Selasa, 26 Mei 2015

Into the Wind

For today's training ride I had a lot on my mind.  A Greek Chorus had settled into my thoughts like fog and I spent the better part of  yesterday cutting through one mess after another.  
       In the last ten days I've attended two funerals, (leukemia), was shocked with the sudden diagnosis (high risk lymphoma) of my nephew's 13-year old friend, was disappointed when I didn't receive a fellowship for a conference I wanted to attend, gladdened when another pro I admire contacted me, and traveled to Milwaukee with DH where his extended family met to celebrate a graduation.  There, I danced with our six-month old grand-nephew, who I met for the first time. Awesome.
       I was thinking about all these things -- and especially Thomas, the 13-yr old with lymphoma, who starts chemo today -- when I took off.  My regular training route is some 26 miles.  The route manages to encompass each and every hill we have in The Woodlands and just as many stop signs and stop lights.  The heat was already well over 85 degrees, the humidity was up and for the first part of the ride, the wind was at my back. A strong wind.
       Then it dawned on my me that at the halfway point I'd be turning back and into the wind.  Images of what  that's like, with the sun beating down on my head and radiating up from the pavement, dust flying into my eyes and sticking in a coating of sweat and sunscreen, and my energy draining, started to slow me down.  I'd made the mistake of doing a few hill intervals then sipped the new, low calorie Gatorade. Suddenly the artificial sweeteners and intense effort combined made me gag. I spit the Gatorade out,  lightened my gears and lightened up. I decided to change my tune. Completely. I'll often use a mantra while cycling and today's was this:  Into the Wind.  Focus. Focus. Focus.  I kept that rhythm up until the negative thoughts dissipated. I didn't deny them, or push them away. I remembered that difficulty can only be encountered once you admit it exists.
         Wind is wind, nothing more, nothing less.  I'd learned to cycle with it a few years ago so it no longer is a matter of not being able to complete a ride.  Now it's about cycling with intelligence.  But learning to cycle into the wind takes time, and patience.  Sometimes it's discouraging to lighten the gear, up the spin, and drop the power intensity, and up your cadence.  But you do, one spin after the next.
         And that's when I realized -- since I'd dedicated my ride to Thomas -- that my upset was about Thomas.  He's headed into the wind now.  Every person who's diagnosed with cancer, or experienced loss from  grief, has a time when they they know their moment is now.  Headlong and face first. That's when it's our turn to remind them that faith is stunning. And that God will reveal something beautiful that you've never realized before.

Blessings,
Jody

Minggu, 24 Mei 2015

Because

Photos from tornado ravaged Joplin, Missouri posted today by @TheAtlantic via @InFocus. The entire collection can be seen at:  http://su.pr/33xlI0


Because you know, as much as anyone, how easily your world can change in a moment's notice please keep the people of Joplin, Missouri in your thoughts and prayers.  

Not only has their world changed, their world is gone.  Gone.


Peace to you and yours.
jms 

Sabtu, 23 Mei 2015

Ten Things You Can Do Now to Fight Breast Cancer

Earlier today I learned that my  friend's 22-year old niece was recently diagnosed with breast cancer.  As a survivor myself, hearing about the disease doesn't often shock me.  But this did.  

As you start this Memorial Day weekend, take stock in all you are and have.  Here are ten easy things you can do -- starting today --  to fight breast cancer:

1)  Do everything in your power to stay physically, emotionally and spiritually healthy.  

2)  Know your own risk factors and move proactively to combat them.

3)  Understand that "breast cancer" is not a single disease but  many. There are various types, characteristics and qualities.    

4)  Remember that the majority of women are living well five, ten, twenty, thirty years after their original diagnosis.  You'll know you're cured, my oncologist told me, when you die of something else.

5)  Participate in research that advances understanding and origins of the disease.  Pioneering surgeon Dr. Susan Love's group, Army of Women -- www.armyofwomen.org -- is currently seeking volunteers for studies that require very little of your time.  Please visit www.armyofwomen.org and sign on.

6)  Another study the Sister Study, is now underway.  Enrollment closed in March, but this will be a landmark investigation.  To date it is the ONLY long-term study of women 35-74 who have not had breast cancer but have a biological sister who has.   I am proud to tell you that my sister Megan, is a participant.   We both hope this effort will help pinpoint what (and  if) environmental factors may contribute to the disease.

7)  You can eliminate a fear of cancer by taking action;  even something as simple as participating in a walk or run for Race for the Cure.

