One less cancer!

It’s been several months since I wrote an update about my health which is usually a good thing because it means that there’s been nothing new to report. This week saw something very big happen though! Before I get into that, let me begin with a bit of history for those who are new to the blog.

In the early fall of 2013, I was diagnosed with neuroendocrine cancer (NETS) which is incurable, but often treatable. Exactly seven months later, a second completely unrelated cancer was found in a my left parotid (saliva) gland. Treatment on the first cancer was halted while that one was removed surgically and followed up with thirty radiation treatments. Once I’d had time to heal from that, treatment on the first cancer resumed. I entered a clinical trial that involved 12 radioisotope treatments (PRRT) over a period of approximately five years. Each of these treatments left me highly radioactive for a week, but I responded well and there was some shrinkage of my tumours. In the fall of 2018, toward the end of that regimen, scans detected something suspicious in my thyroid gland which eventually proved to be yet another unrelated cancer. Since only a small percentage of papillary thyroid cancers are aggressive in nature, the decision at that time was to watch and wait. My body had been through enough and we could afford to give it time to heal before deciding how to address this latest discovery.

Skipping ahead three years to last fall, my neuroendocrine cancer continued to be stable. In fact, 20 months after my last PRRT treatment, I was still experiencing some decrease in tumour size. I was feeling great and able to live a normal, active life. Though there had been no change to the thyroid cancer, we decided that the time had come to remove it rather than taking a chance on allowing it to begin growing or spreading.

Then began the long wait due to Covid hospitalizations delaying surgeries! Finally, on Thursday morning, the same amazing surgeon who did my previous neck surgery removed my thyroid. I woke up very early that morning with two distinctly different kinds of cancer and a few hours later I had only one again! It’s taking awhile for the reality of that to truly sink in.

After an overnight stay in the hospital, I’m home and feeling remarkably well considering. I’ve needed nothing more than Tylenol for pain which is such a blessing as heavy duty pain killers make me nauseous. My neck feels a bit like someone held me in a headlock for an extended period of time which is probably pretty similar to what happened during the 3.5 hours of surgery! I have a very husky voice as the result of some difficulties with the breathing tube, but that should gradually heal over the next couple of weeks. I had a super good sleep last night and now I’m just going to lean back and take it easy for a few days! During the first week of March, I’ll be back in the city for a follow up appointment with the surgeon as well as CT scans to check on the neuroendocrine cancer. In the meantime, I’m just rejoicing over having one less cancer!

NET Cancer Day 2021

Once again, today is Worldwide NET Cancer Day, a day set aside to increase awareness of neuroendocrine (NET) cancers and to promote improved diagnostics, treatments, information, care and research.

The theme of this year’s campaign is

Know the symptoms.

Push for diagnosis. 

Less than 30% of neuroendocrine cancer patients receive a correct diagnosis the first time they reach out for help. In fact, it often takes five to ten years from onset of symptoms to correct diagnosis. During that time, of course, the cancer quietly spreads. Thankfully, compared to many other cancers, NETS is slow growing, but like many of my fellow patients, I was Stage 4 at diagnosis. This means that my cancer had already spread from its origin to distant parts of my body. At this point, 8 years after diagnosis, treatment has halted it’s progress and resulted in some shrinkage, but there is no cure.

Know the symptoms. 

Once considered rare, neuroendocrine cancer is actually the fastest growing class of cancers worldwide. Unfortunately, many health care professionals have never seen a case and know little or nothing about this complex disease. In order to achieve early, correct diagnosis for every patient, we need every primary care physician to know and recognize the symptoms. When they are presented with stomach pain, it makes sense for them to suspect gastritis (inflammation of the stomach lining), but we also need them to wonder if it could be neuroendocrine cancer. When the stomach pain is accompanied by severe diarrhea, irritable bowel syndrome is a definite possibility, but we also need the doctor to be aware that it could be NET cancer. When a woman complains of facial flushing, rather than simply assuming that it’s due to menopause, we need her doctor to ask himself if it could be NETS. Depending on the location of the primary tumour, other symptoms may include nausea and vomiting, rapid heartbeat, anxiety, skin rash, shortness of breath or wheezing, lack of appetite, unexplained weight loss and/or lack of energy.

