#LCSM Salutes World Cancer Day

[This is a reblog of a post on the #LCSM blog.  Reposted with permission]

Tomorrow, February 4th, is World Cancer Day. The focus this year is Target 5 of the World Cancer Declaration:  reduce stigma and dispel myths about cancer. The World Cancer Day campaign seeks to “Debunk the myths” of cancer:

  • We don’t need to talk about cancer
  • There are no signs or symptoms of cancer
  • There’s nothing I can do about cancer
  • I don’t have the right to cancer care

This focus parallels the goal of #LCSM “to educate, develop public support, end the stigma, and facilitate successful treatments for the leading cause of cancer deaths worldwide.”

On World Cancer Day, we hope the #LCSM community will take the opportunity to tweet about lung cancer as well as cancer in general.  Be sure to use “#LCSM” as well as “#WorldCancerDay” in your tweets so followers of both communities can see them. You can find a list of tweet-sized facts and the supporting documents on our Lung Cancer Facts page.  Or, if you prefer, just retweet #LCSM tweets that appear during the day.

Happy tweeting!

Journalists vs ePatient — and How It Got Ugly

This is a story of Bill Keller (former executive editor of the New York Times), his wife Emma Keller (a journalist for The Guardian in the UK), and Lisa Adams (a 44-year-old mother of three who lives with metastatic breast cancer and shares her cancer journey in blogs and tweets).  But, in a broader sense, it’s the story of the disconnect between cancer epatients who share their journey online, and journalists more comfortable with traditional approaches to healthcare and media.

On January 8, 2014, The Guardian published Emma Keller’s article about her fascination with Lisa Adams tweets: “Forget funeral selfies. What are the ethics of tweeting a terminal illness?”  Four days later, The New York Times published Bill Keller’s Op-Ed piece titled “Heroic Measures,” which contrasted Lisa Adams’ very public efforts to stay alive with the private death in hospice of Bill Keller’s 79-year-old father-in-law.  From my perspective, and that of many others, both of the articles appeared to blame Lisa Adams for taking her terminal cancer journey public.

Both articles generated some positive response and a LOT of negative comments.  You can read comments on the NY Times page for a sampling of reactions.  Comments on the Guardian article are here, even though the original post “has been removed pending investigation” (Emma Keller revealed she published parts of private communications with her subject, Lisa Adams, without first obtaining Lisa’s permission.)  The Internet and Twitterverse reacted strongly, and major online media are starting to analyze what happened and what it all means (see links at the end of this blog).

My initial reaction to Bill Keller’s Op-Ed piece was to wonder how a former executive editor of the New York Times could have managed to publish a piece with so many errors in it. He hadn’t read Lisa Adams’ online profiles, or he would have known she had three children, not two, and her cancer became metastatic in October of 2012, not seven years ago.  He couldn’t have read many of Lisa’s online posts, or he would have known that she abhors battle metaphors for cancer and honors each patient’s choice to treat or not treat their cancer.  He hadn’t read the article he cited about palliative care and lung cancer, or he would have known the patients in the study received palliative care during active cancer treatment and were not in hospice care. He apparently doesn’t know much about the healthcare system, since he attempted to verify information about Lisa Adams’ treatment with her doctors, who are bound by HIPAA laws not to disclose her information.  I especially did not appreciate how he blurred the distinction between palliative care and hospice (my thoughts about this appear in the comments section of Bill Keller’s op-ed as well as below).

The more I think about it, the more it seems this mess reflects how little major media and the public at large understand the epatient movement and cancer.  The blogs, tweets and forum posts of actual cancer patients are invaluable to those dealing with the life-changing personal crisis that is cancer, and to their families and caregivers.  Epatients like me share our experiences and learn from each other regarding the symptoms, diagnostic process, terminology, second opinions, treatment options, side effects, research, clinical trials, palliative care, hospice, and dying with grace and dignity.  For some of us, it’s been a literal lifesaver.  If I hadn’t read posts from other cancer patients online, I wouldn’t have learned about the ROS1 mutation and I’d be dead now.

Apparently Bill and Emma Keller think we metastatic cancer epatients should just go silently into the night–with emphasis on the SILENT. Maybe if they actually spent some time reading the blogs of Lisa Adams and other metastatic cancer patients, they would understand instead of blame.

My comment to the New York Times article

“Your characterization of ‘palliative care’ and the related lung cancer study does a great disservice to cancer patients. Palliative care is a specialty that provides comfort care to patients and family members from the day of diagnosis — before, during, and after treatment. Cancer patients can be receiving aggressive treatment and still receive palliative care.