8)  Mom was right on the fruit and vegetables.  Enjoy them!  Your Mom may have missed the boat on processed foods -- but you don't have to.  Evidence also points to the importance of Vitamin D in healthy cell functioning.  If you skip dairy, please ask your doctor or a nutritionist what the best supplement for you might be.  

9)  Visualize what this world would be like without cancer.  Wow.  Let's use that hope to continue our advocacy. 

10)  Breasts aren't everything.  Life is.

Enjoy your weekend.  LiveStrong!

Kamis, 21 Mei 2015

One Berry at a Time


All right.  I will confess.  

For lunch I had graham crackers (two) spread with left-over icing.  And for breakfast? The last, very lonely piece of cake, calling out from the frig.   The rest the cake went home with last night's guests. 

Yesterday I made this heavenly creation -- Strawberry Cake -- for a Silpada party I hosted for my friend Jullie Jones.  She is someone you'd love to meet and have as a friend.  She is sincerely upbeat, naturally funny, honest, smart, and with a faith that is something to behold. And since I'd rather enrich a friend than some meaningless chain or department store I made time to plan a party, cook and invite some friends to stop by, nosh and play with jewelry. How much better can life be?   

First, I took pictures of the jewelry and forgot to get a photo of the cake.  Nobody's perfect. Jullie made an incredible display that featured all the necklaces.  Yum.  She showed us how to pick one foundation necklace, then layer it with subsequent strands for different outfits and looks.  The array of colors went from earth stones and bronzes to rose and of course, lovely freshwater pearls. Very, very nice. Naturally there were coordinating  bracelets,  earrings and rings.  One big plus of the line is a life-time guarantee.  

Most of us were overwhelmed by the all the possibilities, not to mention the incredible spring evening and the opportunity to see each other again.  We oohed, aahed, felt the cool smooth stones, jingled bracelets, ran back and forth to the mirror to look, and ate. Oh, did we.

Back to the cake.  This was a gem I found on one of my favorite cooking blogs, 
The Pioneer Woman, by Ree Drummond.   I saw the recipe and knew it was a winner, a spongy vanilla layer soaked with strawberries and smothered with cream cheese icing.  For fun I combined strawberries and blackmerries.  You mush them up and let them soak into the cake.  I cut some of the fat content down with neufathchel cheese instead of the real deal, without one peep of "gee,  this is only 50% fat instead of 75%!"  Did anyone care?  No.

What a way to welcome summer!

All the best,
jody




Minggu, 17 Mei 2015

Between the Headlines. You Choose.


