Saturday, January 16, 2016

Clincal Trials: Are We Mice or Men? (Or Women Who Just Enjoy a Really Good Roquefort?)

I was horrified today to hear about the clinical trial recipients in France who were recently disabled or became brain-dead from participating in a clinical trial, and my heart goes to them and their families.

I started my Second clinical trial 4 days ago.

When it comes to clinical trials, there are "Phases".  Phase One is "first human to try it out after some success with the animals."  Since diagnosed with Stage 4 cancer, I was under the impression that Phase One trials were for people who were just about to die, and who looked at trials from the perspective of "Why Not?" 
I was shocked to learn that healthy people were used for these Phase One French studies. There are LOADS of dying people who would volunteer for a painkiller study--why'd the Rennes scientists use 'healthy' people? 

My own clinical trial treatment options are Phase 3 (or 4?). Meaning that these anti-cancer drugs seem to be working very well in earlier studies, and now need only more numbers/volume to prove themselves to get accepted for general prescribed use. 
Cancer patients don't get placebos: Jeepers, how cruel would THAT be? ("Oh, sorry, it was just SUGAR! No wonder you died!" )
But somewhere, at sometime, there was a Phase One trial user for any treatment I've had. It could have killed them. But it didn't, and I might live longer because the Cancer Person said "why not try it?" 
But I never really looked at it that way until today.  
I owe a lot of Brave People a big THANK YOU. But they're probably dead now (because of cancer, not because of the trial drug). So I thank their Caregivers, and I respect and deeply thank the Cancer People we lost so that I'm not dead yet. 

With a year and a half life expectancy, Phase One clinical trials have still never been offered to me, I'm considered to be too healthy for that. Thank goodness I'm in the USA, not France.


My First trial was a bit iffy. That drug was Avastin. Not a cancer-killing drug, more of a secondary-hope-it-will-delay-whatever-drug.  They were checking dosage, and had me on Avastin for ages. I guess to see how long it would take for patient failure? I don't know. 
I took it until my joints were so sore I was almost crippled. So the doctor took me off of it. 
But what was a little eerie was that, as I was taken off the trial by doctor's orders, the drug company never asked . . ."Did the issues resolve themselves? Did you recover?" You would hope that those would be questions, but there was never a follow-up. A year of physical therapy got me over the side effects, but maybe taking Avastin gave me that year?  I doubt it.  
I think that drug falls under the Bad Boyfriend rule of forgetting to call after they completely f. . . . . .
So my new, Second, clinical trial is MEK.  Not  Em-Ee-Kay,  but "mek" like "blech" or "wreck" or "I'm-going-to-be-seck."  It's targeted specifically to low-grade ovarian cancer people. Apparently, low-grade ovarian cancer is REALLY RARE. And all of you higher-grade ovarian cancer readers are in WAY better shape and circumstances than me. Take heart! 

But speaking of which, MEK can have effects on the heart, so they take regular EKG scans. 

"Echo Cardio Gram." explained the nurse.
"So what does the "K" stand for?" I asked.

Thinking. . .Thinking hard. . . Blank.
"I don't know," she said.
My life is in their hands. At least they're fun.

(You can't tell by the dramatic EKG photo, but it was quite relaxing and somewhat humorous. All the facial close-ups that my hubby took showed my double chin too much as I was laughing a lot so I'm posting a distance shot).

  
MEK can also affect your eyes. 
It may cause my retinas to peel off or something like that. 
It's a clinical trial. . . should I assume that the Phase 2 recipients lost sight for me to know about the retina risks? How do I right those sacrifices? Somebody experienced that for it to be logged as a risk. . .

Medical records are private. So when will clinical trials patients start their own bulletin boards for voicing effects and personal results? All it takes is someone to set it up who is Not Dead Yet.
(Uh oh, is that me? Help!)

So the MEK study pays for extremely frequent eye exams. My baseline was good. For now.  If my retinas disintegrate, I'll be blind. But anyone who has ever seen the 5 Blind Boys of Alabama play live knows that there are far worse things in life than to be blind, and we just go take it from there.


So far, this MEK is not bad at all. I just take pills twice a day. It's an appetite suppressant. You'd think that terminal cancer, possible heart failure and potential near-future blindness would suppress one's appetite but surprisingly they don't.  (NE14XNsalsa?)  But MEK does.

I just weighed in at 192 lbs when my "good normal" is 165 lbs. Even my kilos-readers can skip the math and visualize those extra layers of FAT (eeew!) 
Chemo CAN be fattening for some of us, but I attribute it mainly to the surgically-induced menopause. . . (can I salvage sexuality while feeling like a neutered cat?)
I have had no problem eating for a year, still don't, but now after starting the MEK I just have no particular desire to eat. YAY!  Back to Normal!  Taking the Zippy Greyhound back to Skinnyville!

Yesterday, I felt really yucky, so I chose the anti-nausea pill that makes me sleepy, because I had a dental appointment. Ta-da! Groggy though the whole thing, I didn't much notice the dentist's noisy drill. Hubby drove both ways, I lost a day but gained a filling. Love these cancer drugs.
During that day my stomach was asleep but my tastebuds needed a little something and got it. They call it "Culpeper Crack" because it's so addictive. It truly is. It's a butter-cheese-salty-creamy combo only sold in a small town 60 miles from here (conveniently halfway to my cancer center). The deli sells cheeses from a lovely Roquefort to Irish cheddars to cranberry chevres. But the 'Culpeper Crack' beats them all. One taste stopped any "cancer wasting" I was enjoying. I had seconds and thirds. And I searched my fridge for the rest of it the next morning, but hubby had finished it.   