“In the lung cancer study you mentioned, patients were assigned ‘to receive either early palliative care integrated with standard oncologic care or standard oncologic care alone.’ This means the patients were receiving active cancer treatment. They were not ‘going gently.’ They were trying to stay alive.

“An article recently published in the Journal of the American Medical Association indicates others suffer from the same lack of understanding as you. It states, ‘Seventy percent of Americans describe themselves as ‘not at all knowledgeable’ about palliative care, and most health care professionals believe it is synonymous with end-of-life care.’ http://www.nejm.org/doi/pdf/10.1056/NEJMsb1305469

“Palliative care may be offered during hospice, but palliative care is NOT the same thing as hospice. Cancer patients in treatment need comfort care too. Misrepresentations such as yours will keep many of them from getting it — they’ll think palliative care means the doctor has given up.”

Commentary in Major Online Media

New York Times Public Editors Journal: Readers Lash Out About Bill Keller’s Column on a Woman With Cancer (Jan 13)

Salon.com: Bill and Emma Keller’s bizarre pieces about cancer patient Lisa Adams (Jan 13)

Wired: Former New York Times Editor, Wife Publicly Tag-Team Criticism of Cancer Patient. Ugh. (Jan 13)

Washington Post: Former NYT editor Bill Keller and his wife under fire for commentary on cancer patient (Jan 13)

The Atlantic: On Live-Tweeting One’s Suffering (Jan 13)

Huffington Post: Bill Keller Criticized For Op-Ed About Cancer Patient Lisa Bonchek Adams (Jan 13)

Slate: There Is No Right Way to Die (Jan 14)

Huffington Post Women: What the Kellers Forgot to Say about Lisa Adams and Cancer (Jan 14)

The Guardian: Why an article on Lisa Bonchek Adams was removed from the Guardian site (Jan 16)

Lung Cancer’s Highlights from 2013 and Predictions, Hopes for 2014 – The First LCSM Tweetchat of 2014

This is a reblog from the #LCSM Chat blog (posted with permission). I changed the post to include links to the blog sites where comments about the chat should be posted.
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Lung Cancer’s Highlights from 2013 and Predictions, Hopes for 2014 – The First LCSM Tweetchat of 2014

By Dr. H. Jack West 

The end of a year is always a time for reflection on the past alongside hope for the future, so our upcoming lung cancer social media tweet chat on twitter (#LCSM on twitter) will focus on everyone’s thoughts of the most significant developments in lung cancer over the past year, along with predictions and hopes for the coming year.

Please join us Thursday, January 2nd at 8 PM Eastern, 5 PM Pacific on Twitter, using the hashtag #LCSM to follow and add to our one-hour chat with the global lung cancer community, where we’ll cover the following three questions:

1) What do you think were the biggest advances in lung cancer in 2013?

2) What do you predict as key changes in lung cancer in the upcoming year?

3) What is your leading possible hope/goal for the lung cancer world in 2014?

It should be a lively, upbeat discussion, so please join us Thursday, or share your thoughts on the #LCSM Chat blog or on Cancergrace.org before or after the live event. Hope to see you there!

Prevention vs Risk Reduction Vs. Screening (a reblog)

Breast cancer survivor  @coffeemommy (Stacey Tinianov) gave me permission to reblog the  article below, which she wrote following the #abcDrBchat tweetchat about lung cancer Tuesday December 10 2013.  She’s written an excellent clarification of the differences between cancer prevention, risk reduction, and screening.

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Prevention vs. Risk Reduction vs. Screening
by coffeemommy

After a series of particularly frustrating exchanges, I have decided it will take more than 140 characters to not only explain the distinction between prevention, risk reduction and screening in ALL cancers but to also explain why a distinction is so critical.

Prevention: definition 1. To keep from happening

Reality check:

  • The only way to prevent breast cancer is to not have any breast tissue.
  • The only way to prevent lung cancer is to not have lungs.
  • The only way to prevent skin cancer is to not have that
    useful covering over your flesh and bones.

You get the idea.

But wait! There’s this list you received from your doctor’s office, right? Certainly it’s titled something provocative like: “Prevent Breast Cancer” and includes some or all of the following:

  • Eat a well-balanced, low-fat diet
  • Exercise regularly
  • Limit alcohol intake
  • Maintain a healthy weight
  • Annual mammograms beginning at age 40

I did all those.

And I was diagnosed at age 40 with two tumors of invasive ductal carcinoma, diffuse DCIS and lymph node involvement in my left breast. Did I misunderstand the rules for preventing breast cancer and do something wrong? No. I didn’t. I tried to reduce my risk and it didn’t work. The above list may be a compilation of helpful hints but, even collectively, they do not prevent breast cancer, they help reduce risk.

