Tag Archives: terminal lung cancer

Tough love for lung cancer

November is Lung Cancer Awareness Month. I have said before that I don’t do months. Lung cancer is weeks, days, minutes, seconds for me. Year round.

In November many of my fellow advocates devote a lot of time to raising awareness–the squishiest form of advocacy. This year I am seeing a lot of upbeat photos of people who don’t look for a minute as if they are living with a disease like lung cancer.

Passing for healthy has been one of my favorite party tricks. At the moment, there’s not a chance in hell I could pull it off.

So here’s the thing. I believe in positivity while also keeping it real. Really real. And the truth is, those pretty pictures are each of us at our best moment.

I don’t believe people care more about something like lung cancer when the message is that people are living. Yes–it is inspirational for our community. But the rest of the world needs to hear the other side. That even though anybody can get lung cancer, very few will survive it.

My friend Andy Lindsay died two weeks ago, almost two years to the day after he was literally at the top of the world. If lung cancer can kill Andy Lindsay, it can kill anybody.

You are aware of my current situation. Having exhausted all TKI’s for those of us who are ALK+, I am back to non-targeted treatments–infinitely less effective and with a greater range of side effects. My friend Diane Legg, diagnosed with lung cancer months before I was, found out two weeks ago that she’s got three brain mets–after sixteen years of her cancer staying confined to her lungs.

Diane and I remain exceptions–having lived far longer than anyone thought possible. But I’d be lying if I said it was getting any easier. Not only is cancer and continuous treatment beating the shit out of us, we each have become close to hundreds of people who have passed away. Wrap your head around that one.

So yes. Let’s stay positive and hopeful. But let’s also get it right–both out of respect for those who have died but also for the sake of those who are still living. We need more money for research and we need it yesterday. Because having an opportunity to get older if you are going to age out of treatment options is one hell of a bitter pill to swallow.

Inside out

Yesterday was like no other. I picked my friend Marc up at 10 am and we headed to Andover where we had a date with an old piano.

Built in 1907, it was beyond repair and its owners–friends of Marc–had invited him to salvage what he could for art materials. Marc knows I love taking things apart and so I got to ride shotgun.

In two hours, five of us got it down to the harp. We then loaded my car up with the dismembered pieces. Marc and I picked up some bagels on the way to his house (I had a french toast bagel–who knew?) but once there, we first toasted our endeavor with gin martinis.

As I departed, Marc gifted me with some brownies. Last night I had one just before retiring. And then I settled in for the show.

And a wild one it was. Something about being high facilitates memories for me. It is as if I am not merely recalling, but rather experiencing yet again. That fresh, that real.

It was a long time before I fell asleep, but along the way I had some sort of breakthrough. A traumatic memory from childhood and its relation to another equally unsettling event as an adult. Turns out the two events are corollary.

When I did finally sleep I was awakened because I had to pee. That, and the sound in my left lung. I am now experiencing not only a wheeze but also dyspnea. I know where this is heading and can’t say I like it.

Tomorrow I have scans, with a virtual consult on Wednesday with Dr. Lin and possibly Dr. Shaw.

Today I carted the parts of the piano (post mortem) to my studio. I also painted for several hours. My heartfelt response to what is going on in my body is that I don’t have time for this shit.

It’s a bloody shame that cancer has such an issue with boundaries. My big plans matter squat to those errant cells. Therefore, I simply have to operate under the assumption that once this therapy fails, there will be other options.

It takes a lot of faith but also fury. Some strange amalgam of acceptance but also hell no.

I cannot, will not go. Not yet.

Living and loving an imperfect life

As I zipped through my social media this morning, I noted that two friends were posting that they were either NED or cancer free.

Good for them I thought. And then I, little miss Never Been Ned, reflected yet again on what it’s like to live not without, but rather with cancer.

It’s ok. Sort of like living through a pandemic.

Once upon a time I wished fervently that bad things wouldn’t happen. But they did. Again and again.

Truthfully we’d all prefer to simply coast but if we can figure out a way to ride into a stiff wind, well, we’re golden.

At least that’s what I tell myself. It’s the same attitude that has me taking the stairs versus an escalator or elevator. Both will get me to the same destination but one has the added benefit of a workout.

Rather than avoiding challenges, I seek them. That is because I am truly invested in becoming better, tougher, stronger, smarter.

COVID-19 is testing us all. This is not the world we once knew. It’s difficult to embrace a concept like social isolation, but also necessary. Not just for our own sake, but for the greater good.

My heart grieves for those who have been taken by COVID or lost a loved one. There is no way to spin this into a positive for some.

But for those of us who are primarily inconvenienced–well–there is the opportunity for a lot of reflection and personal growth here. We can demonstrate that we care about others simply by wearing a mask in public. And by shifting our focus to the small (and yet grand) things.

Like waking up in the morning.

xo

And some piece of mind

I have scans again one week from today. Two days later I am to review them and to have another infusion. I already know that my new oncologist will not be able to meet with me that day—I believe she shall be in the ICU. Younger doctors are being asked to fill all sorts of roles now—previously she was on the COVID19 unit. I am sure they are receiving a phenomenal education but the stress must be extraordinary. And of course, it is hard for their cancer patients as well.

Given the gravity of my decision (yes) I decided that it was best to get in touch with Alice. Yesterday I sent her this message:

“Good morning. Scans a week from Tuesday and I won’t actually be seeing Jess so thought I’d discuss with you. I have been pretty flipping miserable for weeks now—physically and emotionally. Last night my mouth/throat/tongue were the worst yet. Unless those scans show some very compelling reason as to why to stay on this I am done. Done to the point that even if there is not a good next choice done. If I have six months to live I’d rather not be miserable. If there is a good chance the MEK inhibitor will have similar side effects than it is not the drug for me. Honestly I have been so depressed that at times I have been ready to call it quits all together. However, given the possibility of improvement while retaining quality of life, I could rally. So let’s discuss what that might or might not look like.

She responded immediately and then called me later. This next scan shall be telling but my mind is made up per suffering—if it is for naught, I am not on board.

Today was better—the discomfort remains great but knowing that I have drawn a line in the sand I feel safer somehow. Just as it is powerful to know one’s strengths it is also imperative to appreciate one’s limits.

I love life. So very much. But pain is incredibly demoralizing and I have made the choice that for me, not how I wish to spend the rest of my time here.

Fingers crossed that there is an easier option.

What the hey

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.

Absolutely Nothing.

xo

It was

Me giving me encouragement: the Wall of Hope on floor eight of the Yawkey building at MGH. When I first started getting treatment, a secret goal was to one day appear on the Wall of Hope. 🙂

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.

xo

If

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.

xo

Up and over

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.

Consider this a pilot study.

xo

Scaling

I have hit the wall that is week two. Massive fatigue. Rheumy eyes. Gums that weep, a mouth that feels like sandpaper. Nosebleeds.

Loose of bowel, I’ve lost five pounds. Neuropathy is both afoot and at hand.

Numb and bloody. Edges and corners raw. But alive.

Alive, alive, alive.

And happy about it.

I had the thought that this is what cancer reduces existence to. Gratitude even in misery. But then I rethought that thought. And this time it came out this is what cancer elevates existence to.

How fucking fantastic is that. This, my friends, is unconditional love. Life, so treasured, that even when it’s all a bit raggedy it remains sought after. Beloved. Adored. Precious.

Something worth fighting for.

xo

Six oh

I am sixty. Six omg I can’t believe this is true.

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.

xo