Monday, December 31, 2018

Does Sugar Feed Cancer? Yes, but . . .

For the most part I was able to forget that cancer is part of my life during this 2018 holiday season. Unfortunately, I still had to go to infusion on December 22rd, so I could not NOT think about it on that day. As I sat in “the chair”, I listened to a podcast and decided then I would share it here.

bing.com
Untruths bandied about in our society capturing the attention of intelligent or educated individuals bother me. One particular cringe-worthy statement in the cancer community is “Sugar Feeds Cancer”. These three words are truthful, but someone thinking that giving up sodas and sugar in your coffee will stop cancer is a failure to understand basic cellular and food science. Giving up all sugar is nutritionally inadvisable.

Here is where I hand-off the science behind sugar and our bodies to Julie Langford, thecancerdietitian, who is educated in the field of nutrition. One step of her education landed her at UNC-CH where I receive treatment. I was surprised to learn she now lives in a city in North Carolina close to where I grew up. I think you will find her podcast about sugar and cancer easy to understand and wonderfully educational. She is dedicated to dispelling the myths in our culture concerning nutrition. I am a fan.

Before I leave you, I want you to keep these things in mind:
1. All cells need fuel, healthy and abnormal.
2. Insulin from our pancreas opens the door for glucose to enter a cell.
3. Glucose (sugar) is fuel for our cells. Sugar comes in different forms. Simple sugars are: glucose, dextrose, galactose, sucrose (in the body as fructose and glucose). More complex include: fructose, maltose, lactose.
4. Carbohydrates are made of simple and complex sugars along with starches and fiber. Some carbohydrates have nutrients (fruits, veggies, grains); plain sugar—a simple carbohydrate—does not.
5. Our cells cannot pick and chose which sugars to use.
6. If you eliminate glucose, the body will have to work extra hard to make the glucose that it needs to function. If no glucose, the body will break down proteins from muscle.
7. Proteins are made of amino acids. Amino acids can be broken down into glucose for use by the body when necessary.
8. If a person does not get enough nutrients, the immune system will be compromised and cannot protect the body from bad bacteria and viruses.

Hope you enjoy her Podcast. The Cancer Dietitian

And, one more thing since it is December 31st, the last day of 2018 . . .

Happy New Year Everyone!!

Monday, November 26, 2018

Just Pretending I am Normal

If it were not for the help of modern medicine, I would not have celebrated my 54th birthday. 54! I have lived longer than my parents who died at 52 and 53. No rationale to explain why it was important to me to outlive them, but it was.

I made it passed 54 birthdays. I have been able to witness my face change as the gravity of our earth pulls without mercy causing me to agree that plastic surgery might not be such an over-the-top procedure of self-consumed vanity after all.

My birthday came without a lot of fanfare, but to me it was the greatest of days. And with the greatest of days come the other days where I am tired of worrying about dying. Every day it seems in social media someone has died. Poof! They are extinguished from existence. We are all so fragile.

Death is final. It is not like losing a job where you get to pull yourself together and start fresh and find an employer who sees something in you that others did not.

A person dying cannot say, “Hold up, I need a few more days”. Death comes and overtakes you without an apology—not that it can give one—and without any concern for what you needed to finish before your heart no longer beats.

I know death is all part of the circle of life and all that soft language that makes death a lighter subject to talk about. But, the unfairness of how some get to live into their 90’s and others don’t get to see their first birthday is simply extreme no matter what kind of reason some people try to attach to it.

Knowing I am dying—not because I am alive but because I have a terminal illness, does make me think sometimes that my exercise routine that I started in August is a waste of time. I mean, I could be doing something else with that time, but I keep doing it anyway for the “just in case I keep living” scenario or maybe it is partly because I want to pretend I am fine. 

Lately, the metastatic social groups on Facebook I follow have caused me to want to stop looking at my newsfeed. All the sad stories of struggle and sadness can be overwhelming. Since 2013, I have consumed as much information as I could about my disease, learning from others in my desire to keep hope alive. In the beginning I jumped right in and embraced those stories and let them be a part of my life, but I have noticed a change in me. I am finding I want to turn it off. Is five and 1/2 years of letting MBC be at the forefront of my thoughts simply too long? Have I reached the so-called “breaking point” where it is all more than I can handle? I have been slowly pulling away from it, no longer stopping for those stories of people needing help, needing someone to hear them. I feel guilty for being selfish in my needs when their needs are as important as mine.  Yet, I am finding I want to forget about cancer, pretend I am the old Lisa. I want to not be living day to day worrying about my every ache and pain, fearing that my coughing or my recent lower and upper back pain is my disease saying, “Ha ha, you are really screwed now”.