Perhaps we should initiate clinical trials to show the effects of good cheeses on cancer patients. We might enjoy some very positive results.

What? You want to see the 5 Blind Boys of Alabama too? Try this link. .
https://www.youtube.com/watch?v=bCfqS7HgAY0

Sunday, January 3, 2016

Oops! Did I really SAY that? Oh No! Did I SEND that?

We all talk and write and text and communicate in so many ways (en clichés, aussi!)

Sometimes people hold back so much emotion. In doing so, they hide their best and most lovable attributes
Stifling human traits in communication:  Is that lying? Is it from fear? Is it a dated pride of 'stiff upper lip'? Is it some weird survival skill? How do our closest friends perceive our holding back?
Personally, I like to think that emotional discretion falls into a polite "not wanting to overly burden others" category.   But holding back emotion has its own effect.

Happy Cancer People cannot help our Worriers get a little relief until you let us know what you're worried about. You can actually be our "good deed for the day" if you're honest about your emotions--we can set you straight to ease your fears. 
Your Happy Cancer Person is dying to get you to where you need to be emotionally with everything you're worried about, so jump in, dump in, let's go for honesty and openness. Talk. Ask away. To heck with discretion, we don't have time for that anymore.  Be Blunt and Open.  For many of us, "Later" is a fictitious idea. Now's your moment, go on, be brave.

Many times I have started to reply simply to an e-mail, then started having fun with creative writing, getting really into it, and finished by hitting the SEND button in an emotionally triumphant moment  YES!     Although we all know this is not a good thing to do. Ever.
Especially after a night at the pub or, in rural USA, a evening at a friend's home with a good fire and a nice bottle of wine. I wake up to a crumpled morning of unfolding sobriety and it takes an hour of red-eyed confusion before my mad dash to the "sent mail" box to assess any damage from the night before.  Aaaagh!

But afterwards, too, I wonder whether these messages are probably more deeply honest (and much more interesting) than every other message that ever flies, from any of us. 
We all need to Rethink Regret. Propriety can be a little dehumanizing.

There is no excuse for bad behavior, so nastygrams are ALWAYS inappropriate (Not Guilty!). 

Some messages are like puppies who pee on the carpet while they're happily asking you to play and love them. Oops!  It's OK (mostly OK). But most anything beats silence. Silence will come soon enough.

One of my sisters came to visit. (nothing to do with puppies peeing, and we weren't silent either).
My sisters are all perfect sisters, they really are.
As my sister and I were chatting, tears filled her beautiful eyes for awhile. She didn't break down into tears, she just kept up with the conversation while her eyes got really, really wet. Maybe a tear slid down her cheek but I don't think so. No hiding the wellspring of tears, though.
My husband and I do that a lot. Sometimes we just hang out on the bed for an afternoon nap and hold hands, and look at each other, and we're both thinking the same thoughts, and tears well up, and often stream down our cheeks with no words. 
It's not really sadness. It's more just pure, overwhelming feeling.
My sister loves me.  My husband wants me to stay, and not die.
The tears are a beautiful and subtle manifestation of the emotional honesty that comes with cancer.  Beat That.  New words that defy speaking.


Some of us still fight to find any words at all to express our emotions in the difficult situations we face and need to share. We need words to help ease us through it, and to find others who can relate.  When it comes to verbalizing cancer, everything  is 'Well Spoken'. A few words from shy strangers can add so much calm or beauty (or humor) to someone's last experiences.
So, in the spirit of "whatever you say is OK and we forgive you if you totally screw up," can anyone suggest a good response to someone who says that they have terminal cancer? 

Readers, please provide me with better responses to these. . .

"Oh," (seeing my bald head)  "are you a Survivor?"
"Um, no," I say, " I would be, but I'm Terminal."
 (By golly, is that depressing or what? We can do better than this! ) 

Here is a frequent scenario:

"My drop-dead date is summer 2017."
"You mean, that's the last day they start treatment?"
"No, that's the day I drop dead."
"You mean, that's when they decide to stop treatment?"
Bless their hearts, it hurts to clarify to them. . .
"No, it's when all treatments have stopped working, and I die."
"Oh."
Oh.   Heck, what are they supposed to say?

We have LOADS of cancer classes in my area--food, yoga, estate planning, caregivers, health, you name it. But "conversation with cancer patients" isn't there. It's a HUGE area where tact and wit (I think it should be more heavy on the wit) is needed. HELP!

When I left the cancer center a month ago, there was a woman by the door that I talked to briefly. She was fairly old, and really nice. She was having blood treatments to keep her alive for awhile, but she was terminal.  I didn't know that day that I was also terminal.  But then you can get into the "How Terminal are You?" competitions and I always lose, but with this lady I was not even within her competitive league. She probably had weeks to live.
I wished her the best, but thought that I sounded sweet but trite. What was I supposed to say?

"Have a good weekend"?
"I hope you have a nice rest-of-the-day"?
"Keep dry today"?
These all sound silly if it's the last thing you say to someone before they die, yeah?

"God Bless You" is good. But is there something we could add to that to give terminal cancer patients a little more of our God-given humor or insightfulness?  I am one, and I'm stumped.

Reader suggestions are most welcome.
This is where all of you who offered to help with anything I needed get to show your stuff.
C'mon, let's play cancer. Let's risk saying the wrong thing for the right reasons, let's all read comments in the spirit of things with no offense intended.

And here's a fun song by Lauren Hill "Nothing Even Matters"
https://www.youtube.com/watch?v=ISgz5-XFklY

PS-comments to Laurie's fabulous facebook page might not make it here at all so please post your responses to this actual blog (stage4ovarian.blogspot.com). If you sign up to it, the responses to your comment will come to you. Should be safe, it's google-based.