RISK REDUCTION

Risk reduction in the spectrum of the healthcare industry attempts to lessen our chances of receiving a diagnosis by removing potential harmful exposures and/or behaviors from our lives and, in some cases, replacing them with behaviors that can help fend off disease.

To use skin cancer as an example, we can use sunblock liberally but we are merely attempting to reduce our risk. Skin cancer is still a possibility and a combination of exposure and genetics may render our efforts utterly useless.

Never-smokers without lung cancer who may feel they can cross malignant non-small cell carcinoma off their worry list should meet Janet Freeman who “never smoked anything except a salmon.”

And there are tens of thousands more who followed the list of “prevention” tactics but were diagnosed anyway. Specifically, even if you are a never smoker, you may still have some of the following risk factors for lung cancer:

Risk reduction is limiting exposure to the above but does not guarantee prevention. And a genetic predisposition is hard to shy away from.

SCREENING

If we refer back to the sage if woefully mis-titled “Prevent Breast Cancer” document above, I’d like to call out the last ‘prevention technique’ – the oft-touted annual mammogram.

People. People. People. Regular mammograms don’t PREVENT breast cancer OR reduce risk. EVER.

Mammograms are screening tools. Regular screening is encouraged so anomalies can be found as early as possible,be treated as quickly as possible and, hopefully, result in a better longer term outcome.

DISTINCTION is NOT A SEMANTICS ISSUE

This is not a tomato – tomato (c’mon, you’re supposed to pronounce those differently when you read them!) issue. Why is the terminology distinction important? Three reasons bubble to the top for me:

  • Continued Diligence: Individuals must remain diligent in personal and professional screening even when they”do everything right” on the risk reduction list. Mammograms don’t “Save the ta-tas” they simply alert people as to whether or not their breasts are trying to kill them. I can personally attest to the fact that people who follow all the published rules for how to prevent breast cancer, and get a mammogram at 40, still get breast cancer.
  • Removing Stigma and Eradicating Blame & Shame: According to anecdotal data, the most common question lung cancer patients field is, “How long did you smoke?” If you advertise risk reduction as prevention you are perpetuating a falsehood. Perpetuating the idea that cancers are preventable implies that, when a diagnosis is given, somebody did something WRONG.
  • Redirecting Research Focus: While a list of ways to reduce risk for disease is helpful, such a list is not a magic bullet. Already genomic research is leading to personalized treatments. We need to expand efforts in this area. When the general public finally realizes that no one is “immune” to a cancer diagnosis, more focus can be applied in the appropriate areas.

Cancer sucks, no one “deserves” it. Please don’t propagate a false sense of security or imply wrongdoing by patients who are diagnosed by claiming cancer is preventable. Please choose your words wisely.

Tweets for #LCAM2013 Week 4 — How to Help Lung Cancer Patients

For Lung Cancer Awareness Month (#LCAM2013), the #LCSM team compiled a list of tweet-sized lung cancer facts – one tweet for each day in November. We ask all #LCSM participants and lung cancer advocates to tweet the fact of the day at noon Eastern time (9 AM Pacific) to help with trending.  You can come here to copy the tweet of the day, or  if you prefer, you can retweet the fact after @LCSMChat tweets each day at 11:55 AM Eastern Time.

Tweets for the final week of Lung Cancer Awareness Month (#LCAM2013) focus on HELP:  what you can do to help lung cancer patients, whether through providing direct assistance, funding research, advocating, or supporting lung cancer organizations.  Facts for all weeks of #LCAM2013 are collected here.

HOW TO HELP LUNG CANCER PATIENTS

November 25 tweet:
HELP: Distribute information about low-dose CT screening for #lungcancer. http://www.lung.org/lung-disease/lung-cancer/lung-cancer-screening-guidelines/lung-cancer-one-pager.pdf #LCSM #LCAM2013

November 26 tweet:
HELP: Support #lungcancer patients as a volunteer at your local cancer center. #LCSM #LCAM2013

November 27 tweet:
HELP a #lungcancer patient during/after treatment with transportation, childcare, housework, meals, or fundraising. #LCSM #LCAM2013

November 28 tweet:
HELP: Support #lungcancer charities that fund research or assist LC patients. http://lungcan.org/our-members/ #LCSM #LCAM2013

November 29 tweet:
HELP: Support an LC advocacy org or ask your government reps to fully fund #lungcancer research. http://lungcan.org/advocacy/ #LCSM #LCAM2013

November 30 tweet:
HELP: Join an #LCSM chat on Twitter to discuss #lungcancer topics. http://lcsmchat.wordpress.com/lcsm-chat/ #LCAM2013

Tweets for #LCAM2013 Week 3 — Hope for Lung Cancer Patients

For Lung Cancer Awareness Month (#LCAM2013), the #LCSM team compiled a list of tweet-sized lung cancer facts – one tweet for each day in November. We ask all #LCSM participants and lung cancer advocates to tweet the fact of the day at noon Eastern time (9 AM Pacific) to help with trending.  You can come here to copy the tweet of the day, or  if you prefer, you can retweet the fact after @LCSMChat tweets each day at 11:55 AM Eastern Time.

