUNGevity fame … asked on our LUNGevity Facebook group several months ago if anyone was receiving immunotherapy. I quickly raised my hand – again, I love immunotherapy!!

American Association for Cancer Research

The next thing I know, I got an email from the American Association for Cancer Research (AACR). They wanted my story. I said, “sure.” I thought they wanted me to sit down and write a blurb about my experiences with immunotherapy. I expected to spend a half day or so writing and perfecting. I thought I would send it away and that would be that.

Except, I was thinking wrong.

The AACR didn’t want me to write my story. They wanted me to TELL my story. To a video camera and still camera. To people. Uh. No. I don’t DO public speaking. I just don’t.

I grew far less interested. I am camera-shy and I do not … do not … do public speaking. Even when that public speaking is in my living room to only a few people.

So, I started just not answering emails from AACR. Because camera crews (still and video) were not my cup of tea. And not at my house … I HATE to clean house…

Well, responses to emails or not, the AACR was moving forward with plans to come to my house to video me telling my story. I got an email on a Monday that the film crew would arrive at my house the following Wednesday at 10 AM.

There really was no backing down at this point.

I should say that the AACR is an AWESOME organization. It has been around since 1907. It is the oldest foundation in American dedicated to cancer research. Some of the best minds in the US are involved with it. This is no rinky-dink organization I am dealing with!

Film Crew Arrives

So, on that Wednesday, I got up early to do a little cleaning. I finished early, so I fixed Robert and me some breakfast. I was washing dishes when the phone rang and I was informed the film crew was there. Over an hour before I expected them. I hadn’t even had my shower yet!

Thank goodness I am not a worrier! Much of a worrier, anyway. I just told them I would be out as soon as possible – I had to get a shower!

It was a ton of fun to do the photo shoot and video. I have never … and will probably never again … had such an experience.  I had a blast.

The interview, photos, and filming took about 5 hours. The editors managed to get a single page story and a 4:27 minute video! Amazing work because they managed to capture me well, especially in the video.

Here are the results:

http://cancerprogressreport.org/2015/Pages/fernandez.aspx?Page=0 (written story)


My story joins the stories of 49 other cancer survivors. Every year, for the past five years, the AACR has featured 10 survivors in their annual Cancer Progress Reports. I am featured in the 2015 report. It is an awesome report. If you are interested in facts about cancer, you’ll be interested in seeing the entire report: http://www.cancerprogressreport-digital.org/cancerprogressreport/2015?pg=1#pg1

Washington, DC – Capitol Hill

I was told I would get a subscription to a magazine produced by AACR for participating in the video project. So, imagine my surprise when I got an email inviting me to attend the release of the report on Capitol Hill as a guest of the AACR.

I quickly responded that I would love to come to DC to attend the release!
In a day or two, I got another email. I was asked if I would make myself available to the press … and … would I be interested in being a presenter during the release of the report on Capitol Hill?
Hello???? Remember??? This is Donna. She is NOT a public speaker. Not even close. And you want her to speak for FIVE MINUTES to top government officials on CAPITOL HILL???

Speak in WASHINGTON, DC??? ME??????????????

Well, I said I would be happy to make myself available to the press, but I was the wrong person to do the speech. I cannot emphasize enough – I am NOT a public speaker. If I was, I would have a lot more money than I do right now because I was given many opportunities to give workshops about grant writing. Because of my extreme fear of public speaking, those workshops didn’t go well … and I quit even trying. And now, you’re asking me to speak on CAPITOL HILL????

I was encouraged again to speak. I can’t understand why. And, I really can’t believe I agreed to do so. But I did. And, I was really glad that I did.

 

I was only given five minutes to speak. That sounded like a LOT of time when I was first told I had that long. But, trust me, getting a speech down to just five minutes is a challenge! Especially for someone as verbose as I am! But, I did it … at least within a few seconds.
I prayed. Lots of people prayed. I practiced. Thank God for good friends who were willing to help me – read the speech, comment on it, listen to it … When I went to Capitol Hill, I was prepared. And God did the rest – He kept me calm and allowed me to speak with little fear.