Push for diagnosis. 

Diagnosing neuroendocrine cancer is complex. In addition to recognizing the symptoms, we need doctors to order the correct laboratory tests and scans. It’s also important for patients to push for correct diagnosis. One of the most important things I’ve learned since my diagnosis is how important it is to advocate for yourself. Know your body. Know what’s normal for you. Pay attention when something feels off. Take note of unusual symptoms and talk to your doctor as soon as possible. If you don’t get the answers you’re looking for, PUSH! Don’t give up. Years before I was finally diagnosed, I remember thinking “at least it’s not cancer” but I was wrong! If I’d pushed for answers then, perhaps it would have been caught much sooner and the outcome might have been very different!

Know the symptoms.

Push for diagnosis. 

Blogging woes and cancer news

My beloved MacBook Air is getting old; old enough that I’m not able to update to a newer browser. Recently, whenever I opened WordPress to check my stats or work on a post, I received a message telling me that I was using an unsupported browser. Until earlier this week, however, I was able to click through to the appropriate page and work as usual. Then came the fateful day when all that I could open was a blank page with the WordPress logo in the centre!

As I usually do when something goes wrong in my blogging world, I fired off a cry for help to WordPress support and hoped for the best. They’ve never let me down yet, but while I wait to find out what they can or can’t do for me, I’m typing this on my husband’s computer. Not easy! Mine is a Mac, but his is not. The keyboard is a different size and my fingers don’t know what to do. Things jump around when I’m not expecting them to and then there’s the issue of all my photos being on my computer and not knowing how to transfer them to his. With practice, I’m sure these things will get easier, but this is, at best, a very temporary solution! I’m hoping that I don’t have to invest in a new computer right now as mine still does everything else I want it to do, but I have to be able to blog!   

Now, for the other news… 

In mid August, I went through a series of tests and scans, as I do every six months, to determine whether or not there were any changes to my cancers. When the results became available online, I was concerned about a spike in one marker that is particularly significant to neuroendocrine cancer (NETS). Not only had the level increased dramatically, but it was now slightly above the normal range. Knowing that I had to wait several weeks to see the doctor for an explanation, my response was similar to when WordPress quit working. I called for support. I sent out a cry for help to eight godly women asking each of them to pray, not only that my cancer had not grown or spread, but also that I wouldn’t be anxious as I waited for answers. Almost immediately, an unnatural peace descended on me and I was able to go on without undue stress or anxiety. 

“Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”  Philippians 4:6-7

And now for the really good news… my cancer continues to be stable and the doctor has no concerns! Though the spike in that one marker looked concerning to me, she assured me that it would have to be much higher before it was anything to worry about. Praise the Lord!

100 butt darts!

Every 28 days, without fail, a visiting nurse pulls up in front of our house and comes in to give me an injection of Sandostatin LAR. Today was the 100th of those butt darts!

Sandostatin LAR is a long-acting treatment meant to reduce or eliminate the symptoms associated with neuroendocrine cancer (NETS) and for me it has been an absolute life changer! No longer do I live with the stomach pains and diarrhea that plagued me off and on for several years prior to diagnosis. Though the effect of Sandostatin on tumour size, rate of growth, and development of metastases has not yet been determined, it is thought that it might also be of benefit in those areas.

Sandostatin comes as a powder and a diluent solution that must be mixed and administered according to very precise instructions which is why I haven’t been taught to inject it myself. Once the diluent is added to the powder, it must be allowed to stand for a minimum of 2 minutes and not more than 5 to ensure that the powder is fully saturated. Then, after gently shaking the syringe for about 30 seconds to ensure that the powder is completely suspended, the nurse has to administer it without delay to avoid sedimentation. Even following these guidelines carefully and using a fairly large needle (19 gauge), it sometimes plugs. On those occasions, she has to quickly change the needle and try again. On a couple of occasions it has taken 4 jabs to get the medication into me! My 100 butt darts has actually involved about 130 pokes altogether.