Over the last few months, I have been getting the momentary sense that I am paralyzed. I can’t move because I feel unenthusiastic or unmotivated to do much of anything—stupid thoughts of death creeping in to steal my joy, my sense of worth. It is short-lived, but I know that if it takes hold I won’t be able to find my way out. So I switch gears making myself get up and get going. I feel like I am walking too close to the edge of despair where a person finds they are drowning and can’t save themselves, a place I have never been and don’t ever want to be. So, I will find the comfort I need through pretending I am fine because sometimes a person needs a vacation from cancer.

Staying busy has always helped lessen the negative thoughts that go with my situation. So that is what I intend to do. Soon the decorations will come down from the attic and adorn my home, all my children will be physically here, and I will see another Christmas—my 6th since my induction into the metastatic world. I will enjoy every minute of it. For the next month, I am going to do my best to close the door on my disease, so if you don’t hear from me in December, don’t worry, I am just pretending I am normal.

Wednesday, October 31, 2018

Remembering Diagnosis #1 and #2

One thing is certain: I don’t need October to remind me of breast cancer. It is in my mind when I wake up in the morning, throughout the day, and in my mind when I fall asleep at night. But this October I got the added bonus of TaTa Tuesdays and check your “BOO”bies. To say those cutesy names annoy me would be a gross understatement.

Today I say goodbye to October. Tomorrow is hello to November! I get to prepare for birthday #54! Truly excited for that day.

On this final day of Breast Cancer Awareness Month, I will leave you with two entries that I found while recently looking through my old journal. I was a much younger me (13 years ago), so full of hope that I would be okay after my first and second diagnoses before things dramatically changed in 2013. Today, I am still hopeful.  After all, hope is all I have when it comes to my tomorrows. That is true for all of us, cancer or not.

From My Journal:
April 25, 2005. (Before I went into surgery)
Words to my children--ages 10, 10, 9, 2.

I’m writing now so you don’t forget that my whole life has been worth it because of you.
I write this on the following pages so you know what I experienced. Maybe it will help you understand what happened to me if I am not here to describe it to you.

Last June I experienced some pain just above my areola on my right breast. The pain was a pinching sensation that would come and go. The feel of my breast was not lumpy, but firm on the top. (I had an enlarged lymph node too.) A mammogram and an ultra-sound were clear. I was told it was most likely caffeine causing my pain. I went on with life until a woman told me about her cancer diagnosis and the bi-lateral mastectomy that occurred because of it made me wonder. A week or so later the pain started occurring again—the same pinching sensation almost like my breast was beginning to let-down milk for a nursing baby. I began feeling for lumps. Still had the same firmness as before. I did feel a little BB sized knot in the area of pain. I pressed and to my astonishment some milky fluid came out of an opening in my nipple. The fluid was yellowish, greenish and thick and a little sticky.

I made the appointment. with my doctor for Monday March 28th. (2005) She sent me to get an ultra sound and a mammogram--again. Those were scheduled for Thursday March 31st. She also suggested I see a breast surgeon. On Monday, April 4th, I was told the results were clear including the lymph node I was worried about. The next day I saw the breast surgeon. She was quite concerned about the “mass” located at 12 o’clock on my right breast. A biopsy was done in her office. Because the hole from which the tissue was taken wouldn’t stop draining, (the same yellowish, sticky substance) the doctor seemed relieved thinking it might be a delayed mastitis. (Really, though? It is 2005. My last child was born 2 years ago.) It drained until 3 am. On Wednesday, she called to say that there were atypical cells found and that the biopsy would be sent to a lab for further evaluation. I could do nothing but wait.

So we went to visit my sisters in Kentucky as planned. Just before we were going into Mammoth Cave the call came from the breast surgeon. Greg fumbled with the phone. The call was dropped as the cell signal was weak. I tried to call her back but nothing. We drove around the parking lot until we had a signal. Through my tears I somehow heard I had Ductal Carcinoma in Situ—cancer in the ducts of my breast--and that I would have to have a mastectomy. She said the diagnosis wasn’t 100% for sure, but she felt confident.

After returning from our trip, on the April 14th, I went in for a 2nd biopsy. More tissue was taken and after 5:00 that day she called to confirm the diagnosis.