 

 

See the dog? That’s Tank. He belongs to my awesome agility instructor, Ed Scharringhausen. Despite being very busy getting ready for an inaugural agility trial on Luke’s Field, Ed took the time to help me edit my speech … and to listen to me read it. When I was reading it to Ed, my friend Linda, and their dogs, Tank sensed my fear. He doesn’t really know me, but he knew I was really nervous. So, he got up and came across the room to sit right in front of me. He sat tall and straight for the entire speech. I petted him and relaxed some.

I mentioned that I wished he could go with me to Washington. Well, he obviously couldn’t go, so I took the next best thing. His picture. And he sat right there on the table beside my speech the entire time.

Looking out into the room on Capitol Hill before my speech

 

 

The speech went so much better than I could have ever, ever anticipated. All of the prayers worked! I had many people seek me out later. They told me that my speech made them cry, that they connected with me, that they didn’t know WHY I said I wasn’t a public speaker (if they only knew…)…

The fact is, my speech made me cry too. I just barely was able to tell the audience about Kiersten Dickson, my young friend who died at only 20 from lung cancer. It is a good thing I saved her story for the end. I hope at least one heart was touched enough by what I had to say to fight for more funding for medical research, especially for research benefiting those of us with lung cancer.

 

Washington, DC – The White House!!!

It seemed like every time I opened my email, I was surprised by something else exciting! I just grinned from ear to ear when I opened the email that said the AACR and the survivors attending the release of the 2015 Cancer Progress Report were invited to a meeting at the White House!! You have just got to be kidding me!

We rushed … and I do mean rushed … from Capitol Hill to the White House. It isn’t good to be late to a meeting at the White House. But we were.

There were long lines waiting to get through security to get into the building. The building that wasn’t white, I might add. I was very confused.

 

 

I thought maybe we had to pass through this building to get into the White House?? I kept saying, “But this building is not White!!” Well … our meeting with Obama’s Domestic Policy staff was technically NOT in the White House, I was disappointed to learn. We actually met in this gorgeous building – the Executive Offices, which are right next door to, but are not, the White House!

As I said, the lines were long. Full of people – important and self-important. They were not all that happy when our group was whisked in front of them! At least one of those standing in the heat waiting his turn to go through security was a governor of some state. I forget which one. I am sure he couldn’t understand why we got preferential treatment. I’m not quite sure why either, but we did!

Once we were through the three levels of security, we were finally on our way to our meeting.

The ceiling in the vestibule. All different. All gorgeous!

 

Long, shiny hallways. Notice the gold handrails on the stairs.  The young lady was one of those we met on the President’s Domestic Policy Staff.

The building was very quiet. Very uninhabited. I wasn’t sure how many pictures I could get by with taking so I didn’t take a lot. I didn’t want my camera confiscated! (As it turns out, I think it would have been fine to take as many as I wished. But, to say I was a little intimidated is an understatement!)

Our meeting was a good one. It was relatively small. AACR staff, Obama’s staffers, and cancer survivors – all beneficiaries of the latest and greatest cancer research.

 

Green “Appointment” tags for US citizens; pink for non-citizens. If your tag wasn’t green, you had to be escorted everywhere. Even with our green tags, we were escorted everywhere! I wore a pretty blue jacket, but it was warm in the Executive Offices! Conserving energy, I suppose.
The four women in the middle of the picture are members of Obama’s Domestic Policy Staff. They are young … smart and powerful. And as nice as could be.

 

AACR leaders.

Our meeting probably lasted 45 minutes or an hour. I honestly failed to look at my watch so couldn’t say for sure. I felt like the young women were willing to take as much time as needed for the meeting to be a success. I didn’t ask anyone from the AACR staff, but my guess is that they did feel it was a very successful meeting. Had I been one of them, I would have been very pleased. Obama’s staff was very interested in working with groups like the AACR to get medical research moving. That is good news for everyone, I think.

When we left, we were taken out a side door so that we could stand next to the White House. We were mostly all very excited by that!

The hallways go on and on … and they are beautiful. This is a very old building, but it is maintained perfectly.

 

 

The Presidential flag! Maybe I should have tried to peek into the office beside it!!

