Thursday, August 31, 2006


Well the Alberta government has finally seen fit to make Herceptin available to all breast cancer patients who would benefit from this drug.

For more info on Herceptin, check out this excellent article from the CBC (Canadian Broadcasting Corporation, web site:

The promise of Herceptin
Last Updated August 30, 2006
CBC News

When the government of Alberta announced that it would begin picking up the tab for the breast cancer drug Herceptin for patients in all stages of the disease, it became the last province to do so.

Before the Aug. 28, 2006 announcement, Alberta covered the cost of the drug only for people in the advanced stages of breast cancer treatment. That's what the drug was approved for by the U.S. Food and Drug Administration in 1998. And it had proven quite effective in lengthening the lives of women in the late stages of breast cancer.

Herceptin therapy can cost $40,000 a year per patient. Alberta's health minister — Iris Evans — estimates the move will cost the province about $8 million a year.

"I'm very satisfied that the clinical trials have given strong evidence that this is an important therapy for us to use," she said.

Most provinces began paying for the drug for patients in the early stages of breast cancer a year before Alberta's move. Evans said the province wanted to wait until clinical trials were complete before making the same decision.

For advocates of the therapy, the evidence of Herceptin's effectiveness had been indisputable long before Alberta agreed to follow the lead of the other provinces.

Herceptin is an antibody that binds to a protein on human skin cells — the human epidermal growth factor receptor 2 (HER2). It is believed an excessive amount of this protein increases breast cancer growth — and increases the risk of recurrence of the disease and death.

Approximately 25 per cent of patients have this aggressive form of breast cancer.

In May 2005, three large-scale studies of the drug were abruptly halted because of overwhelmingly positive results.

The studies showed the rate of breast cancer recurrence was reduced by more than half when Herceptin was given to women undergoing chemotherapy compared to women who received traditional chemotherapy alone.

Among the findings:

* After two years, there were 261 events (such as return of the cancer, second primary cancer or death before recurrence) in the control group and 133 events in the group taking Herceptin.

* After three years, 87.1 per cent of patients taking Herceptin were alive and disease-free compared to 75.4 per cent in the group not taking Herceptin. After four years, 85.3 per cent of patients on Herceptin were still alive and well compared to 67.1 per cent for those on standard chemotherapy.

* Women taking Herceptin with a particular chemotherapy regimen had a 33 per cent reduction in risk of death.

Dr. Brian Leyland-Jones of Montreal's McGill University was the lead author on one of the studies. He called Herceptin the most important advance in breast cancer therapy in 30 years.

He noted that in traditional breast cancer therapy, one in four women will see their cancer spread sometime after undergoing surgery. In the Herceptin studies, that number dropped to one in 10.

"We're not quite sure [how Herceptin works]," Leyland-Jones said. "There are different factors that stimulate the growth of cells in your body. The targeted therapy interferes with the binding of this stimulating growth factor."

In October 2005, the New England Journal of Medicine reported on the three clinical trials. In an editorial, the Journal called the results "revolutionary."

"The results are simply stunning. With very brief followup (one to two and a half years), all three trials show highly significant reductions in the risk of recurrence of a magnitude seldom observed in oncology trials," the editorial said.

As many as 5,000 Canadian women a year stand to benefit from early use of Herceptin.

There is one significant side-effect. There is a small risk of heart damage in women undergoing Herceptin treatment. Approximately one woman in 200 could suffer heart damage.

Monday, August 28, 2006


I am burned and tired and just plain fed up.

Only six more treatments to go.

Wednesday, August 23, 2006

a conversation

As I sat waiting for my family to pick me up outside the cancer centre yesterday, I was approached by an elderly woman who had been sitting on the next bench.

"You have beautiful skin," she said. I was of course thrilled at the compliment, as I have been feeling anything but beautiful lately.

She asked if I was in treatment at the centre. I said that I was.

"I have lung cancer," she said. "I never smoked but I worked in intelligence. I worked mostly with men. The rooms we met in would be blue with smoke."

"And also, the spyplanes brought in films taken overseas which I handled regularly" she continued, "They had a coating on them. My colonel says he wouldn't be surprised if that's what caused the cancer, as several others we worked with also have it."

I told her that I have breast cancer. She replied that her sister had breast cancer and is doing well but is nervous as she approaches the five-year mark.

"I have lung cancer," she repeated. "And it's not the good kind of lung cancer."