Our tweets for the third week of Lung Cancer Awareness Month (#LCAM2013) focus on HOPE for lung cancer patients: early detection, advances in treatment, personalized medicine, and research results.  For Week 1 tweets, click here.  For Week 2 tweets, click here. Facts for all weeks of #LCAM2013 are collected here.


HOPE FOR LUNG CANCER PATIENTS

November 18 tweet
National Lung Screening Trial showed low-dose helical CT scans can lower mortality from #lungcancer at least 20%. #LCAM2013 #LCSM

National Cancer Institute. (n.d.). National Lung Screening Trial (NLST). Retrieved 17-Nov-2013 from http://www.cancer.gov/clinicaltrials/noteworthy-trials/nlst.


November 19 tweet

Newly-diagnosed #lungcancer patients should consider getting a second opinion about diagnosis and treatment. #LCAM2013 #LCSM

Seattle Cancer Care Alliance. (n.d.). For Newly Diagnosed:  Seeking a Second Opinion. Retrieved 17-Nov-2013 from http://www.seattlecca.org/newly-diagnosed-second-opinion.cfm.


November 20 tweet

Lobectomy performed by video assisted thoracoscopic surgery results in shorter hospital stay, quicker recovery. #LCAM2013 #LCSM

Swanson, SJ et al. (2012 Apr). Video-assisted thoracoscopic lobectomy is less costly and morbid than open lobectomy: a retrospective multiinstitutional database analysis. The Annals of Thoracic Surgery; 93(4):1027-32. http://www.ncbi.nlm.nih.gov/pubmed/22130269

Nicastri, DG et al. (2008 Mar). Thoracoscopic lobectomy: report on safety, discharge independence, pain, and chemotherapy tolerance. The Journals of Thoracic and Cardiovascular Surgery; 135(3):642-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18329487.


November 21 tweet

Patients whose #lungcancer tumors had driving mutations and who received targeted therapy live longer. #LCAM2013 #LCSM

Kris, M.G. et al. (2013, Oct 29). “Treatment with Therapies Matched to Oncogenic Drivers Improves Survival in Patients with Lung Cancers: Results from The Lung Cancer Mutation Consortium (LCMC).” 15th World Conference on Lung Cancer, Sydney, Australia: Abstract PL03.  Read abstract here.


November 22 tweet

Patients with #lungcancer who participate in #cancer clinical trials live longer. #LCAM2013 #LCSM

Chow, CJ et al.  (2013 Apr). Does enrollment in cancer trials improve survival? Journal of the American College of Surgeons 216(4):774-80. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23415510.


November 23 tweet

Immune-based therapy and clinical trials show potential for #lungcancer treatment. #LCAM2013 #LCSM

National Cancer Institute. (n.d.)  Expanding the Playing Field: Immune-Based Therapy Shows Potential for Lung, Other Cancers. Retrieved 17-Nov-2013 from http://www.cancer.gov/clinicaltrials/results/summary/2012/PD-1-immunotherapy0612.

Gillis, Bonnie. (2013 Sep 29). PD-L1 Inhibitor Delivers Rapid, Durable Responses in Advanced NSCLC. Retrieved 17-Nov-2013 from http://www.onclive.com/conference-coverage/ecco-esmo-2013/PD-L1-Inhibitor-Delivers-Rapid-Durable-Responses-in-Advanced-NSCLC


November 24 tweet

Palliative care improves survival and quality of life for advanced #lungcancer patients. #LCAM2013 #LCSM

National Cancer Institute. (n.d.). Palliative Care Improves Survival, Quality of Life in Advanced Lung Cancer. Retrieved 17-Nov-2013 from http://www.cancer.gov/clinicaltrials/results/summary/2010/early-palliative-care0910.

Cancer: The Harsh Story Of Lung Cancer vs Breast Cancer

This blog post highlights some of the reasons the stigma of lung cancer persists. Very well written, and worth the read.

