I don’t know if it was the Captain Marvel movie (love me some scrappy heroine), the hot water with lemon that my friend Peter prescribed to start my day, or Jenny Ro’s bone broth soup. It couldn’t be the chemo, could it?
This girl has turned a corner. As of Monday evening, after a nine hour day of physical labor (I am crazy, but I needed to get the rest of my art stuff out of my old apartment), I have felt not good but GREAT.
Physically strong, almost zero wheeze (what’s up with that?), I am now of the mindset that I am going to live.
Powerful, powerful feeling, that. And just the boost of confidence I needed.
This weekend I am going to spend a couple of days in my new studio space. Making art. I could cry just writing that sentence.
This means I am likely to go another round of chemo prior to starting the clinical trial. As long as I wasn’t feeling any improvement, that was a dismal prospect. However, there is nothing I won’t do if I believe it is capable of knocking down my cancer.
A long, long day. But in the parlance of my kind (the terminally ill), a long day beats a short day all to heck.
First, my life is blessed with a plethora of goddesses. Childhood friends, my daughter, sisters, my many new friends, nurses, phlebotomists, counselors, medical doctors. Men are great and I love a heap of them as well but this group of women has been my consistent go to for the tough stuff.
One goddess was in tow yesterday, my friend Sally: pals since the fifth grade. I am beginning to realize how beneficial it is to have company at these visits, after years and years of going it alone.
I had an appointment with the goddess who takes care of me from the neck up (as I like to say), Mary Susan Convery, my thoracic social worker. She keeps my head on straight.
A quick trip down Charles St for a hug from my daughter (Sally is her actual godmother) and a delicious lamb sandwich at Tatte. And then a long wait in those spaces appropriately called waiting rooms.
Oh, the irony. Those of us to whom time is so precious spend far too much of it waiting.
Anyway, the action got started around four with a visit from the head goddess, Alice. Chit chat about how I am feeling (great for the moment, on that artificial steroid high, my dyspnea temporarily under control.) But I was eager to cut to the chase—how about those scans? She had read them herself and her assessment was that they were mildly worse than the ones in December. Now remember this is while getting chemo so bummer. Of concern is the lymphangitic spread as well as the fact that the slight amount of fluid in the bottom of my left upper lobe is also increasing.
Alice puts more store in symptoms though and mine are not encouraging. Definite downward trend. So we agreed that I’d go ahead and get chemo one more time (and possibly two, depending on timing and tolerance) in the hope that it is at least slowing down progression.
There was a bright spot though and that was in the form of options. I figured we were down to one–lorlatinib plus a mek inhibitor. But Alice described yet another possibility. That after all these years on TKI-s it might be good to take a break. Maybe let my cancer forget some of what it has learned. To try a novel therapeutic, one my cancer is completely naive to.
While getting infused I signed the consent forms for a phase I clinical trial for a drug called DS-1062a; an antibody drug conjugate which targets a protein called trophoblast cell-surface antigen2 (TROP2), which is found in copious quantities on the surface of cancer cells.
This sounds exciting to me–a fresh possibility. But it is going to be intense. First there are the necessary hoops to jump through in order to qualify, including a lung biopsy, heart scan, ECHO, and eye exam. And all that blood, blood, blood (30 teaspoons for the first three cycles).
Every three week infusions but the first week, at least two additional visits. And then for the subsequent nine weeks, I return to the hospital once a week, with a second lung biopsy at week two. It is going to be consuming–that is, assuming I qualify.
But it also has given me fresh hope (I love the luxury of choices).
Good thing. Chemo may not be kicking cancer’s ass, but it is kicking mine. My liver is a tad inflamed–Alice asked me if alcohol might be involved. Truth? Yes. Goodbye to that for the time being. Sally filled me with healthy fluids last night and this morning she made me oatmeal, hot lemon water, and a vegetable chicken soup. I am in good and loving hands.
So yes. Stability or response would have been the preferred report but this feels if not a door, at least a window. And that’s what I need. Fresh air and a bit of a vista to contemplate.
When I was a wee child I would recite a prayer before bed each night:
Now I lay me down to sleep and I pray the Lord my soul to keep. If I die before I wake, I pray the Lord my soul to take.
And then my parents would turn off the light and shut the door to my bedroom, leaving me alone with that happy thought. A stupid little prayer that scared the shit out of me and was undoubtedly at least partially at the root of a life long case of acute anxiety. I mean, WTF? No wonder I suffered from nightmares.
I thought of this prayer today as I have begun to preface so very many of my thoughts with ‘and if I live.’ Irony free.
Only someone who has been in my position where death is not just a possibility but rather a probability can understand.
It is rather like being in an out of control vehicle, hurtling headlong to a bluff overlooking the ocean. There is a remote chance that you will be able to steer the car to safety at the last moment. However, as you don’t want to waste a moment of what might be your last time on earth, you are also doing your utmost to enjoy the scenery.
It is that flipping surreal.
I have a CT scan on Tuesday which will give a clinical assessment of where we are at. From the objective of the person who is in this body, I can only tell you that it’s getting harder and harder to breathe in here. Hardly encouraging.