While dire statistics about male breast cancer may have sounded like the big story from the American Society of Breast Surgeons’ (#ASBrS2012) annual conference early in May, there were others with more far-ranging consequences that didn’t hit the wire.
The name of the game for any woman facing breast surgery now is still ACOSOG Z11, the sea-changing clinical trial which showed that extensive lymph node surgery is no longer needed for women who have microscopic cancer cells in one or two lymph nodes. 
“There’s still a need to educate surgeons and patients that axillary dissection is unnecessary in many patients who have positive nodes (1-2) and who are undergoing lumpectomy and subsequent whole breast irradiation plus chemotherapy for breast cancer,” says Deanna Attai, MD, FACS, and co-moderator of the weekly #BCSM chat on Twitter.
With ACOSOG Z11 one of the pillars of breast cancer treatment, axillary lymph node dissection (ALND), took a serious hit.  Physicians know now that biology combined with staging predicts long-term survival in breast cancer patients, not just the stage at diagnosis.  This study will save thousands of women from painful, disfiguring surgery and its attendant life-long risk of lymphadema.  ACOSOG, a clinical study group of the American College of Surgeons established by the National Cancer Institute, is also looking at whether or not the same survival benefit applies to women undergoing mastectomy instead of lumpectomy as part of their treatment.  It seems logical to expect that it will.
            But to date no studies have been done to show whether or not women who receive accelerated partial breast irradiation, or APBI, could also bypass extensive lymph dissections.  Yet. 
            APBI, a form of brachytherapy, is one of the newer kids on the block in treatment.  In brachytherapy a device is implanted within the breast next to or within the original tumor site.  This is done on an outpatient basis after pathology reports confirm that surgical margins are clear and the scar from the lumpectomy incision has healed.
             Brachytherapy also has attracted some controversy.  Last December at the San Antonio Breast Cancer Symposium researchers from MD Anderson said that bracytherapy was associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation.
            Then on May 2, the same day the ASBS conference opened, I saw this JAMA article “Association Between Treatment with Brachytherapy vs. Whole –Breast Irradiation and Subsequent Mastectomy….” with headlines like this “More Women Need Breasts Removed” right on its heels.
Coincidence?  Probably. Soothsaying has never been one of my skills.  But note that a trial ASBS presented, “Brachytherapy as Effective for Local Breast Cancer Control as Whole Breast Irradiation” wasn’t released until May 4, two days after the JAMA article appeared.
There’s a lot to say.
In both cases, the retrospective data analyzed by the MD Anderson group or the Mammosite® trial reported by the ASBrS, survival was NOT adversely affected by the use of brachytherapy or APBI in women with early stage breast cancer who had been treated with lumpectomy.  In other words, a woman does not increase her risk of death in choosing between the two.
What the JAMA issue does not analyze (nor could it) is the best candidate for the short-term course of radiation.  The JAMA data was compiled from an analysis of Medicare claim forms (not medical records) of 92,735 women – the average patient age was 74 – treated between 2003 and 2007.  And while the potential risk of mastectomy in patients treated with brachytherapy echoed loudly in headlines what were the actual numbers? 
For older women with early breast cancer, some 3.95, or close to four percent were more likely to have to undergo a mastectomy vs. 2.18 percent undergoing whole breast radiation.  Granted, if you are the woman in the differing 1.77 percent having to undergo a mastectomy after prior lumpectomy and APBI would be difficult yet the inference, that the subsequent mastectomy was related to brachytherapy cannot be inferred from claims data. The information isn’t complete.  
Another question is how many women within that 3.95 percent had cancer recur close to the original tumor? That is the million dollar question and what only trials can determine.
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society said here, “The question has always been whether the use of these newer techniques has the same benefit of treating those silent areas that we know exist in other parts of the breast.”
The great majority of local recurrences actually occur within one centimeter of the original tumor, Dr. Attai said.  In the ASBS study, seed radiation via MammoSite® (the implanted device that delivers the radiation) is as effective as traditional or whole breast radiation in preventing local recurrence in a subset of patients with early breast cancer.  These patients have now been followed for five years.
           “Right now offering APBI outside of a clinical trial is only recommended for women older than age 45-50, with tumors <3cm, clear margins, and negative lymph nodes,” Dr. Attai said.  “It will remain to be seen if factors such as tumor grade, ER/PR and Her2/neu status, and other factors are important in the patient selection process.”
          Bottom line:  if you are currently considering brachytherapy carefully research both your surgeon and radiation oncologist. You need to ask pointed questions. Accelerated radiation, delivered twice a day for five days as opposed to 30 – 33, is a great deal more convenient for working women. It also delivers less ionizing radiation to the surrounding tissue -- remaining breast tissue as well as ribs, lung and heart -- than whole breast radiation. 
It’s important that you know what device the surgeon uses(whether MammoSite® or SAVI or Contura) and her/his experience with it.  One of the coolest things I ever encountered in my own ‘ask the doctor journey’ was when I was considering reconstructive surgery and asked the plastic surgeon how many (free) flaps he’d lost.  Without missing a beat and not minding the question at all he simply said, “none.”
But you have to ask. You also need between the headlines for the information you need to make critical decisions about radiation.  Shorter-term has its own set of side effects (physician skill is key) and benefits – better cosmetic outcome and skin damage in most cases. As with any newer procedure a surgeon’s training and experience are the best predictors for the best possible outcome.  In essence, APBI with MammoSite® is shown as effective as conventional radiation for women with some early stage breast cancer.
              “MammoSite was the first device approved and has the largest amount of associated data. Newer devices allow us to better sculpt the radiation dose and minimize excessive exposure to the skin, ribs and lungs, and potentially making this treatment available to a larger number of women,” Dr.  Attai said.
               Keep asking your questions.  Talk back to the headlines until you’re comfortable that you’ve gathered all the information you’ve needed for the best possible cancer treatment.  I think that with the right surgeon, APBI is an excellent option.  But you have to know it’s available, to even choose.

#  # #

1) May 7, 2012 Tweetchat:  Findings from the ARBrS2012 Conference
2) American Society of Breast Surgeons: APBI Selection Criteria

Disclosure:  I am a patient liaison for the American Society of Breast Surgeons, a voluntary advocacy role.  I was not asked to nor did I accept any payment for this article.  But I did ask questions because hearing both sides of the story, especially in regard to breast cancer therapies, is always important to me.

Sabtu, 16 Mei 2015

The Call


This post was originally posted on "Join OuR Loop," March 10, 2010


Without a doubt a trip to the dentist last week now outranks my first wisdom tooth extraction as my “most incredible appointment ever.”