Update July 2, 2020:
My original post was a reblog of a Nov-2013 cancergeek WordPress blog which has since been deleted.  However, its iconic picture was archived by @LungCancerFaces (Deana Hendrickson) on Twitter.

The picture, which compares Googled images of “breast cancer people” (on the left) vs “lung cancer people” (on the right), clearly shows that lung cancer has an image problem. Breast cancer has smiling faces, pink ribbons, and throngs of supporters.  Lung cancer has images of diseased lungs, dying people, and smoking.  In many people’s minds, “lung cancer” equals “smoking.” This clearly captures the stigma the lung cancer community faces. This stigma has stifled research funding, fueled physician nihilism, impeded good patient care, and inhibited community and family support of lung cancer patients.

Cancergeek, the author of the original blog post, wrote a Medium article a year later that carried much of the same sentiment.

cancergeek's avatarCancerGeek

{I will preface this post by saying that anyone that is diagnosed with cancer has their world changed forever. The clock begins to tick, world closes in on you, and your world is changed in a way that will never be the same. I am being provocative. I am challenging.}

For those of you that I have had the privilege of meeting, and for those of you I have not met, you know and will come to find that cancer is the story of my life. It is what I have dedicated my professional career to try and make an impact. I am fortunate enough to be able to combine my passion, my talent, and my wisdom all into one single focus.

In October I made a commitment to wear a bow tie the same color of the cancer awareness for that specific month. October was easy, it was Breast…

View original post 1,269 more words

Tweets for #LCAM2013 Week 2 — Personal Stories

This was posted today on the #LCSM website. Throughout November, please tweet a lung cancer fact at noon Eastern Time for Lung Cancer Awareness Month (#LCAM2013) and help us trend!

Tweets for #LCAM2013 Week 2 — Personal Stories

For Lung Cancer Awareness Month (#LCAM2013), the #LCSM team compiled a list of tweet-sized lung cancer facts – one tweet for each day in November. We ask all #LCSM participants and lung cancer advocates to tweet the fact of the day at noon Eastern time (9 AM Pacific) to help with trending.  You can come here to copy the tweet of the day, or  if you prefer, you can retweet the fact after @LCSMChat tweets each day at 11:55 AM Eastern Time.

Our tweets for the second week of Lung Cancer Awareness Month (#LCAM2013) focus on the personal stories of those who have lung cancer.  For Week 1 tweets, click here.  Facts for all weeks of #LCAM2013 are collected here.

PERSONAL STORIES OF LUNG CANCER

November 11 Tweet
Faces of #Lungcancer: NFL player Chris Draft remembers wife and LC patient Lakeasha http://www.catchitintime.org/story/chris-draft #LCAM2013 #LCSM

November 12 Tweet
Faces of #Lungcancer: Emily Bennett Taylor, college athlete, diagnosed with LC at 28 http://embenkickscancer.wordpress.com/ #LCAM2013 #LCSM

November 13 Tweet
Faces of #Lungcancer: 7 Canadians Share Their Stories http://www.huffingtonpost.ca/2013/11/05/lung-cancer-awareness-_n_4213854.html?utm_hp_ref=tw #LCAM2013 #LCSM

November 14 Tweet
Faces of #Lungcancer: Janet Freeman-Daily “Why I’m in a Clinical Trial.” https://grayconnections.wordpress.com/2013/11/03/why-im-in-a-clinical-trial/ #LCAM2013 #LCSM

November 15 Tweet
Faces of #Lungcancer: 1000 faces, 1000 unique stories http://www.lungcanceralliance.org/get-involved/help-raise-awareness/faces-of-lung-cancer/ #LCAM2013 #LCSM

November 16 Tweet
Faces of #Lungcancer: Tonya Sears lost 4 family members to LC — now she’s an advocate http://phillytrib.com/healtharticles/item/11442-personal-connection-fuels-advocacy-for-lung-cancer.html #LCAM2013 #LCSM

November 17 Tweet
Faces of #Lungcancer: The Bonnie J. Addario Story http://www.lungcancerfoundation.org/2012/06/the-right-woman-for-the-job-the-bonnie-j-addario-story/ #LCAM2013 #LCSM

Gray Connections's avatar#LCSM

For Lung Cancer Awareness Month (#LCAM2013), the #LCSM team compiled a list of tweet-sized lung cancer facts – one tweet for each day in November. We ask all #LCSM participants and lung cancer advocates to tweet the fact of the day at noon Eastern time (9 AM Pacific) to help with trending.  You can come here to copy the tweet of the day, or  if you prefer, you can retweet the fact after @LCSMChat tweets each day at 11:55 AM Eastern Time.