 

Here we are! Right beside the White House! (This picture was taken as we stepped out of the Executive Offices building)
Standing in the parking lot, we saw people coming and going to meetings at the actual White House! We had to keep moving out of the way because the visitors were dropped off at the canopied door.
I never saw soooooo many black Surburbans!! They were everywhere!!! Some other makes and models were represented, too, but they were all black!

 

 

Do you see it? The Presidential Seal? This is as close as I got to actually stepping into the White House!
The armored car.

I just cannot tell you how special this day was!! I would have never, ever, in my wildest dreams expected to speak on Capitol Hill, especially given my extreme fear of public speaking, or to go to the Executive Offices of the President.

Reception

There was still a reception and an awesome dinner. Both were just unbelievable. The reception was held in the Kennedy Caucus Room in one of the Senate buildings. The Senate buildings are much more beautiful than those for the House. There is lots of marble, gorgeous ceilings, the feeling of power. In the House buildings, I just felt like I was in old, but fairly well-maintained buildings. They were nothing special.

 

 

 

 

Many organizations took place in the Rally for Medical Research. Did it make a difference? I can only say, “I hope so.”

 

The AACR president, Dr. Marge Foti.

 

 

 

Many famous events took place in the Kennedy Caucus Room (before it was so-named!)

Let me tell you – the hors d’oeuvres served at this reception were delicious!!! I was speaking at lunchtime so failed to get any lunch. I was starving when we arrived at the reception. I was full when we left!! Coconut chicken, some kind of fresh salmon wrap, cheeses, chips and crackers, I can’t remember what all. There were a variety of wines and beers – all domestic, I heard – available as well as sparkling water and some soft drinks, I think.

I was getting tired at this point and didn’t get a bunch of pictures. Wish I had taken some of the food! So I could eat my heart out now! I wondered how people that attend many of these functions stay slim.

 

Dinner

We came back to the hotel at about 7:45 PM. I was dragging. We were given the opportunity to change clothes (and shoes … ahhhhhh! My feet were so happy to change into tennis shoes!!!) and rest just a moment before returning to dinner at 8:15.

I planned to stay at dinner no longer than absolutely necessary. But, that was before I ended up at the first table – the one with the heads of cancer clinics all over the US. I can’t remember all of their names and, unfortunately, never caught the last name of one who was so kind to me. Her name was Karen. She heads a cancer clinic in Philadelphia. Her specialty is prostate cancer. And, she is one of the kindest souls I have ever met. She made sure that I felt like a part of the group the entire dinner. When there was an “inside joke,” she made sure I understood it. She always explained who was talking and what their specialty was. I wish I knew her full name. I would love to send her a thank you card. For her compassion. For her humanity.

It was so very interesting sitting at that table and listening to top doctors discuss cancer and research. I was suddenly not tired at all. I didn’t get back to the room until after 11 PM.

The food was absolutely divine. The company and conversation even better. I was so on top of the world after this day that I couldn’t begin to fall asleep.

Which is probably a good thing, because I had to pack everything up so I could turn back the room the next morning!

June is Immunotherapy Month!

Who knew? LOL! It seems like there is something to celebrate every single month of the year! There’s absolutely nothing wrong with that!

Sad Facts About Lung Cancer

When I was first diagnosed with cancer back in October 2012, no one expected me to live very long. Stage IV lung cancer is pretty deadly. The following facts are from the American Cancer Society’s Web site about lung cancer in 2015:

  • About 221,200 new cases of lung cancer (115,610 in men and 105,590 in women)
  • An estimated 158,040 deaths from lung cancer (86,380 in men and 71,660 among women)

Lung cancer accounts for about 27% of all cancer deaths and is by far the leading cause of cancer death among both men and women. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. 