Not that I’m writing an epistle about incredible dental appointments, but there’s something about surviving cancer that incredible things happen in the places where you’d least expect it.

Serendipity, yes. Uncanny coincidence? Perhaps.  The act of a mysterious and often unfathomable God?  I leave that for you.  I have my own thoughts, my own faith, there.

When I first saw Anita, my dental hygienist, she looked like she was an exceptional mood.  Since she’d soon have that handy-dandy scraping tool in the vicinity of my gums I was glad for this. Insanely grateful, in fact.  I was also glad because it had been a bad year for her….man trouble, then a divorce, followed by money issues.  So we talked for a little bit about that and how she actually and truly WASN’T fat. I get that.

She turned around with her back to me, lifted the bottom hem of her top and pinched a tad of flesh over her hips. “See?” she said, “I’m getting fat.”  

She isn’t.

Girlfriends, Anita is drop dead gorgeous.  Tall.  Long dark hair and eyes, with lovely brows that move up naturally in a question.  She’s intense, driven, funny, and the first girl you’d be in a hair-pullin’ mud fight with.  She’s an ass kicker and is gifted with horses.  If you ever have a “my little pony” moment and end up buying a horse, call HER first. If harnessed (forgive the pun) she would make an extraordinary advocate for any cause. She’s also, not surprisingly, a perfectionist.

I donned the stylin’ paper bib with the clips, and she peered into the computer to pull up my records.  She got to work.  When she was still working on my lower teeth she mentioned something about expecting a phone call from a doctor. She scraped on. Then she dropped the word biopsy and headed toward a tooth that usually sends me into the stratosphere.

By then I turned into one large nerve.

“Wha eyopsee,” I mumbled.

There was something about a breast lump, then oh, there were actually two breast lumps, and a lymph node that looked funny to the doctor so they did one there, too. The next thing I know she leans in to work on the inside of my front teeth – you know that space in between the upper incisors – and starts talking about how she negotiated the price for all of this with the practice business manager.

“I got all of it for $550,” she said then. She sat up suddenly and the scraper made a gesture through the air, “for pete’s sake my deductible is $10,000 and you know whose fault that is. Did I make a deal about his $6,000 of plastic surgery when we split?  Hell no you know I didn’t.”

She zoomed back in to check another troubling space between my bicuspids.  A space she tapped the handy-dandy tool against. “What happened there? I don’t like the sound of that,” she said. “Do you suck on hard candy?”

She was maybe an inch from my head, concentrating on my damn, stupid, stupid, tooth. I felt her phone start to vibrate. Then again.

I gently pushed her hand back. “Your phone,” I said.

“Oh forget it,” she said.

“Let’s answer it.”
 
I already knew.
### 
We sat together while the call came in. I held her hand.  She squeezed mine back, in fact, so I covered hers with my other hand.  She talked for a few moments and I knew what she knew.  She was calm, and then moved the phone toward me so I could listen. Our heads were touching.  At that moment the strength of every survivor I’ve ever spoken with – and the grace of God – informed me.  It has been ten plus years since my diagnosis and anything I suffered, and my family suffered with me, condensed into helping Anita.  All that energy collapsed into a 90-second pause.  I prayed this strength would help form the foundation for her upcoming battle.  I felt the strength of all of us, the strength of my sister and yours.  Those I’d met, and those I’ve yet to meet. 

Eventually I ended up with the phone and took notes for her.  I asked her doctor to fax us her pathology report.  I listened to the doctor talk about how hard it was to get into MD Anderson and I said, ‘you can refer yourself now.’ To myself I said, “what kind of BS is that?”  Anita is 37.  She’ll needs every tool in the cancer arsenal plus some, to do battle with this.  I showed her how to refer herself to M.D. Anderson, an NCI designated facility, before I left her office that day.


Because she’s pretty, and she likes her looks (why shouldn’t she?) the strength of this woman is underestimated.  But her strength comes through loud and clear. She’ll kick that bastard cancer where it hurts.


That’s one gift of survivorship. I’m here to tell you about Anita and urge you to support her fight, as I support yours.
 

Love to you.  Do what you can, as you can. 
Helping Anita © by Jody Schoger 

Minggu, 10 Mei 2015

A Mother's legacy: did her cancer help cure mine?

In l951, some twenty years before President Nixon would declare war on cancer, a technician at John Hopkins Hospital in Baltimore meticulously cut a biopsy sample into one-millimeter squares, covered them with a culture medium developed in the same lab, sealed them in test tubes and put the tubes in an  incubator.
         The lab assistant had done this hundreds of times before, in an attempt to establish an infinite line of cells -- the Holy Grail in medicine then – for research.