On Monday the 18th, I went to see a plastic surgeon. Tuesday I went back to see the breast surgeon. She went over the amount of tissue she was going to take. The plastic surgeon would follow behind her and insert the expanders.

Friday, I was informed that surgery would be performed April 29th. (Things moved quickly.)

All kinds of emotions flow through you with this type of news. Mostly you cry because you don’t want to die and not see your kids grow-up. That is my biggest fear. Other people seem concerned about re-construction. All I care about right now is waking up from the surgery, going home and recovering. I am so scared and worried that cancer cells will be in my lymph node, and I will have to go through chemotherapy. So be it if I don’t have breasts. All I want is my life to spend with my family. I am so lucky to have you. Your daddy has given me so much. Sometimes I don’t tell him enough how much I love him. He has given me everything I have ever wanted or needed.

I love you all.

Dec 31, 2010 (Diagnosis #2 Stage 1, November 2009)

It is about 8 minutes till 12 midnight on New Year’s Eve. This year has been the hardest of my life due to chemo, radiation and Herceptin for a year. My treatments ended Dec 16th with my final Herceptin treatment. On Dec 17th, my port was removed. I am grateful it is over. PET scan showed no cancer!

4 minutes now to go and I am looking forward to a wonderful year. I will try to curse less, and realize that nothing is worth the kind of stress I often experience. The only times worthy of stress are due to the death of a loved one and a diagnosis that could end your own life. I will try to keep that in perspective when things go wrong in my life. 

A bad day is not a bad day when it is a day I lived.

3 seconds. Happy New Year! It is here!


Tuesday, September 25, 2018

Hurricane!



Words entering ears
Grabbing and shaking
Is this real?

Preparations take place
Direct hit?
Complete miss?
Anxiety abounds

Hours turn to days
Words confirm the worst
Impending doom
Becoming reality

Rain falls harder
Along with the tears
Winds blow stronger
Taking all sense of control

The storm quiets
Destruction seen
Trees no longer standing
Power gone

Trees along the fence at front of our property

Grass covered land
Now holding water
Rising higher and higher
Will it stop? 

The back of our house in the aftermath of the storm

Shingles of protection
Winds ripping away
Roof no longer defending
All things underneath

My husband, stopping the leaks

Rain and wind pounding
Changing the structure
Never the same

Effects now visible
Attic items moved
Away from the water
Dripping . . . dripping

A foot unexpectedly
Stepping
Through a wet ceiling
Not falling
Into the the room below

My entire leg fell through. Luckily the rest of me did not.

Mold growing and spreading
Insurance claims
Repairing, rebuilding
Takes time

Our garage ceiling

More destruction follows
Rivers incapable of containing the swell
Breaching the banks

Holland Shelter Restaurant in Pender County

Killing people and livestock 
Destroying homes
Leaving people and pets
Displaced, now homeless
Hungry and wet

Posted on Facebook by Pender County Emergency Management

In the aftermath
Harm continues . . .

Mosquitoes breeding exponentially
Larvae becoming pupae
Emerging from watery wombs
Relentlessly attacking
Upon opening the door
Forcing refuge
Away from the swarm

Hurricane gone
Help arriving from everywhere!
Bringing calming relief
Thankful for all

Pender County Emergency Management Posting

Is this story about hurricanes or cancer
I wonder?

Thick with similarities 
The winds of uncertainty
Never stop blowing

Cells 
Growing into a frenzy
Destroying, killing
Treatments flowing through blood
Changing, damaging
The body 

The onslaught of either
Resembling watery roadways
Impossible to maneuver
Causing cancelled infusions
Medications delayed
Possible progression
Potential for death

As with a hurricane
Time moves forward
Coping mechanisms kick-in
The winds of acceptance
Ebbing and flowing
Depending

For some
Unfortunately
Stormy conditions remain
Long after its landing
Leaving us searching
For that showcase of hope
In a beautiful rainbow
That the flooding will stop

Clouds moving on
The sun peeking through
Shining life into all
Once again

My front yard before hurricanes Matthew and Florence destroyed the trees along our fence.



Monday, August 27, 2018

Scan News!

For every scan I go through, I practice the same routine of how I will handle bad news. Today, all that practicing wasn’t necessary. I got great news!

Next scan in another 6 months.

Yea! I am pretty flipping happy. 

Thursday, August 23, 2018

Awareness and Early Detection Saving Lives

Life for me is busy. That is a good thing; it means I am doing well, though it leaves me little time to write about topics that are important to me and post them to this blog. Today, somehow, I found the time.