The later the stage of the cancer, the more likely it is that you will not survive even a year. Only 4% of those diagnosed with late stage (aka distant or metastisized) cancer are expected to live five years after diagnosis. The following information is copied from the American Lung Association:

Survival Rates

  •  The lung cancer five-year survival rate (17.8%) is lower than many other leading cancer sites, such as the colon (65.4%), breast (90.5%) and prostate (99.6%).
  • The five-year survival rate for lung cancer is 54.0 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 4.0 percent.
  • Over half of people with lung cancer die within one year of being diagnosed. 
Lung Cancer Diagnosis and Survival by Stage
http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html 

If you let yourself think about it much, it will scare the living daylights out of you! According to Lung Cancer Alliance, 432 individuals die of lung cancer every single day.

Funding …. Or Lack Thereof

Before I step off of my soapbox, I need to address the sad lack of funding for lung cancer. It makes my blood boil. It should make everyone’s blood boil. Since lung cancer is the third most common (behind breast and prostate) and the most deadly cancer there is, it is bound to impact your life either directly (you get diagnosed yourself with it) or indirectly (someone you love gets diagnosed with it).

When someone hears a person has lung cancer, the first question is not, “Will they survive?” Nope, the question everyone asks is, “Oh, do they smoke?” Because we all know that (1) lung cancer only happens to smokers and (2) all smokers deserve to die of lung cancer because they brought it upon themselves. Right?

NO!!!!

Let’s look at some facts. These are for 2015; they are not old and outdated.

In 2015, the Centers for Disease Control and Prevention (CDC) estimates that 157,499 men and women will die of lung and bronchus cancer. (I realize this number differs slightly from what the American Cancer Society estimates. I do not know why the numbers are different, but they are both estimates.) During the same time, 52,028 people are expected to die from colorectal cancer, 41,557 women from breast cancer, 38,797 from pancreas cancer, and 27,245 men from prostate cancer.

Despite common belief, lung cancer affects never-smokers, too. And, in 2015, 28,192 of them are expected to die from the disease.

The fact is that only 20.9% of those diagnosed with lung cancer are active smokers. Nearly 18% (17.9%) have never put a cigarette to their lips. And, 60% are former smokers. Some of those former smokers have not smoked for 40 or more years. (These stats come from the CDC report, “Cigarette Smoking Among Adults – United States, 2006″.) So much for the fact that only smokers get lung cancer.

The federal government devotes billions of dollars to health issues. Funding for cancer is estimated to be $5,414,000,000 in 2015. Of that, $255 million will be dedicated to lung cancer.  That amounts to a measly $1,153 allocated for each person expected to be diagnosed with lung cancer. Per death (158,040) from lung cancer, $1,619 is allocated.

By contrast, a total of $685 million is expected to be designated for breast cancer projects. According to the American Cancer Society, a whopping 231,841 individuals (mostly women, but men also get breast cancer) will be diagnosed with invasive breast cancer during 2015.  An additional 60,290 will be diagnosed with carcinoma in situ (the very earliest stage of breast cancer). Of all of those diagnosed, a total of 40,290 are expected to succumb to their breast cancer. The federal government is spending $17,002 in 2015 for every death that will occur from breast cancer.

Prostate cancer is the second most prevalent cancer in the United States. In 2015, the American Cancer Society expects that 220,800 men will be diagnosed with prostate cancer. It is expected that 27,540 men will perish from their prostate cancer. The federal government is expected to spend $255 million on prostate cancer (the exact same amount as being spent on lung cancer) in 2015. For every death from prostate cancer in 2015, Uncle Sam is spending $9,259.

Let’s look at this again:

Breast Cancer                        40,290 deaths                          $17,002 allocated
Prostate Cancer                   27,540 deaths                         $   9,259 allocated
Lung Cancer                        158,040 deaths                         $   1,619 allocated

Does anyone else wonder why the disparity?

But, I digress. This post is about Immunotherapy.

Immunotherapy – A Life Giver

If one must be diagnosed with cancer, this is not a bad time. Scientists and researchers are on the brink of making astonishing discoveries. More strides are being made now than in previous decades. Exciting strides!

Immunotherapy is a treatment that allows a person’s own body to attack cancer cells. According to the Cancer Research Institute, immunotherapy “represents the most promising new cancer treatment approach since the development of the first chemotherapies in the late 1940s.”

Yes!! I agree!! Having been put through the horrors of chemotherapy, I can attest that immunotherapy is exciting. For anyone wishing to learn more about immunotherapy, a good place to start is the Cancer Research Institute.