        Within days something that had never been witnessed before occurred.   The cells from the cancerous tissue were not only still alive but multiplying “…with mythological intensity.”  To this day these cells, HeLa, as they were labeled after the first two initials of the women they came from, have not stopped. 
         This incredible moment in science – for all its ramifications – is just the tip of the iceberg that journalist Rebecca Skloots taps in The Immortal Life of Henrietta Lacks, the spellbinding story of Henrietta Lacks and what happened to the cancerous cells removed from her without consent.  The book holds up a mirror of the past century’s biggest issues – race, women’s rights and health, the commercialization of medicine and research, the term “informed consent”, the rise of the patient advocate movement, the search for cures and vaccines, inequality in health care. 
          You could develop a year-long high school curriculum from The Immortal Life of Henrietta Lacks, and still have ample topics remaining, starting with the obvious beauty of teaching science in a way that cements discovery to time and place, ethics, public policy, journalism and even literature.  Because in essence this story is so deeply human, I’m finally writing it on Mother’s Day, even though I’ve had the book since January.
           The Immortal Life of Henrietta Lacks is one young Afro-American mother’s equally wondrous and equally devastating legacy.  The first follows the time bomb that made Henrietta Lacks “immortal” in the first place: a malicious adenocarcinoma of the cervix.  Her cancer was made worse by the diseases her husband brought home with him as well -- HPV, gonorrhea and syphilis. HPV implants itself into a cell’s DNA, where it spits out proteins that lead to cancer, and venereal diseases weaken the immune system.  Both of these factors probably contributed to the aggressive nature of her cancer.
From those vicious, cancerous cells the resulting HeLa cell line would eventually become a commodity, purchased from one lab to another for research, making millions of dollars many times over.  None of the funds ever went directly to tDr. George Gey, whose lab replicated the cells, or the Henrietta Lacks family. HeLa cells we learn, helped develop a vaccine for polio, researched the genes that start and stop cancer, and helped develop drugs for some cancers and Parkinson’s, among others.  As of 2009, more than 60,000 scientific articles have been published on HeLa research.   
But for Henrietta Lacks in l951, cancer treatment was something she endured primarily alone.  She knew something was wrong and told the receptionist at John Hopkins that, “I got a knot on my womb.” Her cervix was not removed, nor did she have a hysterectomy. She received two radium treatments in the “colored-only” operating room of John Hopkins then began a month of x-ray therapy.  By August she would be back in the hospital, tumors beginning to fill her body.  When she died on October 4, she left five children.  Two were still in diapers.  Her daughter Deborah, was about 15 months old.
This is the other, devastating legacy of Henrietta Lacks’ short life, the loss her children experienced growing up without a mother, and then some twenty years later, finding out that a part of her was still alive, written about, and sold.  The Lacks themselves could not afford health care, and their lack of education and experience to understand the health care system?  Today this is called  “access to care.”  It doesn’t mean that they couldn’t physically get to John Hopkins (although it certainly can) but it does mean that the lack of understanding about how that hospital works put them at a terrible disadvantage. 
At one point, one of Henrietta’s sons simply calls the switchboard at John Hopkins and asks the operator “where the mother cells are,” as though everyone there might know. Their misery, loss and anxiety leaves Deborah especially, suspicious, sometimes paranoid, and vulnerable to others who would do them harm.  At one point Deborah said in footage edited from a documentary by the BBC, “I often visit her hair in the Bible (she had both a lock of Henrietta’s hair and her Bible).  When I think about this hair, I’m not as lonely.  I imagine, what would  it be like to have a mother to go to, to laugh, cry, hug.”
Many of the issues raised in The Immortal Life of Henrietta Lacks will leave you thinking, which is as it should.  Rebecca Skloots does a superb job of weaving all the story lines and not injecting herself into the narrative any more than is absolutely necessary to accurately recount a situation or conversation.  This in itself is exemplary, given the ten-year quest Skloot was on to research and write the book, the special care she took with Deborah Lacks.  Eventually Deborah comes to call Skloot “Boo” and would say such things like, “HI, my name is Deborah and this is my reporter.” 
Ultimately the story is Deborah’s story, Rebecca’s story, and anyone sharing the same post-war generation.  Eventually I realized that one of my brother’s was born the year Henrietta died, and that both Henrietta and my mother were born the same year: 1920.  Like Henrietta, my mother also lost her mother at a very early age so I’ve witnessed the legacy of a motherless child.  It gave me pause.
And I have nothing but accolades for Rebecca Skloots and the final twist of this incredible story.  While many are jaded about journalism, or might cop an attitude about searching for the truth The Immortal Life of Henrietta Lacks shows us otherwise.   By following the string of facts about Henrietta Lacks, her cancerous cells, and the impact of those cells on her family and society Rebecca Skloot gave the Lacks family back part of their history, part of their life.  Skloot has established a foundation to help, in part, provide scholarship money and health care assistance for the Lacks family.  The story was also a gift for this survivor, in that Henrietta Lacks’s cancer may have helped cure mine and thousands of other individuals.  It is a story to remind us to never, ever say never.