"I'm thinking of going to San Antonio, Texas. There is a doctor there...They can cure cancer now but if the drugs don't make money, then the drug companies won't sell them. And the doctors here, they won't do anything that isn't in the medical mainstream."

"I think I'll go. But I need to find out more. I shouldn't say this, but I have lots of money. Still, I want to make sure they aren't quacks. I looked the place up on the internet and it looks good. I have a brother who is a doctor in Victoria. Im going to get him to look into it but I think I'll go."

"So many people have cancer now."

She paused to look at the book in my lap, "What are you reading?" (It was The Lighthouse, by PD James). "I haven't read that one. She's not my favourite. Well, her stories are OK, but as a person...(makes a face)."

"Are you waiting for a ride?" I ask her.

(Laughs) "Yes, my daughter. She drives an old jalopy. It's a wreck. She has a million dollar house but still drives that thing. She's not a showoff, that's for sure."

"Such beautiful skin," she says again, and reaches out to stroke my face.

I go back to my book, and shortly after, her daughter pulls up in a battered blue Toyota Camry, with the windows rolled down.

She waves goodbye as she gets in the car.

I liked her.

I wonder how much of her story was true.

Monday, August 21, 2006

good to be here

I ran into a group of friends yesterday, one of whom I hadn't seen in a long time. When she said that it was nice to see me, I replied, "It's good to be here."

My friend C., who was in my shoes two years ago, said, "It means a whole lot more than it used to doesn't it?"

It does indeed.

It's good to be here.

Tuesday, August 15, 2006

in perspective

I was going through some papers today, looking for information on lymphedema when I found some notes summarizing the results of the tests performed on my tumours.

I've been so bogged down in the grind of treatment and its side effects that I sometimes lose perspective on why I am doing this. This was a worthwhile, if chilling, reminder to re-visit the medical big picture.

The pathologists from whom I had asked for an informal second opinion explained that I had a "high grade tumour and very agressive cancer." They also advised me that I probably had dormant cells elsewhere in my body, since my cancer cells "showed an inherent characteristic of dissemination", as was evident from the fact that I had positive lymph nodes (and, by the time of surgery, palpable tumours under my arms). Their final words of advice were, "don't hold back thinking you'll have multiple ways to come back at this. Assume this is your best shot now."

And that is why I am putting myself through all this. Agressive cancer means agressive treatment.

As my friend A. said, in a very loving message she sent me in February, "Cancer is bad but we will be badder."

And we have been.

Saturday, August 12, 2006

the revolution starts now

Today's blog is brought to you by Steve Earle, from the Revolution Starts Now (2004).

I was walkin’ down the street
In the town where I was born
I was movin’ to a beat
That I’d never felt before
So I opened up my eyes
And I took a look around I saw it written ‘cross the sky
The revolution starts now
Yeah, the revolution starts now

The revolution starts now
When you rise above your fear
And tear the walls around you down
The revolution starts here
Where you work and where you play
Where you lay your money down
What you do and what you say
The revolution starts now
Yeah the revolution starts now

Yeah the revolution starts now
In your own backyard
In your own hometown
So what you doin’ standin’ around?
Just follow your heart
The revolution starts now

Last night I had a dream
That the world had turned around
And all our hopes had come to be
And the people gathered ‘round
They all brought what they could bring
And nobody went without
And I learned a song to sing
The revolution starts now

I especially love that second verse. Sometimes, during treatment, I have needed to stick my head in the sand. Sometimes, like tonight, thinking about the big picture has helped me to feel strong and optimistic and purposeful. This is such a hopeful song.

Next week end, Steve Earle is playing at the Ottawa Folk Festival and I am going to see him.

Thursday, August 10, 2006

cancer and me

A few days ago, I attended a Melissa Etheridge concert. It was an amazing show. The woman is a wonderful musician and song writer who performed with great energy for more than two hours.

And she's a cancer survivor. In fact, she discovered her lump when she was last in Ottawa in 2004. Her return to this city must have felt triumphant. I have always been a fan of her music but the way she handled cancer and what she wrote about the experience have turned her into one of my heroes (and her description of chemotherapy really resonated with me. It's hard not to feel a kinship with someone whose experiences so closely reflect my own).

I have listened to her music a lot during treatment; her old songs, to which I know all the words and some new ones, recorded more recently, that can bring tears to my eyes or make the hair on the back of my neck stand up.