When I was first diagnosed with lung cancer, I started a chemotherapy protocol of Carboplatin, Avastin, and Alimta. Avastin is not technically chemotherapy. It is a drug designed to starve tumors of blood supply (anti-angiogenic therapy). Alimta and Carboplatin are both chemotherapies that attack tumors, but also affect healthy cells. They are basically poisons. The hope is that they do more damage to cancer cells than healthy cells.

I can’t begin to describe what it is like to go through chemotherapy. I would get my infusions on a Thursday. By Saturday, I was in bed, except for when I had to be up throwing up. For two or three days, I would be so sick, I could just barely move. No anti-nausea medicine worked. On top of the extreme nausea, a fatigue that cannot be described set in. It was difficult to walk from the couch to the restroom or to the refrigerator without resting.

You gradually begin to feel better. By the end of the second week after the infusion, I could make myself, through sheer will power, go to agility practice. This is a testament to just how much I love agility! By the third week, I was feeling pretty good, considering.

Toward the end of the time that I received my chemo infusions, I was starting to get very depressed. It seemed so futile to finally feel better just to knowingly make myself sick again with yet another infusion. I am afraid that if the infusions had lasted much longer, I would have either quit them or would have had to take anti-depressants.

And, the fact is, I was healthier than most who were getting chemotherapy. My blood tests remained perfect throughout my treatments. Most people, at the least, have their white blood cell counts tank. No one really knows why mine didn’t. My blood pressure also stayed in the normal range.

Since you are being infused with poison when you are getting chemotherapy, you can only get it for so long before the benefits are outweighed by the drawbacks. Chemo itself can (and does) kill cancer patients. As noted by the World Journal of Clinical Oncology:

Over the past few decades, platinum based chemotherapy is the standard of care for advanced stages of NSCLC. These systemic therapies have significant toxicities and confer unacceptable morbidity.

My tumors responded well to the chemo treatments. They shrank by half or so. But, as soon as the chemo stopped, the tumors took off. They were back to their initial size in a matter of weeks.

My oncologist told me that I basically had two options. I could either (1) undergo a different kind of chemo, one that historically made people sicker and was less successful than the first treatment I received, or (2) I could get into a clinical trial and at least help researchers understand some of the new and coming treatments for lung cancer patients in the future.

I didn’t think for a second about the choice. I opted for participation in a clinical trial. I had no desire to be sicker than before! And, if I was going to die, I might as well be a guinea pig for those coming behind me. I really didn’t think much about the clinical trial affecting ME positively.

Nevertheless, the best thing that has happened to me during this cancer journey was the decision to participate in a clinical trial. Few choose this route. I’m astonished by that. I would more than likely be dead if I had chosen to just continue with the traditional treatments.

I started immunotherapy treatments in July 2013. Information about the trial I am participating in can be found at https://clinicaltrials.gov/ct2/show/NCT01673867?term=BMS-936558+Docetaxel&rank=2 and http://news.bms.com/press-release/opdivo-nivolumab-first-pd-1-inhibitor-demonstrate-superior-overall-survival-versus-sta. Unlike chemo treatments, immunotherapy does not poison you, so the treatments never end (unless they quit working). Because immunotherapy isn’t poisonous, you don’t suffer the horrid side effects of chemotherapy. Or, I haven’t. Some people don’t have quite the same positive reaction that I have, but many do.

I have been getting immunotherapy for nearly two years now. I get treatments every two weeks. I have CT scans every 6 weeks (so often, that I can now drink barium without gagging).

Like when I was getting chemotherapy, my blood tests have remained perfect throughout the treatments. Blood pressure and oxygen levels have stayed in the normal range. The only side effect from the immunotherapy that I have suffered is that my thyroid has quit working properly. No big deal. I just take Levothyroxin every morning to keep the thyroid functioning as it should.

The CT scans have shown that the tumors have not grown nor spread at all since I began immunotherapy. One radiologist who reads the scans calls the tumors “scars.” My oncologist does not necessarily agree that they are simply scars. Since we don’t know for sure, we continue the treatments. At the least, it is an insurance policy against the lung cancer.