Our tweets for the second week of Lung Cancer Awareness Month (#LCAM2013) focus on the personal stories of those who have lung cancer.  For Week 1 tweets, click here.  Facts for all weeks of #LCAM2013 are collected here.

PERSONAL STORIES OF LUNG CANCER

November 11 Tweet
Faces of #Lungcancer: NFL player Chris Draft remembers wife and LC patient Lakeashahttp://www.catchitintime.org/story/chris-draft#LCAM2013 #LCSM

November 12 Tweet
Faces of #Lungcancer: Emily Bennett…

View original post 92 more words

Why I’m in a Clinical Trial

The fact that I’m alive is a modern-day medical miracle. And I owe it to clinical trials.

In early 2011, I was in good physical shape, slightly overweight, eating healthy and exercising regularly. After I tolerated a nagging, slight cough for a few months without any relief from antibiotics, my doctor ordered a chest x-ray. Before I’d left the lab, she ordered a CT scan. Before I arrived home from the clinic, she called: the radiologist saw a mass in my lung. Two days later, a Friday, I saw a pulmonologist who performed a biopsy. He called me Tuesday evening, May 10, 2011, with the news: at age 55, as a never smoker, I had lung cancer.

Scans and tests over two weeks rendered a diagnosis of stage IIIA non-small-cell adenocarcinoma complicated by obstructive pneumonia. I was not a candidate for surgery, but the oncologist considered me curable. My tumor didn’t have either the EGFR or ALK mutations.  After ten days in the hospital and weeks of IV antibiotics, I recovered enough to get radiation therapy and low-dose chemotherapy, followed by one full dose of chemo (my side effects were too severe to allow me to have more chemo). I finished first-line treatment in early August 2011.

My post-treatment CT scan in late September 2011 showed the lymph nodes were almost completely clean, and the tumor had shrunk by over 90%. I thought I had a great chance at a cure. In the next two weeks, I underwent several tests to determine if I was healthy enough to have the lung removed. One of the tests was a PET scan, which found a hot spot on my right front collarbone. A few days, later two lymph nodes were removed in an open biopsy and found to be more of the same cancer. I was now stage IV–metastatic lung cancer. No lung surgery for me. The radiation oncologist advised waiting rather than radiating because I’d had a large volume of lung zapped already.  My oncologist also advised waiting a few months before starting a new chemo to give my body time to recover.

I decided to learn more about treatment options during those few months. From my participation in the Inspire.com Lung Cancer Support Community, I’d learned about the Lung Cancer Mutation Consortium Protocol clinical trial, which tested for ten mutations in lung cancer tumors. I had lots of slides courtesy of my two new tumors; testing for more mutations sounded hopeful, and I liked the idea of contributing in some small way to the science looking for a lung cancer cure. I searched for the trial on clinicaltrials.gov and emailed its contact person at the University of Colorado in Denver. I couldn’t travel to Denver (my pulmonologist thought my hollow tumor might cause a collapsed lung if I flew), but UC accepted me into the trial and tested my tissue anyway.  A few weeks later I received a call from the head of the trial, Dr. Paul Bunn: I had none of the ten mutations.

In two months, a visible 3-inch tumor grew by my right collarbone in the area where the lymph nodes had been removed. I had a CT scan the day after Christmas, met with my oncologist to discuss treatment, and had a power port installed. After six rounds of chemo over five months, CT and brain MRI scans showed all my original tumors were gone, no new tumors had appeared, and the collarbone tumor had shrunk over 90%. We decided to go for a possible cure with more radiation.  Six weeks later, my Sep 2012 PET-CT scan showed the original tumors were gone and the collarbone tumor was dead. However, I had two new nodules suspicious for cancer, this time in my right lung. Twice now I’d recurred within two months after finishing treatment. What to do next?

Someone on the Inspire.com forum suggested that because I was a young, healthy, never smoker with adenocarcinoma, I fit the profile of patients who had new mutation called ROS1. The poster was in a ROS1 clinical trial in Boston, but the trial was also at University of Colorado. I asked my oncologist about ROS1 testing, but he hadn’t heard of it (the research had been published just nine months earlier). While visiting family in Denver, I arranged to meet with Dr. Bunn and learned UC now tested for new mutations, including ROS1 and RET, and that my tumor had a 10-20% chance of having one of them.  I agreed to let UC test my remaining slides.

I had a biopsy a week later. The pulmonologist said he got a good sampling of the larger nodule but couldn’t find any cancer cells. We decided to wait a month and do another CT scan to see if either nodule grew. The very next day, an email from Dr. Bunn told me I tested positive for ROS1. UC had an opening in a clinical trial that involved a pill called Xalkori, which targeted cells having the ROS1 mutation.  Since I didn’t have a biopsy confirming cancer, Dr. Bunn offered to hold a trial slot for me pending results of my next scan.