In addition to the benefits that the drug offers, getting it into me and not wasting it is of vital importance because every one of those butt darts costs $2358.52 CAD! In other words, over the past almost 8 years, we have pumped more than $235,000 into my posterior! You could buy a nice house in our small town for that much.

This is where I’m really glad to be Canadian. I pick up the Sandostatin at my local pharmacy every 4 weeks and don’t pay a cent! The cost is fully covered by the government and that includes the cost of having the nurse come to my home. A Mobile Administration Program even enables me to have my injection administered by a trained nurse anywhere else in Canada. A simple phone call is all it takes to make the arrangements. I have to take the medication, which has to be refrigerated, with me but I’ve found that an insulated lunch bag and a mini freezer pack do the job as long as I can put it in a fridge overnight. So far, I’ve had butt darts administered at all 3 of my children’s homes. Arranging to have it done outside the country would be more complicated and isn’t something I’ve tried at this point.

So, is getting my monthly Sandostatin a pain in the butt? Not really. As a child, I was terrified of needles, but I lost that fear a long time ago. Only once in awhile does really hurt going in. Today was one of those occasions, but it went in on the first try, so I’m not complaining! The injection site often feels bruised for a couple of days and a lump often forms that gradually dissipates over the next few weeks, but these minor inconveniences are well worth it when I consider the benefits. So, 100 butt darts down and here’s hoping that I can have 100 more! Or 200. Or more!

It happened!

I had my second Covid-19 vaccine injection today! It was an uphill battle getting here, but it happened!

Continuing from where I left off when I wrote the post Am I expendable? on April 18th, I called my MLA’s office and the Ministry of Health. By that time, the cry for cancer patients to receive their second vaccine within the recommended time frame had hit the media and was definitely on the government’s radar. Though I wasn’t given any details, I was told that a decision would be announced soon.

Finally, late on the afternoon of April 22, the Chief Medical Officer of Alberta announced that cancer patients and others who were severely immunocompromised could begin booking their second appointments by phone the following day. Actually getting the appointment was quite a gong show though. I started calling first thing the next morning, but the lines were clogged. I was absolutely elated when I got through later that morning and was able to book my appointment for the morning of April 30, just two days beyond the 21 day interval recommended for the Pfizer vaccine. My excitement was short-lived, however. Within a couple of hours, I received an email, with no explanation, telling me that my appointment had been cancelled!

I immediately phoned again and made a second appointment, only to have that one cancelled the following day! At that point, I started to think that somehow the information that I was a cancer patient must not be getting into the system. I admit to being pretty hot under the collar by the time I called a third time to make the same appointment! I mentioned my suspicion and the gal who did the booking agreed with me. She told me that there was a new button to click to indicate that a caller was part of the patient group who could now book their second injections. Apparently those who took my first two calls either didn’t know that or forgot. Fortunately, while all of this was going on, today didn’t completely fill up and I was still able to get in.  

I’m glad that no one checked my blood pressure during the two days that it took to finally get an appointment that stuck! The whole rigamarole certainly added to my stress level and I almost feared checking my email for the next few days in case I once again saw a “Covid-19 Immunization Cancellation” message waiting for me! After fighting so hard to see this happen, I didn’t feel 100% certain that it would until the needle was actually in my arm! 

The fight isn’t over yet though. The majority of cancer patients across Canada still don’t have access to their second vaccine within the timeline proven most effective by clinical trials. CONECTed, a national network of oncology groups supported by over 17 national patient organizations, has launched a campaign asking the federal government to revise the National Advisory Committee on Immunization (NACI) recommendation for cancer patients so that they would receive 2 doses of Covid vaccine within 21 to 28 days of each other. They are also asking provincial and territorial governments as well as local administrators to ensure that adequate directives and resources are provided to achieve this goal. 

Being fully vaccinated isn’t actually going to make any difference to how I live my life at least in the short term. It typically takes two weeks after a person is fully vaccinated for the body to produce enough antibodies to provide protection from the virus and even then, with the Covid-19 situation here in Alberta the worst it’s ever been, life won’t be getting back to “normal” anytime soon.  