Because of immunotherapy, I have totally reclaimed my life. I am back to running agility regularly. I keep testing my stamina levels and I keep passing those tests!! WhooHoo!!

As you have seen from my previous blog posts, I started a garden for the first time ever. I go to the movies and out to eat with friends. My calendar rarely has a day without something scheduled to do.

No one knows how long the immunotherapy will continue to work. But, from what researchers know now, patients do not build up a resistance to it like they do to targeted therapies. In addition, it appears that the immune system continues to work against tumors for an extended time even after treatments end.

Immunotherapies are being tested on all kinds of cancer. The Cancer Research Institute (CRI) shows how it is working on their site at http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers. The following quote is from the CRI:

From the preventive vaccine for cervical cancer to the first therapy ever proven to extend the lives of patients with metastatic melanoma, immunology has already led to major treatment breakthroughs for a number of cancers. Every cancer type is unique, though, and immunology and immunotherapy are impacting each cancer in different ways.

In the future, those diagnosed with cancer may never have to go through the horrors of chemotherapy. Perhaps even surgery and radiation can be avoided through the use of immunotherapy. And, the death rates from cancer may decline sharply.

Let us hope!

P. S. If you have cancer and you are interested in immunotherapy, you can find out what trials are available by visiting the Clinical Trial Finder.

What Does Lung Cancer Look Like?

What does lung cancer look like? Do you suppose that it looks like someone who is about 70 years old, very emaciated, with a cigarette in her hand? Someone who looks like they are about to die?

Or do you envision a 20 year old girl with her whole life ahead of her? Except that she’s currently bald from her chemo treatments and searching desperately for the drugs that will keep her alive? Or, maybe you see a beautiful, cheerful 24 year old young woman who has already lost part of her lung? Girls who were physically active; girls who never smoked; girls who weren’t around smoke?

In the picture below, three of the people are not lung cancer survivors. Can you guess which three? I bet not. Because lung cancer doesn’t have “a look.”

Photo credit: Randy Elles Photography LUNGevity Foundation — in Washington, District of Columbia.

Who gets cancer? Is it the 20-something college student? Is it the 30-something veterinarian? The 40-something TV reporter? The 50-something long-distance bicycle rider? Is it your 60-something vegetarian neighbor? Is it your postal worker? Your doctor’s office receptionist? The professional baseball player? The IT superstar down the hall? Your doctor? If you answer “yes” to all of these, then you are absolutely correct.

The fact is, no one is immune. Whether or not they smoked. Whether or not they exercised. Whether or not they ate only vegetarian foods. If they have lungs, they are susceptible to getting lung cancer.

The scary thing about lung cancer is that there are not often many symptoms until it has advanced so far that there are not a lot of treatment options. If you suddenly develop a smoker’s cough, but you didn’t smoke, or if you have extreme shortness of breath, wheezing, or asthma-like symptoms, or if you begin to drop weight for no reason, you might have lung cancer. A CT scan can be done in a matter of minutes to detect if there are tumors in your lungs. The earlier lung cancer is detected, the more likely that you will survive.

 

Photo credit: Randy Elles Photography LUNGevity Foundation — in Washington, District of Columbia.

Here’s a link that I hope will stay active for a long time. It has pictures that were contributed to WhatNext.com by cancer survivors. Now, these people do not all have lung cancer, but they are all surviving some kind of cancer. I hope you’ll follow the link. I think you will be encouraged.

What does cancer look like?

I don’t know about you, but what I notice most is how many of these individuals have large, happy smiles. Smiles that reach their eyes. These are cancer survivors (some who are “NED — No evidence of disease” and some who are newly diagnosed and in the throes of chemo). They have cancer. Cancer doesn’t have them.

 

In the middle of difficulty, liesOpportunity

 

“You can cut all the flowers, but you cannot keep Spring from coming.”

Albert Einstein once said, “In the middle of difficulty, lies opportunity.” I believe that. Do you?

The fact is that while I would never choose to have cancer, it has presented many opportunities for which I am very grateful. Isn’t that something?