Also, fingers crossed, scan is Monday. So hard not to think about that cause it is getting closer and closer and . . .

Is Awareness and Early Detection Useless?

The controversy of awareness and early detection concerning its usefulness or uselessness in saving lives is a topic I have been thinking about for years. I have found I am having trouble committing to a firm stance on which side I am on because my knowledge is lacking and the facts are not at my finger tips since I am not a breast cancer researcher or a breast cancer specialist. But, you will see in this post that I am leaning more in one direction than the other. Please tell me where I am wrong if you care to chime in.

For years I have heard metastatic patients say that awareness and early detection are useless in saving lives because it doesn’t prevent the typically agreed upon figure of 20 to 30% of early-stage patients from becoming stage IV. But, that leaves me wondering about the other 70 to 80% who never progress.

I understand that people who say this are probably coming from a place of anger at their situation. Some might have been told: It was caught early! You have a 98% change (if stage I) that it will not return (sometimes this part is left out) in 5 years.

I, too, am that patient. An initial diagnosis of non-invasive stage 0 disease gave me the sense I would be fine. I had the “good" cancer, so to speak, because look how early it was caught. So, yes, I was angry when my stage 0 became stage I and when my disease progressed to stage IV.

Metastatic and early-stage patients desperately want more dollars for research into metastatic disease. I want that too. Their rallying cry, though, asking the public not to buy pink merchandise so dollars spent won't go to more awareness and early detection screening may not be in the best interest of those who will eventually be diagnosed with breast cancer.

(Oh, and yes I know, the pretty, positive, sexy pink party that is associated with these campaigns is a huge problem. And, I know the huge profits some companies and people are making because of this disease is another huge problem. But, I am not going to discuss any of that here.)

I can’t seem to get on the bandwagon yelling: enough with awareness; enough with early detection. It doesn’t work! Because I can’t find proof that it doesn’t work, for many.

Wide spread use of mammography for early detection became available in 1976; that is 42 years ago. Mammography has improved over this time period. (Though, it didn't catch mine.) In looking at the data, the number of new breast cancer cases appears to have increased probably due to an aging population and better screening technology. Also, there are concerns about over-diagnosis of non-life threatening conditions adding to the increased number of cases. Some knowledgeable people believe that unnecessary surgeries are occurring due to these ductal carcinoma in-situ cancers that will never be dangerous. I had a radiation oncologist once chuckle at my stage I diagnosis because he was in disbelief that I had a recurrence from stage 0. While true that some DCIS cancers are considered pre-cancer in some circles and may never become cancer, it is also true that researchers do not know exactly which of those will go on to become invasive and metastasize and which won’t. Unnecessary surgeries are a downside but when dealing with a “we just don’t know” scenario, I believe surgery, and perhaps additional types of treatment as well, is the right decision in these cases.

Some patients and advocates say that over the last 40 years breast cancer deaths have not decreased but instead are increasing or are at least remaining constant. On my recent visit to the SEER website, here, the trend in the rate of  new cases and deaths per 100,000 people is declining. However, the trend in the number of actual cases and deaths is increasing. (Rate is the amount of occurrences in a certain number, 100,000 in this case. Number is the number of occurrences over an entire population.) Blanket statements saying breast cancer deaths are increasing are not providing all the information. Different variables affect the results of data: aging population, changes in the size of populations, better treatments, better technology. All of that needs to be part of this discussion.

The truth is early detection is only as important as the treatments that follow. Treatments are getting better, longer remissions are happening, and I believe lives are being saved because of better treatments. As treatments continue to improve, I think early detection will become more important. When researchers find out which cancers will metastasize and kill, earlier and earlier detection techniques will continue to be important because people would want to--need to--know if they have breast cancer and if it will threaten their life. Catching it early would certainly lead to a positive outcome once better treatments are completed. Researchers just don’t know enough yet which means early detection and the treatments that follow is the best that can be offered at this time. Hopefully it is saving someone. I want to, I need to believe this is true. With that, I think abandoning the mantra of "awareness and early detection saves lives" at this point doesn’t make sense.

Awareness I think is important as well. People tend to forget or don’t pay attention. People must continue to educate by making others aware of the disease(s) and especially aware of the deadly nature of stage IV. It is no different than smoking. If people keep hearing that smoking is not good for you and could kill you, one day they may listen and quit. Young people who don’t care to listen or have had no one they love impacted by breast cancer may at some point begin to listen and benefit personally from finally becoming aware.

While some breast cancers seem to become metastatic long before a detectable tumor is found--those are definitely in the 30% figure cited as becoming metastatic after early stage—I wonder how many more would become metastatic if nothing were done in the early stages. Of course, I can't prove this but I imagine there would be a lot. And, since a large scale statistical collection of information in a registry such as SEER has only been operating since the 70's, no one can say differently because they cannot state facts.

One thing that appears evident is that present treatments are not preventing the deaths of 99% of those early-stage patients that progressed to stage IV, but treatments are helping many have longer remissions (still in treatment with no evidence of disease). I understand lead-time bias, here, is a factor, but I also know I would not be doing well today nor would others like me if not for treatment. That is progress. Also, early detection in the metastatic setting may prove for a small percentage of patients to have the potential for cure or at least really long remissions with Cyberknife radiation and with use of some newer drug treatments. In those cases early detection is crucial. I hope oncologists will start being more concerned about early detection for metastatic disease.

Unless I can be convinced otherwise, I think the conversation about awareness and early detection should continue while also adding to the conversation more emphasis on dollars spent on researching the cellular workings of breast cancer especially in metastatic disease which is proving to behave differently than early-stage disease. Research dollars must also be directed toward better treatments. All of these things must be done together: awareness, early detection, education of the complexity of breast cancer and specifically about stage IV because it kills, and of course the need for donations. All of these are important. Without each individual piece everyone loses.

Tuesday, July 31, 2018

Catching Up

On a trip to Chicago, Illinois this past June to see one of my daughters, I noticed my physical fitness has declined more significantly than I thought. While there, my daughter, her boyfriend, and I were sprinting to catch a train. Up the stairs they flew. Up the stairs I . . . struggled. No Chicago wind blew behind me, encouraging me, offering to help push me up those flights of stairs. The only movement of air was of my own making through the rapid exhaling and inhaling of my breathing that was not giving me an adequate supply of oxygen forcing me to slow down. My muscular legs from long ago were not there to move me quickly to my destination. My eyes watching the young, fit bodies of my hosts run ahead of me left me feeling quite alone wondering: Should I yell for them to wait? Do they realize I am not right behind them any longer? 

I worried I would have to stop; worried I couldn’t catch up; worried we would miss the train because of me.

My brain pushed my legs to move, leaping over steps when I could, worrying all the while my heart would be my downfall, giving out, causing my body to meet the ground.

It didn’t. But the interaction between my brain and body had me saying to myself, Good grief, I am  . . . (inhale) . . . out of shape!

It wasn’t pretty.

When I returned home, I joined a fitness center. Never in my life have I been a member of a gym, but this one was reasonably priced for my budget, and the membership fee is due on a month-to-month basis; I can cancel at any time. If my daughter hadn’t taken a Health and Physical Education Class required by her high school this summer, I probably would have continued my sometimes daily walks around and around my front yard like I always have. Walking is exercise, and I have done it for a long time, but after feeling breathless sprinting for the train, I knew something had to change. I needed to add more difficulty to my already existing—hardly called exercising at all—routine in order to strengthen my heart, lungs, and muscles that are sadly not what they used to be. Exercising at a gym with my daughter was the change I needed.

My progress is slow—I don’t want to overdo it fearing I will injure myself. And, feeling tired on most days brings with it a lack of motivation leaving me wondering: Am I supposed to feel this tired? Is it age related, treatment related, or both?  It is probably both. Once I get moving, though, I do feel a great satisfaction after working my tired body. It feels good to watch my muscles work while I lift weights; it feels good to feel my heart rate increase with the steps I take on the treadmill. It even feels good when the machine rewards me with its squares of bright orange after I reach my targeted heart rate.  Having my daughter as my work-out partner has proved to make this a fun endeavor and forces me to get moving.

Month number two of exercising is about to begin. I realize I won’t ever be the Lisa from years ago with the red face, heart beating wildly, lungs expanding grabbing all that oxygen and feeling wonderful while not worrying about dropping dead at any moment. Exercise won’t stop my cancer from doing what it is going to do, but it does give me hope that if my next Chicago foot tour finds me sprinting for a train that is about to leave the station, I will be smiling because it feels good to run, and it feels good not to worry that I am falling behind the sprinters, or that I am pushing my heart too hard. I am hoping I can close the gap between us, but if I can’t, I know I will catch up. Just give me a few extra seconds.