Am I expendable?

Cancer has been trying to defeat me for almost 8 years. Now it looks like it’s trying to recruit Covid-19 to help it out. No, I don’t have Covid and I’m trying to do everything I can to keep from getting it, but I’ve run into a dangerous roadblock that is affecting cancer patients across our country. 

Vaccines have been touted as our way out of this pandemic and I believe that they probably are IF they’re given correctly. That’s where the problem lies. According to the product monographs and based on the trials that were performed before the vaccines were approved, the second Pfizer dose should be given 21 days after the first, Moderna 28 days, and AstraZeneca 4 to 12 weeks. Here in Canada, however, the National Advisory Committee on Immunization (NACI) has recommended that in order to maximize the number of individuals benefiting from the first dose of vaccine, the interval between doses be extended to four months or 16 weeks.

While there is no evidence to show that this is an effective way of administering these vaccines, the extended period between doses may not make a big difference to the general population, but that is not true for those of us with cancer. Research conducted in the UK has shown that while an antibody response was found in 97% of the healthy volunteers tested after their first injection, the response was less than 40% in patients with cancer. That number increased dramatically to 95% if they received their second shot at the recommended time, but only 43% if that time was extended. 

I had my first injection of the Pfizer vaccine on April 7. That means that I have 10 days until I should be getting the second one, but I feel like I’ve been beating my head against a wall trying to make that happen. I’ve called Alberta Health Services to no avail. The clinic where I received my cancer treatments was unable to help. I’ve attended a webinar with members of various patient advocacy groups across the country and I’ve contacted the media. A petition has collected more than 20,000 signatures over the past few days and news sources are coming onside, but will the government listen? Ontario and Manitoba are moving forward with the second dose for cancer patients, but here in Alberta not one word of hope has been heard from our government. It would seem that they have decided that those of us who are already fighting for our lives are expendable! 

Photo: Spencer Davis

The Cancer Fashionista: fighting cancer one outfit at a time

When I first read about Donna McNutt, Instagram’s Cancer Fashionista, I was instantly intrigued and so inspired that I immediately started following her. I identified so strongly with her message that cancer could break her down, but it wasn’t going to take who she is! Today, I have the privilege of introducing you to Donna.

Donna, please tell us a bit about yourself and your cancer story. 

In early 2015, at age 55 and after raising three children, I had just moved into my dream cottage in Laguna Beach, California when I began experiencing rib pain. About three months later, on Easter morning of that year, I was in so much pain that I couldn’t do the one thing I always do, get dressed. I went to the hospital where it was discovered that I was in the last stage of multiple myeloma and my kidneys were failing.

 

After a two week stay,  I began a chemo regimen to prepare for a stem cell transplant at City Of Hope (one of the leading cancer hospitals in the United States) that would put me into remission. Multiple myeloma is an incurable cancer, so although the transplant was a success, I will always be on some form of treatment.

 

Multiple myeloma is a relatively uncommon blood cancer that starts in the plasma cells which are mostly found in the bone marrow.

 

Please tell us about your involvement with the Rose Bowl parade. 

 

City Of Hope is where I got a second chance at life. I was so honored when I was asked to ride on their 2020 Rose Parade float, representing patients and the hope we feel being a part of COH’s family.

 

 

 

How has fashion helped you cope with having cancer?

 

I’ve always loved getting dressed. It’s probably the most defining part of me.  I knew that the only way I was going to survive cancer was by continuing to get dressed. So little by little, I would wear lipstick, maybe a cute pair of shoes, and  eventually I started rocking the cutest outfits when I went for my treatments. The Cancer Fashionista was born!

 

Getting dressed is my distraction from all the many tests, treatments, and procedures that I endure. It also shows the people I love, I’m going to be ok. Look, I’m getting dressed! It has now become my mission to tell others, find your thing, the thing that makes you whole, do not let cancer take it. For me, that thing is getting dressed.