My motto has been and continues to be, “I have cancer, Cancer doesn’t have me.” What’s that mean?, you ask. Well, it means that I try hard not to be defined by cancer. I try to live my life to the fullest.

In fact, in my way of thinking, every moment I spend worrying or fretting over having cancer is a moment where cancer wins this battle. It robs me of my joy for that length of time. I don’t know how much time I have left here on this earth (none of us do). But, what I know is that I want to make the most of every moment that I’m here!

Cancer has allowed me the opportunity to finally concentrate on me, not on everyone else around me. I always worked a job or two and put 110% of myself into it. With family obligations taking up the remaining hours in the day, there was just never really any time left over for Donna.

But, having cancer allowed me to quit working. What a blessing that was, especially since my job had gone from good to very, very bad with changing regimes. Politics. Aren’t they great? (NO!!!) For the first time in my adult life, I have had the time to do things that make me happy. And I have enjoyed that to the max!!!

You probably have already figured out what those things are that make me happy.

I’ll just state right at the beginning, my joy comes from the Lord. He is the reason for my happiness. He is the reason I do not worry about dying or about having cancer. He is the reason I can enjoy all of the activities listed below. Without the peace I have from Him, none of the rest of this would be possible.

Agility

 

I love, love, love agility. I found this sport late in life. I had really only just gotten started in it when I found out I had cancer. Barney and I were trialing nearly every weekend and sometimes Cotton came along! (She got to come along more often then than now … the one bad thing about this retirement stuff is that my income decreased by two-thirds. I have to be much more frugal than I used to be … talk about a hard lesson!!)

Barney was then and is now a superb agility partner. That little dog has a huge heart. He will play with me, over and over and over again, until I can’t go any longer. He tries so hard to please. Always, his goal is to make me happy. Because if mama is happy, everyone is happy! Seriously, he loves agility, but mostly he loves me and he wants to do what pleases me.

I was initially taught that running agility meant running alongside your dog, directing him or her to do whatever the next obstacle in the sequence was. Many venues require that you stay fairly close by your dog in order to direct him over the obstacles correctly. My venue of choice, NADAC, is a little different. It allows you to work away from your dog.

Running your dog with distance between you and him is a completely different way of handling. My personal belief is that it is more difficult to teach your dog to run without you right beside him. It is especially challenging when the dog has first been taught to work right beside you.

Barney and I are in the process of learning to work at a distance from one another. I practiced my new skills some at the Run As One trial over the Memorial Day weekend. The video above shows our runs from Sunday of the three day trial.

Practicing our newly learned skills at distance (we are still very new in the learning process) is only part of what made me smile at the Memorial Day trial. The other is that I had the stamina to go help set-up for the trial on Friday, run four runs on Saturday, return Sunday morning for three more runs, finish with three runs on Monday … and stay to help tear down and load up all of the equipment. Previously, I had only tried to trial one day for fear of being too tired the following day. REmarkABLE!!! I am so blessed.

Gardening

I wish I had a dollar for every time Robert suggested I start a garden. I always refused. I was just not interested. Then, this spring, I changed my mind. I don’t even know why I decided this was the year I wanted to plant tomatoes and cucumbers and squash and zucchini. We have watermelon and cantaloupe and bell peppers. And okra. And something that I no longer remember what it is!!! I can’t wait for its fruit or vegetable to appear so I will know just what it is!!

I know nothing about gardening. Like a bull in a china cabinet, my typical way of doing things, I just started buying plants and putting them out in the ground. I STILL know nothing, but I am fortunate that my plants seem not to care all that much.

Here are some pictures I took this morning. I go out and look every single day. I take pictures at least a couple of times a week. Sometimes more often! The little fruits and vegetables are like my babies! I love watching them … except for an impatient person like myself, it is also a bit of a challenge!

Now that the sun has begun shining again, the ‘maters are ripening!

 

The herb garden. Yum!!!

 

Zucchini? Squash? Cucumbers? All of the above?

 

Squash … some will be ready for picking very soon!
More tomatoes that will soon be ripe enough to pick and eat!