                                                   #   #    #

Photo from:  www.rebeccaskloot.com/ photo by KJ Murti 

Jumat, 08 Mei 2015

48 Hours: My Life in a Clinical Trial

(Note: I'm back. I've been away longer than I anticipated for a cycling vacation with the girls and a family wedding in Seattle. But I've been on Twitter and #BCSM Monday evenings. I hope you have been too. Now that Houston's notorious summer weather is returning, I'm back in the writing swing.)


What if? 
      What if, once you turned 50, you could bypass the well-known and dreaded prep for colon cancer screening with something much simpler, and much easier?
      What if that test were as simple as a blood test?
Some of my 'homework.'
      What if the only thing standing between that possibility and reality were healthy volunteers (that would be us, friends) who could spare a a few hours and a few poops to participate in a clinical trial?
       Sigh. Yes. I said poop.
       OK, I said a few poops.
       Let's use our inside, adult voices now. All I want is for you to use whatever word you need to keep reading. For most people shit happens daily. For too many, so does colorectal cancer, the third largest cancer killer in our country. It can be readily detected - and cured - long before invasive cancer has developed.

Here's what happened. I was on deck to have a follow-up colonoscopy this year. My first was ten years ago when I finished breast cancer treatment. Ever since my diagnosis I thought the topic of a clinical trial would be part of treatment at MD Anderson. Even if you're willing, finding the right trial is anything but easy.  Until last week.
         The researchers found me. There was the first surprise. And they waited for me, and not the other way around, while I was meeting with a nurse practitioner to discuss my upcoming colonoscopy. After all, I needed to select my preferred flavor of  GO-Lytely  (honestly, who could you make that word up?) and anesthesia, since something other than "JustKnockMeOut" was required for the orders.
         The trial, as you've already guessed, will test whether or not a proprietary biomarker in blood, urine, and stool samples can accurately predict the presence of adenocarinoma, the most common form of colorectal cancer. This is a ten-center project sponsored by NCI's Early Detection Research Network  that seeks to accrue 6000 patients over the next three years. Let's say that everything works out, awesomely and wonderfully. Even with that, the earliest the news would hit the public eye through papers, conferences and then to the media would be five years.  That's science. And if it doesn't work out, if the hypothesis fails, the only time you'll hear about this is possibly now.

In real life science can be excruciatingly slow. In real life the two researchers (whom I can't identify even though they were terrific) had to think through every possible way the sampling process could go wrong ...in detail you don't want to imagine although we had a great laugh about someone whose sample rolled away. Needless to say, I listened and signed the consent form. Blood was drawn and a urine sample was produced.
         Back to the poop.
         It really wasn't so bad.  My new research friends went through every aspect of my 'homework,' and they then they sent me home with the necessary supplies in a white-shopping bag. At MD Anderson the white shopping is a clear giveaway for #NewPatientOnBoard. You might as well just stamp "PleaseHelpMe" on your forehead. It was difficult not to tell many sympathetic onlookers that this was nothing more than a "shitty test" but I held my tongue. I just smiled.
        Because the fact is we need to smile and laugh to work through our weird feelings about every single substance our bodies produce, regardless of what end is involved. I laugh right along with and at myself, especially in my anal (oh, so appropriate) attempts to make sure I followed the instructions to the letter. Heaven forbid my samples might fail to qualify. If there's a marker to be found then let mine be the first in line.
This one's for you,  Pat.

Earlier today I read a phenomenal post by Pat Steer, a CRC survivor I wrote about two years ago. Today she is the same woman, with the same clarity and courage. But her health is not the same.  She has stopped treatment and describes this in No More Room in the Bucket.
       Her post just happened to overlap my writing today. It reminds us to move past the  'ew factor for the greater good. If you're 50 and older, don't wait to discuss colorectal cancer screening with your doctor. Bring the topic up if she doesn't. If you live near one of these cancer centers. consider joining the clinical trial I just concluded. My last bit of  homework is now in the mail.  In the long scheme of things it wasn't much to ask.  No, not at all.