 

Even in the hospital, Donna chose to wear her own colourful pyjamas instead of hospital gowns. 

 

 

 

How would you describe your style? Has it changed over time?

Because I love fashion so much, my style has changed many times over the years. I dress for what I want to project. Date night is when I wear heels, a red lip, and maybe experiment with a style I wouldn’t wear during my day. For me, dressing starts with shoes and then I build my outfit around them.

 

Some people knit, paint or exercise as hobbies, I try on clothes and create new spins on old favorites. I believe that whatever makes you feel confident, no matter what age you are, people will see that. That confidence is the most important thing you’ll be wearing.

 

 

Who takes your fashion photos?

My husband takes all my photos. I call him Hubbyrazzi. It’s been amazing having him by my side and a part of my cancer journey. When he takes my photos, he gets to see and capture the best part of my day and for this I am grateful.  

You’ll meet Hubbyrazzi and hear his perspective in the video below. When I look at these photos and so many others on Instagram, I see colour, imagination, and creativity, but I also see courage and a woman telling cancer that it can’t rob her of who she is. In my mind, that’s beautiful and very inspiring! 

Through a program at City of Hope, Donna mentors other patients who are preparing for stem cell transplants. She’s made it her mission to share her journey whenever she has the opportunity to help other cancer patients not feel so alone and to show them that there can be another side of cancer.

I tell them that I have fought cancer one outfit at a time. We have to have a little humor when dealing with cancer!

Perhaps this message, which I also found on Donna’s Instagram, says it best. 

Now, please take a few minutes to watch the video and if you’ve found Donna’s story inspiring, you might also want to follow thecancerfashionista on Instagram.  

Good news!

In these days of political turmoil, Covid variants, earthquakes, avalanches, and ice storms, we seldom seem to hear any good news, but today was different for us.

It started with a phone call 45 minutes before we were planning to leave for the city to meet with the doctor to receive the results of the CT scans that I had last Friday. Scans that would tell us whether or not my neuroendocrine cancer (NETs) had grown or spread. Would I be okay with a phone consultation instead of meeting with the doctor in person? You bet I would! I’ve been feeling fine. I didn’t have any specific reason for needing to see the doctor in person and a phone call would save us four and a half hours of driving! 

The really great news came with that second phone call, the call from the doctor himself. Almost immediately, I heard the word I’d been hoping for. Stable! But then I heard, “for the most part.” For the most part? What did that mean? “It’s good news” he hastened to assure me.

There has been a change, but it’s a change for the better! Twenty months after my final PRRT treatment, after feeling like I was stepping off a cliff because I would no longer be on any treatment other than the monthly injection that I’ve been receiving since diagnosis in 2013, I’m still improving! A spot on my liver has decreased in size since the last scan almost seven months ago!

Another indication of how I’m doing showed up in the blood work that accompanied my scans. Chromogranin A, a protein released by neuroendocrine cells, is the most valuable marker of neuroendocrine tumours. In December 2019, six months after that final PRRT treatment, my Chromogranin A level was 112, which in the words of my doctor, was “at or slightly above normal, but not worrisome.” By last August, it was down to 49 and now it’s 27! This, too, is pretty remarkable. 

Neuroendocrine cancer is incurable. I’ll have scans and blood tests again six months from now and once again, we’ll wait for the results and hope to hear that wonderful word. Stable! In the meantime, we’re praising the Lord for today’s good news! 

NET Cancer Day 2020

Once again, today is Worldwide NET Cancer Day, a day set aside to try to increase awareness of neuroendocrine (NET) cancers and to promote improved diagnostics, treatments, information, care and research. The focus of this year’s campaign is to highlight the challenges that patients and clinicians face around the early diagnosis of NETs.

A recent worldwide survey of NET patients showed that only 27% of them received a correct diagnosis the first time around. 44% of us, myself included, were misdiagnosed for several years before the correct source of our symptoms was discovered, often by accident. Globally, it has been taking 5 years on average from initial symptoms to diagnosis; 6 years here in North America which was also my experience.