 

Yellow zucchini. The plant thrived while it rained daily. Not looking so good now.

 

The bell pepper!!! It will ultimately be a red pepper. There’s only one on the bush!

 

Watermelon. This plant has not always looked as healthy.
My Meyer Lemon Tree. What fun!

 

Baby lemons!!

I am learning as I go. Next year, I hope I learn from some of my mistakes. I crowded things this year. They looked so small and so widely spaced when I first planted them. Do I hear you laughing???? If you have done much gardening, I am sure you are!

I have been reading that you should plant certain plants with one another … and shouldn’t combine others. Next year, I hope to have an organized plan! This year, I just walked down the rows at Lowe’s and chose plants that would produce vegetables or fruit that I thought I might want to eat.

I gave away some of the first fruits of my labor. Carol got a bag with squash, zucchini, and a couple of tomatoes. I plucked a little tomato off of the vine yesterday morning as I was walking out of the backyard to the car. I gave that to Linda. I THINK I am going to have plenty to share. I hope so.

Photography

I guess it is pretty obvious from my blog that I enjoy photography! Having cancer has opened my eyes to all of the beauty that surrounds us. I love to take my camera and just explore the backyard. I NEED to take my camera and explore a little further away than my backyard!! But, for now, I have been content to wander through the yard and take pictures of dogs, flies, bees, flowers, fruits, and veggies … and an occasional lizard. Hopefully, there will be no opportunities to snap a photo of a snake.

The pictures below were taken this morning. I originally grabbed the camera because I saw the bees inside the flowers of the squash plant. I thought they were certainly worth a few pictures!! As long as I was out there with the camera, I explored a bit more!

I love these delicate little flowers. No clue what they are.

 

Another little flower that I think is pretty. It is some wildflower that I planted.

 

This plant and the one below speak to me. This little weed is growing out of the brick wall!

 

This petunia came from I don’t know where. Like the little flower above, it is growing in a crack in the brick wall. Perseverance. At its best

 

That frog is lucky it is in the water. Cotton was VERY interested in it!

 

We have so many of these bugs. I don’t know what they are, but they sure like my new garden.

 

Flies like the garden too.

 

I love quotes. I love photography. On occasion, I try to combine the two. These are the bees that initially sent me running for the camera.

 

Other Interests

My calendar is usually very full. I don’t like to have very many days when I don’t have something to do. Currently, I have agility class twice on Tuesday and once on Friday. I may have to quit going to the Tuesday night class – it is more traditional agility (where you run right beside your dog) and I don’t want to mess up what Barney and I are learning with our distance. We are going to be taking a break from our Friday class as well. It has just gotten too hot. So, for the summer, we will rely on practicing at the park at 7 AM rather than going to class at 10:30.

On days that I don’t have agility, I love to meet my friends for lunch and/or the movies. I rarely ever saw a movie before I retired. But, since I have been retired, I have been lucky enough to go to quite a few.

Walks. Linda and I complain nearly every single morning when we meet about how we didn’t want to come! We meet at 6:30 AM now that it has gotten so hot. We never want to get up. But, once we are at the park and walking, we’re glad we made the effort. The dogs love their walks as well. And, it is so good for us! On days that I don’t walk, I usually just waste the time that I would be spending getting some exercise. And, boy oh boy, do I need exercise!!

You should see my Kindle app. I have so many books on there just waiting on me to read them. I keep buying them for those times when I might not feel like doing the things I am doing now. I hope that day doesn’t come for a long time. But, when it comes, I’m prepared!!!

Opportunity

So back to the title of this post. “In the middle of difficulty, lies opportunity.” Cancer is my difficulty. But, oh the opportunities it has brought with it! If I hadn’t been diagnosed with cancer, I would still be plugging along at a job that I had grown to hate instead of enjoying every waking moment! There’s just never enough time to get everything done that I want to do! Even now! But, now all of the moments are full of things that I love to do.

Hedonistic? I feel like maybe so. But, I also think that I deserve the bliss I am experiencing now. Not because I have cancer, but because I have worked so very hard all of my life. It is wonderful to have the OPPORTUNITY to work hard at having fun instead of at a job.