For other clinical trials, go to: www.ClinicalTrials.gov

Thanks so much,
Jody

       

Selasa, 05 Mei 2015

This or That

That day changed everything.
One started on Palm Sunday
Another in the startling blue October sky
Another a steamy April afternoon
in the Texas Medical Center
and another
and another
another
cancer.
Until even though well
I simply cannot sleep
thinking, praying for all 
these precious lives.

This day is ours to own
we can go up the down staircase 
through shadows and into light
climbing, walking, arms open 
face open
because we can
pause for a long moment
and 
watch sunlight dance through motes
wondering if or how
that same energy could stop cancer cells from breathing.
Stop them.


Photo credit:  Kathi Kolb

Deadline 2020: Who Knew?

NBCC Call To Action
There's a challenge on the table for anyone - and everyone - who has ever been affected by breast cancer.
       The challenge is to end the disease by the year 2020.
       When I first heard of the campaign - launched by National Breast Cancer Coalition this past January -  my skepticism did an automatic override.  My immediate thought was that it was a bold fund-raising campaign.
        Still, I was curious and impressed with their conference program.  I applied for, and was granted a scholarship to attend, which covers both the registration fee and three-nights shared lodging in DC.
       Understanding the science, and the "who's doing what where" in breast cancer is imperative to 1) prevent and 2) completely stop metastatic activity in its tracks. Metastatic cancer, those cancers that relocate and take up residence in the brain, the lungs, the liver, or the bones is what kills close to 40,000 million women per year.
Patricia Steeg, PhD - NCI
         Yet, as Patricia Steeg, PhD, chief, women's cancers section at NCI, pointed out, the drugs used to treat women with metastatic cancer are those developed for primary breast cancer, not specifically for metastatic disease, which by its very nature is different. In another way, do we have chemo, biologic or hormonal therapy specifically developed to fight metastasized cancer cells?  Or drugs developed to see how much a drug will slow slow the progression of the disease?  That is a huge distinction.
           Into this milieu comes the goal of ending breast cancer by 2020.  Here comes my skepticism lurking in the corners.
           But.
           I never thought that Osama bin Laden would ever be found and killed, either. Even the grandest campaign, the best marketing, the combined passion of advocates, planners and researchers could not have spit out this event in the middle of the conference.
          While having a long conversation with Gayle Sulik, PhD, author of Pink Ribbon Blues, Sunday evening about "changing the conversation" about breast cancer, the news broke on CNN that after a ten-year hunt, the 9/11 mastermind had finally been hunted down and killed.
          In time we'll eventually hear the work that went into this raid. The planning. Rehearsals. The failures. Redirection. Training and work across agencies, specialties, and capabilities.  It was a multi-disciplined approach toward a unified cause: to stomp him out.
          It took ten years to track down Osama.  Ten years to end breast cancer?
          As I flew home last night, outlining the work ahead to communicate what I learned and what I think we need to do, what dawned on me finally was this:
          I'd grown complacent.  Not in believing that breast cancer(s) - there are many - could be cured, but   when or how.  Within complacency was another unsettling: how could I believe in finding cures for others if I didn't accept that my remission - my thirteen years of healthy survivorship, was real, too?
          This conference ferreted out the last of my own lingering fear.  I believe in my health and in so doing I've become a better advocate for the incredible women I met at the conference with cancer and all those I don't know for who are in treatment now.
          There was a seek and destroy mission out on Osama Bin Laden.   Stick around.  We're about to do the same for breast cancer.  How will you help?

Senin, 04 Mei 2015

MD Anderson Strikes Out "Cancer"

This is big, bold and beautiful.


The University of Texas M.D. Anderson Cancer Center takes a visual step forward today with its announcement of a new graphic that visually symbolizes its even wider mission: to eradicate cancer. 


Not just eliminate, but eradicate.  Since the word literally means "to get rid of as if by tearing up by the roots" just imagine cancer vanishing from its source.  Imagine that the roots of a particular cancer, mysteries buried deep within a cell, can be destroyed. To me that seems like a dream.  MD Anderson, at least, wants to put that elusive goal out there for all to consider.


The change to the logo is actually simple, which is part of its beauty.  The powerful "Making Cancer History" tagline, part of a l996 advertising campaign where surviors take a red pen and strike through the word cancer, remains. But the red-lined cancer now is incorporated into the graphic where it was only subliminallly related before.   