It was quite wonderful to see her on stage, obviously strong, fit and joyous.

There was, however, a moment during the concert that has given me much to think about. Melissa talked about the brutality of chemo and the love and support of her spouse and community that got her through. She also talked about how cancer made her re-examine her life and re-think her priorities. These things are true for me as well. Then, she summed up her experience by saying, "Cancer is a gift."

That's when she lost me.

There is no question that there are ways that having cancer has enhanced my life. I am stronger and more confident. I am also much more cognizant of what a fortunate person I am. I have benefitted greatly from the time I've had to reflect over the last few months.

But would I say that cancer is a gift? Am I glad that it happened to me?

Absolutely not.

I am still furious.

Not long after my diagnosis, I purchased a t-shirt from that more accurately reflects my feelings. It has the letters CCKMA emblazoned on the front, with the smaller caption: "Cancer can kiss my ass."

Friday, August 04, 2006


Sounds like a fake age, doesn't it? But today is really, truly my 39th birthday.

Thirty-nine things I have learned this year (in no particular order):

1. Sometimes all it takes is a bit of initiative to create change in an unpleasant situation.

2. Most people will surprise you with their goodness and generosity (this is especially helpful to remember in today's disturbing global context).

3. I have a greater capacity to forgive than I thought I did.

4. It is possible to fall in love all over again.

5. Children, no matter how sensitive, are surprisingly resillient.

6. My children are lovely human beings (OK, so I knew that already but the boys have been tested this year and have impressed me in countless ways).

7. Laughter really is the best medicine.

8. I am loved (I knew that before but now I can feel it in my bones).

9. I have a nicely shaped head.

10. I really am a 'glass is half full' person.

11. I am also, as a friend said when I was first diagnosed, 'a tough customer.'

12. I should feel proud of my strength and positive outlook. They are getting me through treatment in better shape than many cancer patients.

13. I can do anything I set my mind to do.

14. I don't have to do everything, just because I can.

15. Somewhat paradoxically, admitting vulnerability makes me stronger.

16. As youth is wasted on the young, good health is wasted on the fit. I didn't know enough to appreciate good health until my health was seriously threatened.

17. Sadness and joy can be inextricably mixed.

18. Someone I love told me a few months ago that I had impossibly high expectations of those who care for me. Just because someone cannot do one thing I ask or expect does not mean they do not love me or that they are rejecting me. She was right. This was a very important lesson for me to learn.

19. Trusting is not a sign of weakness, nor is distrust a way to protect myself from getting hurt (see above).

20. It is OK to ask for help when I need it.

21. Red and blue are my two favourite colours. Passion and peace, activity and reflection. These are things I require in equal measures.

22. A pedicure is good therapy.

23. Exercise is a panacea.

24. There is no perfect way to support someone in crisis. Whatever feels right to you will probably be the right thing.

25. I am less judgemental than I used to be.

26. I will never be a religious person.

27. Very sick or severely disabled people used to scare me. They still do but I know how to get past my fears.

28. My own fears help me understand why some people are now uncomfortable being around me.

29. It is fortunate that I was in the best physical shape of my life when I was diagnosed with cancer. I was the only woman in my arm of the clinical trial who was not admitted to hospital during treatment. My doctors think this is because I was mentally tough and physically fit.

30. I love to write and I'm good at it.

31. Being patient is very hard work but worth the rewards.

32. Life is too short for pettiness.

33. Having a life-threatening illness is not a scary as I feared it would be.

34. A missed opportunity is not a disaster. Life is full of opportunity if one is open to it.

35. It is infinitely easier to be sick and middle class than sick and poor.

36. Medicare works.

37. There is a cancer club. None of us would have chosen to join but we understand each other in a way that no one else can.

38. I have a very good life.

39. I still have a great deal left to learn.

Wednesday, August 02, 2006


Too much to think about. New experience, new information to absorb. I had been warned that the mind can go to a pretty scary place when the door closes on the radiation room and the buzzing starts.

It's too soon to feel the effects of the beam and each session only lasts for a few minutes. I find it hard, though, not to lie there and ponder what these rays could be doing to my body. And to consider my own mortality. It is after all, a bit of a mind-fuck that the treatment for cancer is in itself carcinogenic.

I'm fine, though, really. And the radiation therapists are really nice.

Twenty-three radiation sessions to go.

I think it's time to curl up with a bowl of ice cream and a good murder mystery while I listen to my dog snore on the couch beside me.