My October 2012 chest CT showed the smaller nodule grew nearly 50% in one month. I called UC the next morning and started the process to apply for the ROS1 clinical trial. They agreed to consider me without a biopsy. I scrambled to collect all my medical files and scan CDs. Five days later I flew to Denver for two weeks, hoping I’d pass the screening and be accepted into the trial. I took my first Xalkori pill November 5, 2012.

For the next sixty days, I flew to Denver every two weeks, departing Seattle on Monday and returning home Wednesday. I had blood and urine tests every visit, along with other tests (like EKGs and eye exams), and a clinic visit at whichI met with the doctor to review test results and discuss symptoms. I then flew home with two weeks worth of pills. The first PET-CT scan on New Years Eve showed my two lung nodules were gone and no new hot spots—my first clean scan in 20 months of lung cancer. The side effects I experienced were far easier than either chemo had been. I had my life back.

After the first scan, my visits to UC shifted to every four weeks; after ten drug cycles, they shifted to every eight weeks. Now at UC visits I have blood work, a PET-CT scan, a visit with my UC oncologist Dr. Ross Camidge, and a brain MRI every six months. I have blood work done at my home clinic in off months.

I am not cured–the Xalkori only suppresses my cancer. However, Dr. Camidge has a plan for treating my recurrences.  It’s an odd existence, living from scan to scan. I’ll be in treatment for the rest of my days. Yet I’m hopeful that if/when each clinical trial stops working, a better one will be waiting for me.  Maybe they’ll find a cure for me before I die.

And in the meantime, I’m living.

Tweet for #LCAM2013 (Lung Cancer Awareness Month)

THIS IS A REBLOG OF A POST I WROTE FOR THE #LCSM CHAT BLOG.

The October 24th #LCSM Chat on “Social Media and Lung Cancer Advocacy: What Can I Do?” identified lots of information that the public needs to know about lung cancer.  Chat members decided we’d like to tweet those facts during Lung Cancer Awareness Month (#LCAM2013) this November. Some suggested we all tweet the same fact each day to generate the greatest impact on Twitter.

To coordinate this effort, the #LCSM team compiled a list of lung cancer tweets based on verified facts – one tweet for each day in November. Links to the sources for the facts are listed below the tweets for those who want evidence.

@LCSMChat will tweet each day at 11:55 AM Eastern Time if you prefer to retweet rather than come here to find the tweets.

The tweets fall into four groups, roughly by weeks:

Week 1:  WHY — reasons why curing lung cancer matters Week 2:  WHO — personal stories of lung cancer patients Week 3:  HOPE — symptoms, early detection, personalized treatment, research Week 4:  HELP — what you can do (how to fund research, advocate, support patients, etc.)

Trending: We’ve included #LCAM2103 and #LCSM in every tweet to help with trending. If we all tweet/retweet the fact of the day at the same time, we might achieve it!  Please try to tweet/retweet each daily fact as close as possible to 12 noon Eastern Time (New York City time for those of you outside of North America). Hint: The tweetdeck app will allow you to send tweets at a scheduled time.If we all tweet at the same time, we might achieve trending. Please try to tweet each day as close as possible to 12 noon Eastern Time

Week 1 tweets are listed below.  Tweets for Weeks 2-4 will be blogged later in the month. If you subscribe to the #LCSM Chat blog, you will receive an email when our blog posts are published. All the facts will also be available on a “Lung Cancer Facts” page of the LCSM Chat site for easy reference.

WEEK 1: WHY – REASONS WHY CURING LUNG CANCER MATTERS

November 1 Tweet
Myth: Don’t smoke? Can’t get lung cancer. Fact: Lung cancer in never smokers is 6th leading cause of US cancer deaths. #LCSM #LCAM2013

Johns Hopkins Medicine. Guide on Lung Cancer in Never-Smokers – Different Disease Different Treatments (09/15/2009). Retrieved Oct 30, 2013, from http://www.hopkinsmedicine.org/news/media/releases/Guide_on_Lung_Cancer_in_NeverSmokers__Different_Disease_Different_Treatments.

November 2 Tweet
Lung cancer kills almost 2x as many women as breast cancer & 3x as many men as prostate cancer. #LCSM #LCAM2013

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2010 Incidence and Mortality Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2013. Retrieved from http://apps.nccd.cdc.gov/uscs/toptencancers.aspx. To access data, select year 2010, “death rates” tab and view table for all ethnic groups Per CDC, 2010 cancer deaths were caused 37.9% by lung cancer and 21.9% by breast cancer in women, 60.1% by lung cancer and 21.8% by prostate cancer in men.

November 3 Tweet
160,000 Americans will die of lung cancer this year. 80% will be never smokers or nonsmokers. #LCSM #LCAM2013

SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/lungb.html In the United States in 2013, it is estimated there will be about 159,480 deaths from lung cancer. Approximately 6.9 percent of men and women will be diagnosed with lung and bronchus cancer at some point during their lifetime.

Centers for Disease Control and Prevention. MMWR Weekly 56(44);1157-1161. (9-Nov-2007). Retrieved Oct 30, 2013, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5644a2.htm. Lung cancer cases are 17.9% never smokers, 61.2% former smokers, 20.9% smokers (see Table 2, lung neoplasms).

November 4 Tweet
The 5-year survival rate for lung cancer is 16%, about the same as it’s been for 40 years. #LCSM #LCAM2013

SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/lungb.html Current 5-year survival rate of adults with lung and bronchus cancers is 16%. In 1975, the 5-year survival rate for lung cancer in adults was 11.4%.

November 5 Tweet
World Health Org: Air pollution is responsible for 223K lung cancers deaths/yr worldwide – it’s worse than 2nd-hand smoke. #LCSM #LCAM2013

International Agency for Research on Cancer, World Health Organization. Press Release No 221 – IARC: Outdoor air pollution a leading environmental cause of cancer deaths. (17-Oct-2013). Accessed 20-Oct-2013 from http://www.iarc.fr/en/media-centre/iarcnews/pdf/pr221_E.pdf

November 6 Tweet
Lung cancer takes more lives than breast, prostate and colon cancers combined – it accounts for 27% of all cancer deaths.  #LCSM #LCAM2013 

American Cancer Society. Cancer Facts and Figures 2013. Atlanta: American Cancer Society; 2013. Accessed 20-Oct-2013 from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-037115.pdf

November 7 Tweet
81% of prostate cancer and 60% of breast cancer cases are diagnosed before they spread. Lung cancer? Only 15%. #LCSM #LCAM2013

 American Cancer Society. Cancer Facts and Figures 2013. Atlanta: American Cancer Society; 2013. Accessed 20-Oct-2013 from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-037115.pdf

November 8 Tweet U
S research $ per cancer death is far greater for colorectal (4x), prostate (8.5x) & breast (14x) cancers than lung cancer. #LCSM #LCAM2013

National Lung Cancer Partnership. What You Can Do (graphic). (Mar-2013). Accessed from http://www.nationallungcancerpartnership.org/images/uploads/files/NLCP_FS_1Facts_NextDayFlyer_2013_BACK.pdf.

American Cancer Society. Cancer Facts and Figures 2013. Atlanta: American Cancer Society; 2013. Accessed 20-Oct-2013 from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-037115.pdf.

U.S. Army Medical Research and Materiel Command, Department of Defense. 2012 Congressionally Funded Medical Research Programs. (30-Sep-2012). Accessed from http://cdmrp.army.mil/pubs/annreports/2012annrep/2012annreport.pdf.

NIH Research Portfolio Online Reporting Tools. Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC). (10-Apr-2013). Accessed from http://report.nih.gov/categorical_spending.aspx.

November 9 Tweet
Lung cancer is the second leading cause of all deaths in the US. #LCSM #LCAM2013

National Lung Cancer Partnership. What You Can Do (graphic). (Mar-2013). Accessed from http://www.nationallungcancerpartnership.org/images/uploads/files/NLCP_FS_1Facts_NextDayFlyer_2013_BACK.pdf 

November 10 Tweet
Lung cancer is also linked to radon gas in homes (20,000 deaths/yr), workplace exposure, genetics, & cancer treatment. #LCSM #LCAM2013

US Environmental Protection Agency. Radon. (26-Aug-2013). Accessed from http://www.epa.gov/radon/.

World Health Organization’s Environmental and Occupational Cancers Fact Sheet http://www.who.int/mediacentre/factsheets/fs350/en/

Coté ML et. al. Eur J Cancer. (Sep-2012). Increased risk of lung cancer in individuals with a family history of the disease: a pooled analysis from the International Lung Cancer Consortium. Accessed from http://www.ncbi.nlm.nih.gov/pubmed/?term=22436981

American Cancer Society. Second Cancers Caused by Cancer Treatment. (30-Jan-2012). http://www.cancer.org/acs/groups/cid/documents/webcontent/002043-pdf.pdf