"With this new mark, we've told the world where we stand in the effort to end cancer," said John Mendelsohn, M.D., president of MD Anderson. "We're proud that we've created tremendous momentum in cancer research and care.  Every patient and research finding teaches us more about how we can eliminate cancer." 


As many of you know, I'm a "graduate" of MD Anderson and was diagnosed there in l998 with a locally advanced breast cancer (or Stage IIIB).  My cancer may indeed be history, and the same for my husband who is a two-time melanoma survivor.  He too has been treated there and also participated in a clinical trial for a melanoma vaccine.


Until now, oncologists have been jumpy about using the word cure and cancer together, or in my case, to consign cancer to a limited time frame.  Gone.  But certainly not forgotten.  For if that were true, there wouldn't be so many of us, working so hard, with such diligence and determination, to bring the elusive cures to fruition.  Imagining a world without cancer isn't something I can conceive of.  Just yet.


What about you?  How does this affect your thinking about cancer?  Do you you think cancer can be eradicated in your lifetime?  Or that of your children?  

Sabtu, 02 Mei 2015

Your Lungs, Your Life

The other day I came across a newspaper headline that made me drop what I was doing to pick up the paper:  Cancer battle inspires Memorial softball team. The 'battle' is that of  a 43-year old softball coach who was diagnosed with Stage IV lung cancer after stroke-like symptoms sent her to the emergency department of a local hospital last year.

The nonsmoking, athletic woman had tumors all over her lungs. Both her hip bones and liver were damaged by cancer as well.  With no symptoms -- and as yet -- no reliable screening method for early detection  the fact that Tina Young found out about her cancer (even if by accident) probably added months to a very dark prognosis.

Fourteen months later she still is holding her own against the disease. Her story, others like hers and the advent of extraordinary report released this past Monday by Brigham and Women's Hospital --  "Out of the Shadows: Women and Lung Cancer" -- will hopefully raise the blinds on a public health issue that has been advancing steadily for the past twenty-three years. This points to a collective and alarming "see no evil" stance that results when any behavior-related cancers are being discussed.

The year my mother died of lung cancer -- 1987 -- is the same year lung cancer surpassed breast cancer as the leading cause of cancer death in women.  Not the progress any man or woman who ever championed equality ever had in mind.

Here's the facts about lung cancer in women today from "Out of the Shadows":
  • More women (and men) die from lung cancer every year than breast, prostate, colon and pancreatic cancer -- combined.
  • Some 200 women die every day from lung cancer.  
  • The incidence of lung cancer in women has increased six-fold over the last 30 years.  The death rate for women began increasing while that of men declined.  In fact the death rate for women increased from the mid-1970's through 2003.  The death rate appears to be leveling off.
  • Lung cancer kills more women every year than any malignant tumor.  By comparison, more women are diagnosed annually with breast cancer, but through effective screening methods (ie earlier diagnosis) and treatment options more women live longer. Cancer caught in its "infancy" can be successfully treated.
  • The last and most alarming:  60 percent of new lung cancer cases consist of people who have never smoked (or are former smokers). The majority of those who never smoked are women. One in five women with lung cancer are not -- never have been smokers. Adenocarcinoma, once rare, is now the most common type of lung cancer in women of all ages, particularly young people who haven't smoked.
There are sex-related factors that come into play.  How they do so is not clear as yet to researchers.  This much is known:  women -- even when diagnosed at a similar stage than men -- survive longer.  Women are more likely though, to be diagnosed at an earlier age.   Women too, seem to be more susceptible to second hand smoke.  This difference, and a variation that has been identified in a tumor-suppressing gene, may prove to be a promising avenue for researching new therapies.  

One of the assets of "Out of the Shadows" is its clear presentation on policy implications, from understanding sex-related differences to pushing emerging technologies for early detection and developing public health interventions with African American and Native Hawaiian smokers.  Both groups carry a significantly higher risk of developing lung cancer than whites.

The best thing we can do first is understand the extent of the problem, gather our compassion, and start advocating.  The reason this topic doesn't reach the headlines is that too many of those affected die.  

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Lung Cancer Alliancethe only national non-profit organization dedicated solely to providing patient support and advocacy for people living with or at risk for the disease. Our mission is clear: leading the movement to reverse decades of stigma and neglect by empowering patientselevating awareness and changing health policy.

LUNGevity Foundation founded by seven Chicago-area lung cancer survivors in November 2000 to increase funding for lung cancer research.

Grass roots organizations: