In Remembrance of What Matters Most

hawaii-rainbow

Today, people in the world may be shocked, sad, or grieving in response to events recent or remembered, people lost, and sacrifices made.

Having a terminal illness altered my perspective about what constitutes a disaster, and what matters most.

Stuff happens. We don’t control the universe. We don’t control how many days we have. We might not control where we live, who we live with, or whether others treat us well.

What we do control is how we choose to spend whatever time is given us.

Each day, I have another chance to feel (shock, sorrow, hope, compassion, whatever). Another chance to show love to family and friends. Another chance to use my body and mind as best I can. Another chance to laugh. Another chance to dream.

Another chance to use my unique set of skills, interests and resources to make a difference in the world.

Tomorrow is another day. How will you spend it?

Four years on a cancer clinical trial, and still NED–yay for research and hope!

Four years ago today, I took my first dose of crizotinib in a clinical trial for patients who had ROS1-positive lung cancer. My first scan–and every scan thereafter, including this past Monday 10/31– has shown no evidence of disease (NED). Not bad for a metastatic lung cancer patient who previously progressed on two separate lines of combined chemo and radiation.

I’m very grateful for cancer research and the availability of clinical trials. We’ve had more new drugs approved in the past five years than in the previous five decades!

During November, which is Lung Cancer Awareness Month (#LCAM on Twitter), please consider donating to your favorite lung cancer research facility (one option is the Lung Cancer Colorado Fund at the University of Colorado) or a lung cancer advocacy organization that supports research. 

And for a bit of hope, check out the NEW LCAM website, which represents a partnership among 19 lung cancer advocacy organizations led by the International Association for the Study of Lung Cancer (IASLC).

 
lcam-multi-color-logo

HOPE LIVES! More research. More survivors.

A Natural Remedy for Cancer Scanxiety (Almost)

When basking in the wonders of volcanoes, rainforests, and oceans, I can focus on something other than cancer for a while.

When heading to a cancer center for brain and body scans, not so much.

Still, facing the possibility of progression is easier when I’ve been immersed in nature for a few days.  I suspect most cancer patients might benefit from a “nature break” to combat scanxiety before a scan.

Care Partner on Deck

gerry-on-deck

Today hubby Gerry (my care partner) and I had a good start to our morning: we discussed how cancer affects relationships, then reviewed some time-critical household management chores over breakfast. Afterwards, he went out to paint the deck, and I prepared for some medical appointments and errands. Before I left, I poked my nose out the deck door to let him know I was leaving (carefully keeping both cats inside), then closed the door and departed.

After Gerry was through painting the deck, he was greatly surprised to discover his chemo-brained wife had locked the deck door from the inside (as was her routine) while he was outside (which was not routine).

He was alone on a freshly-painted deck at 11 am, ten to fifteen feet off the ground, knowing that I wouldn’t be home for another seven hours.  He tried to get the attention of some workmen two yards away so they could call me, but they couldn’t hear him over their lawnmower.

Ten minutes of staring at the earth motivated his engineering brain to develop a plan that (he hoped) wouldn’t contribute to our medical bills.  I cringed to hear the route my 77-year-old spouse chose to climb down to safety.  I won’t bore you with all the details, but he successfully dealt with the challenge so he could care for me another day.  This evening as the sun was setting, he graciously re-enacted the moment so I could take a picture.

I’m glad this didn’t result in a care partner role reversal.

Happy 50th Anniversary, Star Trek!

Yesterday (September 7, 2016) marked the 50th Anniversary of Star Trek’s first airing. I can’t count the ways in which this show has influenced me.  The biggest conscious influences:

  • encouraged me to pursue a career in science and engineering
  • motivated me to write my own stories
  • helped me to accept that being analytical, making mistakes and expressing emotions are all OK
  • showed people using logic and science to solve difficult problems (yeah, OK, and sometimes emotional convictions, intuition and force–that’s human too)
  • showed me that others also value an upbeat vision of a future based on exploration (concepts as well as new places and people), tolerance, celebrating differences, and the scientific method.

Thanks to Gene Roddenberry and the multitudes of dedicated, creative people who helped bring the world of Star Trek to screens big, small, and flat.

New Survey Available for Patients with Any ROS1-Positive Cancer

You might already know that my cancer is ROS1-positive. This means my tumor cells test positive for a rearrangement of the ROS1 gene in my DNA.

Now we ROS1-positive patients can help researchers learn more about our cancer by taking a survey.  If you’re already sold, click on the link at the bottom of this page.  For more info, read on!

All human cells have the ROS1 gene, but in adult humans the ROS1 gene isn’t very active. However, sometimes the ROS1 gene fuses with another gene and becomes “rearranged.”  Cells that have certain ROS1 rearrangements become cancerous.  ROS1 cancer is rare – about 1% of non-small cell lung cancers – and is found in several types of cancer such as brain cancer (glioblastomas), angiosarcoma, and melanoma.  ROS1 cancer can be very aggressive, but many patients respond amazingly well to a drug called crizotinib, which is FDA approved for ROS1-positive lung cancer.  You can learn more about ROS1 cancer, some of the patients who have it, and available treatments and clinical trials on the ROS1 portal .

Over 100 patients who have ROS1-positive cancer of any type (regardless of where the cancer started) have joined a Facebook group called “ROS1 Positive (ROS1+) Cancer.” We hail from a dozen different countries. We discuss how to handle side effects of treatment, explore the treatments and clinical trials available to us, and post new research findings. And we share concerns about our futures, because … well, those of us with metastatic ROS1-positive cancer are not curable.

I’ve had no evidence of disease (meaning we can’t detect any cancer) on crizotinib since January 2013. I wish I could say I’m cancer free, but I can’t.  For most everyone who takes crizotinib, the cancer eventually develops resistance to the drug, and tumors start growing again.

We ROS1ers need researchers to learn more about our cancer, and find more effective treatments. Now we can do something to help.

PatientDrivenResearch_Final_April 13, 2016

The Bonnie J. Addario Lung Cancer Foundation has partnered with ROS1ers to inform more people about our disease and develop patient-driven research that will hopefully find more effective treatments for us.  Although the ALCF focuses on lung cancer, this effort is addressing ROS1-positive cancer regardless of where in the body the cancer began.

The first step is an online survey that aims to discover what we ROS1ers might have in common and hopefully identify some causes for this rare cancer (the majority of the patients are young, fit never smokers). To our knowledge, this is the first-ever research into the possible causes of a genomically-driven cancer across cancer types.

Please complete your survey ASAP! While the survey will remain open for a long time, the first round of data analysis will commence on July 15, 2016, with a goal of announcing preliminary findings at the World Conference on Lung Cancer in December 2016.

If you have ROS1-positive cancer, please complete this survey.
If someone you know has it, please encourage them to complete this survey.
CLICK HERE FOR ROS1 PATIENT SURVEY

Opportunity to honor Dr D Ross Camidge

Camidge and daughters

Dr. D Ross Camidge, MD, PhD, at the University of Colorado (CU) Cancer Center has provided me and many other lung cancer patients and caregivers with hope, support, effective clinical trials, remote second opinions and excellent cancer care. On April 5, Dr. Camidge’s work will be honored as he formally accepts the newly-created Joyce Zeff Endowed Chair in Lung Cancer Research.
   
A patient speaker (not me) will be talking at the event about Dr. Camidge’s impact on patients. We have a unique opportunity to show Dr Camidge–as well as the donor Ms. Zeff and CU–how many people he has helped in lung cancer patient communities .
   
If you are willing to have your Camidge experiences and kudos shared from the stage at the recognition ceremony, please post them below. I’ll make sure they get to the patient who will be speaking. If you want your name (real or online) associated with the quote, please say so in your post.
   
Thanks in advance for your contributions!
   
Janet Freeman-Daily (AKA Squanch)

Crizotinib (Xalkori) approved for ROS1-positive NSCLC!

The anticancer pill I take in my clinical trial, Xalkori (generic name crizotinib), was approved today by the FDA for my type of lung cancer: ROS1-positive non-small cell lung cancer.  I’m one of the 50 patients whose results were included in the clinical trial data.

In addition to being happy that I found an effective treatment for my lung cancer–I’ve had No Evidence of Disease for 36 months and counting–I feel proud to be part of the research that is making new cancer treatments available for more patients.

Precision medicine, targeted therapies, and clinical trials are awesome.

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Edit 2016-03-11 2 PM to add:

Some people have asked what this approval means to my participation in the clinical trial.

The short answer:
Nothing has changed for me. I’m still in the clinical trial, and I still get my drug free (but have to pay for my travel).

The long answer:

Last April, Xalkori for ROS1+ NSCLC received “breakthrough” FDA designation, which is one type of accelerated FDA approval. The accelerated approval process allows the FDA to grant approval before a Phase 3 clinical trial is completed, but still requires a Phase 3 trial to be completed eventually. So my clinical trial must continue until the Phase 3 trial is complete, or the FDA will pull its approval of Xalkori for ROS1 NSCLC.

Xalkori originally received breakthrough designation for ALK+ NSCLC, and was granted FDA approval through the accelerated process in August 2011 (the fastest drug approval to date). The Xalkori for ALK+ NSCLC phase 3 clinical trial still continues over four years later. So I suspect my clinical trial will be continuing for some time.

However, even if I left the clinical trial, Xalkori is already covered by most insurance plans, and today’s FDA approval means pretty much all plans will cover it. However, the copays vary considerably.  Some plans cover it as a pharmacy benefit with a substantial out of pocket expense.  Others cover it as a medical expense, with a standard deductible.  I haven’t checked to see how (or if) my plan covers it.

I plan to stay in the clinical trial at the University of Colorado for the forseeable future.  I like having regular access to some of the top experts in the world on ROS1 cancer and molecular testing for precision medicine.  My writing income goes to fund their Lung Cancer Colorado Fund for lung cancer research.  I also participate in their research as a patient advocate on the NCI-sponsored CU lung cancer SPORE (Specialized Program for Research Excellence) and get to learn about cutting-edge cancer research, which satisfies the geek in me. Besides, I’ve grown fond of several people I’ve come to know at CU.  It’s become a second home of sorts.

So, yeah, this approval does not change my treatment. But hopefully it will make the treatment more available to more patients ASAP.

A Crowning Achievement

Here’s an example of technology making a huge positive difference in healthcare, with very little fanfare.

While waiting for the dentist to see me during my recent checkup, I asked the hygienist if they had an old printer running a large print job–I could hear a continuing buzz from somewhere in the office.  I was imagining a 1970’s style printers with those spiky little wheels feeding long continuous sheets of paper and a dot-matrix ink cartridge zipping back and forth, like those that ran our card batch jobs during my college days (yeah, I’m that old).

Turns out, it wasn’t an OLD printer.  She took me into the next room and showed me a device the size of a microwave.

My dentist can now create a custom crown using a 3D printer during one office visit. The system designs the crown using 3D imaging to ensure a good fit in your mouth–no more temporary, ill-fitting crowns.  More on the process is here.

3D crown printing

So we have a new variation on Precision Medicine–custom crowns designed while you wait.  Technology is so cool.

image from “New At The Dentist: 3D Printing Dental Crowns While You Wait

 

Tropical Sniffles, or Under the Wonderful Weather

 The night before we left for our Hawaiian vacation, I had developed a stuffy nose and sore throat, and slept only three hours because I couldn’t breathe through my CPAP.  On the plane, I went through an entire pack of Kleenex.  In the Kapaa condo, I collapsed at 8 PM with a fever, but awoke at 1:30 AM with screaming sinuses.  To avoid waking hubby, I hung out in the darkened bathroom playing Whirlyword on my phone with tissue stuffed up my nose for two hours.  I finally got back to sleep around 3:30 AM.

This morning, I awoke to guava juice, sunshine, tropical breezes, a balcony overlooking a lovely garden, and the crow of Kauai roosters.  If I’ve got to be sick, this is the sickroom I want!

  
Today was a Kauai afternoon with 3 generations of family, good Hawaiian food, whales breaching offshore, the sound of crashing waves below, and a stellar sunset. I just sat in a corner of the lanai and soaked it all in while life happened all around me.

  
 I am sated.  Sometimes it’s enough to just BE.

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Thanks to Steve and Gerry for crowdsourcing the blog title