And yet the view out the window? Still extraordinary.
When titling my previous blog I had a verb in mind. An action verb.
Chemo is a wall. And–frankly–that is the point. What sucks for me hopefully sucks for my cancer as well. All those side effects are indicators that the poison is going about its nasty little business.
What I’d like to clarify is how I’m taking this. Not lying down.
This particular chemo combo is a small misery compared to what I have experienced in the past. Fifteen years ago I was given a doublet of cisplatin and taxotere. My then oncologist explained, in the bluntest terms possible, that he intended to bring me to the brink of death and then bring me back. All in the name of eradicating my cancer.
Well he was true to his word. That shit blew. And I’d start to feel the side effects before we even got home after infusion. I spent days riding out the storm in my lazy boy chair (dubbed the lazy girl). By the fourth cycle I didn’t have a hair or an ounce of extra fat on my body and I was coughing up what looked like coffee grounds.
Now that, my friends, was hell. And it gave me some perspective. A rocky baseline if you will. Added to the mix was the fact that seven weeks earlier I’d had a lower left lobectomy, not vats but rather the old fashioned way. Ribs spread, large incision. Brutal.
So this is, relatively speaking, a walk in the park. I do feel a tad crummy. But I am also going about my business. As I live alone that means walking the dog, shopping for groceries, cooking. And, because my life is in fact over the top crazy, moving.
Yes. Again. My current situation did not work out quite as I imagined. One of my closest friends understood that this had become a source of stress for me and as fate would have it, an apartment that was located directly across the street from her opened up.
It was now or never and given the possibility that I may feel worse rather than better in the future, it was a no-brainer.
So yeah. Rather than surfing the couch I have been loading and unloading boxes. Yet again. On Wednesday my friend Melinda has arranged for a moving company to take the furniture and the books. And yet another impossible task will have been accomplished. Under ridiculous yet necessary circumstances.
I share this all so that others understand that even though chemo is undeniably unpleasant, it is also doable. This is an important concept for those who have only been on targeted therapies, and who are loathe to consider chemo, because of its bad rap.
In my case, I have a clear and unwavering agenda. It’s this: I really want to live. And I am willing to scale a million walls in order to do so.
Who knows. Maybe chemo works better if you’re not laying on a couch. I kinda doubt anyone has done any research around physical activity post infusion.
The first thing I said when I got up this morning was ‘Linnea, it’s your birthday. You’re still alive. Not sure how you do it, but you do.’
Gotta say, I didn’t think I was going to have an opportunity to get old. And so far, I’m loving it.
However it is all very bittersweet. Yesterday I spent time with someone who I care very much for. Someone who is young–too young–and who is in the last stages of fighting this disease.
And that breaks my flipping heart.
We’ve made significant progress when it comes to the treatment of lung cancer. More of us are living longer. However, the majority of effective treatments are still targeted therapies that are classified as inhibitors. By definition, inhibition restrains or restricts. When you are talking about targeted therapies, inhibition is almost always temporary. Cancer is an incredibly wily bitch; it finds a way around.
And sadly, medical research doesn’t operate at quite the same speed as wildly mutating cells.
It’s all quite complicated, actually. Regulations, incentives, the sheer enormity of the problem. However, from the perspective of the patient, it is actually absolutely straight forward. We want to live. And far too many of us are still dying.
So yes, I am happy to have this opportunity to turn sixty. It is a reminder of far we have come. But also how far we have to go.
I am generally possessed of a mighty thick skin. Not a quality I was born with but rather one acquired through repeated injury. I don’t say this with any drama—it’s simply a fact. And I, being a scrappy survivor, have developed tools/personality traits to effectively protect myself.
However every once in a while something gets under my skin. When I logged onto Facebook this morning, another cancer survivor had characterized my cancer as ‘amazingly slow growing.’ I should have just let it go but I responded by saying that I wished my cancer did grow more slowly, before listing for her all the modalities of treatment that I have undergone since my diagnosis. And then I counseled her to be more sensitive when describing another’s cancer as amazingly slow growing.
For those who wonder what the fuss is all about, here is the synopsis from my most recent radiology report:
Surveillance for lung cancer status post left lower lobectomy. Sub-solid mass like opacities in the left upper lobe have increased in size and attenuation since the prior study as described.
Persistent and slightly increased groundglass and interlobular septal thickening in the basilar left lung, suggestive of lymphangitic carcinomatosis.
Additional subsolid nodules in the left lung are stable or slightly increased in size compared with the prior exam.
Slightly increased small loculated left pleural effusion.
Secondly, just for scale, the largest of my masses is now 4.4 by 2.1 centimeters. No small potato when one is talking about cancer.
So yes, I am darn fortunate that I have been able to survive for as long as I have. But I haven’t exactly been sitting around and eating bonbons as I’ve fought (yes, fought) rather tirelessly to stay alive.
There. Got that off my chest. Now if I could just get this other shit out of my chest I could get back to that box of candy.