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Monday, July 29, 2013

Report: Biopsy, compression screws and treatment changes

There’s a lot going on in Ruth’s Wonder-full world of cancer lately. I’ll try to report it as succinctly as possible. This post is for reporting purposes only. Reflections may come later.

Biopsy: My onc suggested to me that I submit my tumor for large-scale genetic testing. A place called Foundation Medicine has invented a new test that analyzes tumors for more than 200 genes / mutations. The tumor will be tested for mutations for which it has already been tested (in case someone goofed) for which there is targeted treatment, and also for mutations for which there is currently no treatment. By knowing what your mutations are, you are more likely to be involved in and benefit from clinical trials. They had run out of my original tumor tissue, and so last Wednesday, I had a needle biopsy (which I gotta say, is the easiest procedure I’ve had yet). Realistically, it will take about a month to get the results.

Compression screws: The first part of July, I fell (I’ll spare you the details) and, although I didn’t realize it at the time, I cracked my left femoral neck bone. The bone was already weakened from an old tumor which had left the bone soft/hollow and ready for injury. In order to keep the crack from becoming a fracture for which I’d have to have a hip replacement, the doctor is going to insert three compression screws from the outside of my femur through the femoral neck and into the femoral head, holding all of the pieces together. Surgery is tomorrow and then at least two weeks off of work. I have a couple of knitting projects in the hopper to keep me from going completely bananas.

Treatment changes: As I’ve mentioned before, my cancer had started to grow – slowly – but grow. With two scans – both lung and bone showing growth, it is now time to change my chemotherapy mix. My onc originally gave me two options – one more toxic than the other. I opted for the lesser toxin combined with an agent that I used in my original, non-maintenance chemo (carboplatin + gemzar). I’ve also asked to stay on the Avastin to keep brain mets away and there will be a new skeletal agent as well. I’m a little concerned because instead of treatment once every three weeks, I will receive treatment once a week for two weeks and one week off. It sounds like a good recipe for one sick puppy to me.
At this point, I’m not sure if they’ll be waiting to get the genetic testing results back before this new chemo or not. There’s also some new experimental immunology-type treatment that’s in the hopper with my onc. I think she’s applied to receive some or be a part of a study or something. If that comes through, I could be eligible and that would be a different course of treatment. Again, I’m not sure what the timing is on that either.
Until I do, I am striving for 

Friday, July 5, 2013

The Titanic – A Cancer SurvivorSHIP metaphor –(yuck, yuck)

The Titanic, as most readers will know, was a British passenger liner that sunk on its maiden voyage after colliding with an iceberg in the northern Atlantic Ocean. The craft carried 2,224 people, including the crew. My guess is that none of the people who boarded that ship on April 10, 1912 doubted that they would survive the trip. Some of them did, but many, sadly, did not.

Now, using the ‘logic’ that we use to call people cancer ‘survivors’ (anyone who has ever been diagnosed with cancer), all of the 2,224 people on the Titanic were survivors. They boarded the Titanic. They stayed on the boat for a period of time. By today’s standards, they could have all owned and proudly sported t-shirts that read “I am a Titanic Survivor!”


For the sake of honest communication, the term ‘survivor’ should to be applied to people who go through something, live through the during part of the something, and then continue to live after that something is over.  The term may be accurately applied to people diagnosed with early stage cancer, although I think many of them will never feel like their trip on the cancer Titanic is over.

For me to say, “I’m a lung cancer survivor!” is a complete misnomer. I’m surviving cancer, but can I survive cancer? Surviving and survivor mean different things. One is for the present. One is for the future.

Popular culture encourages our say-it-loud, say-it-proud pronouncement of cancer survivorship and unfortunately, American economy enjoys great boons from the cancer survivor ‘market’. Think of all of those wrist bands, survivor t-shirts, breast cancer walks with its accompanying push to buy, buy, buy (“The more of us who walk, the more of us survive!). And let’s not forget the month of October when you can buy just about anything in pink - from yogurt, to Barbie dolls, to footballs, to electric mixers. And cancer survivorship marketing must work very well, as it has now been discovered that some companies color their products pink so that people will buy them thinking they’re supporting those with cancer (I use the breast cancer example because of its prevalence.  Other cancer types are catching up).

So for those of you who have actually survived your cancer, like The Unsinkable Molly Brown survived the Titanic, I am nothing but happy for you. For those of you who believe that your story will more likely resemble that of the 1514 people who did not survive, you’re not alone.


Titanic Memorial in DC