I’m part of the 36% who were initially diagnosed with gastritis, inflammation of the stomach lining. It was a GP who made that diagnosis based only on my symptom, a gnawing abdominal ache. I don’t fault him for that as NET cancer usually presents symptoms that mimic much more common ailments. Had we done a colonoscopy, however, the tiny tumour growing in my cecum would likely have been found before the cancer spread. It was several years later, when unusual spots on my liver showed up on a completely unrelated ultrasound, that suspicions were raised and I eventually learned that I had Stage 4 cancer! By that time, my symptoms had grown to include chronic diarrhea as well as occasional flushing and episodes of tachycardia (extremely rapid heart rate), all common characteristics of NET cancer.

There are 3 As that would significantly improve the outcome for many NET patients:

1.  Awareness of symptoms  –  We need health care professionals at every level to be aware of this complex disease and to be able to recognize its symptoms. My family physician had been practicing medicine for approximately 20 years when I was diagnosed, but I was his first NET patient and he knew very little about it. I’ll never forget the locum who argued with me that neuroendocrine tumours aren’t malignant (some aren’t) and that I didn’t actually have cancer at all! 
2.  Availability of diagnostic tools  –  The most precise tool for detecting NET cancer is the Gallium 68 PET scan, but I have never had one. In fact, only 18% of the surveyed patients worldwide have. It isn’t available at many cancer treatment centres. For the past few years, there’s been talk of one coming to the Cross Cancer Institute where I receive all my care, but as far as I know it hasn’t happened yet. 
3.  Access to NET specialists  –  In the survey mentioned above, 24% of the patients had not even heard of a NET cancer specialist and many others travel long distances to see one. 

So, every year on November 10, and whenever I have the opportunity in between, I’ll do my bit to raise awareness, never giving up hope that eventually better diagnostics and treatments will be available to all NET patients and that ultimately a cure will be found!

HOOFED IT!

Over a three day period while camping at Miquelon Lake Provincial Park this past week, Richard and I hiked a total of 23.9 km, pushing me to within just 2 km of my final HOOFING IT Across Canada goal. This evening, under dark cloudy skies that look like they were about to let go and pour rain, I crossed my self-imposed finish line! Since July 1st, I’ve HOOFED IT 179.5 kilometres (111.5 miles). That’s 2.5 km more than the distance from our front door to the Cross Cancer Institute in Edmonton where I receive all my neuroendocrine (NET) cancer care.

If you’ve been reading my blog or following me on Facebook this summer, you know that I’ve been taking part in the CNETS Canada campaign to raise funds for NET cancer research. The goal was for participants to rack up 5514 km, the distance from Newfoundland and Labrador to the Yukon, by walking, hiking, kayaking, swimming, cycling, roller-blading, or any other forward moving activity that they could think of. We did that in spades, criss-crossing Canada almost five times!

Fundraising has been a bigger and vastly more important challenge. This evening, we’re sitting at just over $73,000, but approximately $20,000 of that has come in over the past ten days! For that reason, the deadline for making donations has been extended to September 25. With an extra two and a half weeks, we’re hopeful that we can bring in the final $27,000 necessary to continue funding critically needed neuroendocrine cancer research.

The need for research and awareness was brought home to me again this afternoon when I spent some time chatting online with a NET patient in another Canadian province who was diagnosed in May of this year. She’s been seen by an oncologist and has had surgery, but she hasn’t been referred to a NET specialist. She hadn’t even heard of Sandostatin, the injection that I’ve been receiving every 28 days since diagnosis. It’s been the workhorse medication for neuroendocrine cancer patients for the past 30 years, but her oncologist may never have encountered a NET patient before and may have little or no idea how to treat it. Sadly, this is a common occurrence for NET cancer patients!

Today, with so much attention being directed toward COVID related research (and rightly so) a relatively unknown cancer like ours can easily get overlooked. With many people facing financial difficulties, it’s not easy to keep asking for donations, but let me do it one more time. If you haven’t already and you’re able to give even a small donation, please visit my fundraising page and help us reach our goal. Every dollar counts!

Born To Be Wild by Sylvia Sotuyo