The past week was my Cancerversary Week or maybe this month is my Cancerversary Month. At this stage in the game of life or cancer journey, this is definitely cause for celebration. Eight year with stage IV lung cancer is definitely remarkable. Thanks to two targeted therapy drugs, thoracic oncology experts at https://www.dana-farber.org, research scientists, the hard work of my family (Dan has made at least 80 trips to Boston and does whatever needs to be done without complaint. My sister has done so much for us from the beginning, and our children have taken care of things at home) and the hopes and prayers of many, I remain “stable” with the Lady Lorlatinib holding her high heel firmly on little ROS1+. 
Before I recall the journey we’ve been on, I must express my gratefulness and a deeper gratitude for this gift of time. Together Dan and I have had so many more wonderful experiences to enjoy together, including our grandchildren’s graduations and sport events galore.We’ve been able to enjoy our time at camp watching the sunrise, the sea life, and our garden. And, of course, time with family, including our pet children. My appreciation for all life has to offer in everyday, simple ways has grown as I’ve found joy in the everyday every day. Has it all been blue skies and calm seas? Of course not. But what a gift that I could be here and well enough to help when times were and are tough.
When I made the decision, in May 2017 after the cancer found my meninges, to give up a piece of my life and stop teaching, it was because it was evident that keeping my body and mind as fit as possible was the only way I could survive what I would go through as a stage IV lung cancer patient with cancer here, there, and not quite everywhere in my body. I was about enroll in a clinical trial, requiring frequent trips to Boston. We had already been through a lot. Now, looking back over the eight years, having had radiation, biopsies, spinal taps, over 70 oncology appointments, 50+ blood draws, more than 40 CT scans of my chest/abdomen and sometimes pelvis, at least 35 brain MRIs, numerous ECGs, and medication side effects, I know it was the correct decision for my body. Staying alive to hopefully thrive was (and is) the priority.
EIGHT YEARS ago on Sunday, Jan. 3, 2016 Dan took me to a walk-in clinic because my undiagnosed cough cough had turned into “Now I can’t breathe.” (We were staying at camp and I couldn’t walk up our small hill without stopping to rest.) The NP at the urgent care was the first person to do a chest x-ray. (I had been to my PCP numerous times since early October, my chiropractor, the ER. Everyone thought it was linked to the stress from the house fire.) I could tell when she returned from seeing the x-ray that she was concerned and really wanted to help me breathe better. She did a nebulizer treatment, said that a radiologist would look at my x-ray and send results to my PCP. The treatment did little to help, but I sensed that she was on to something. The next day I received a call from my PCP (nothing happens the next day where we live). There was something seen in my chest x-ray that required I have a CT scan Wednesday morning. Holy smoly! That’s quick. Something? Like what kind of something? I had the scan on Wednesday and an appointment with the PCP was scheduled for Thursday AM. 
On Thursday, January 7, Dan and I waited for the doctor to come in. We really already knew what to expect, but were holding on to the bit of hope not knowing the details provided to us. This lady was not good at hiding her emotions when she came in. Dan and I didn’t even have to hear what she said to know what was wrong. A mass in the left lung hilum. (The left hilum lies below the arch of the aorta and anterior to the descending aorta. The left main bronchus lies at the most posterior aspect of the hilum, with the left superior pulmonary vein located anteriorly and the left inferior pulmonary vein occupying the inferior portion of the hilum. The left pulmonary artery is anterosuperior to the left main bronchus. Pulmonary veins always lie anteroinferior to the pulmonary artery. Radiopaedia.org) ”Could it be anything other than cancer?” ”Not really, I’m sorry.” It was then that Dan and I knew, like we had always said, that as soon as we possibly could, we would go to Dana-Farber Cancer Institute. But first an actual diagnosis was needed. The next weeks included a consultation with a pulmonologist who seemed to not believe I was a nonsmoker, the bronchoscopy to remove a piece of the tumor to test, and a PET scan (whole body except head) to see where it might have spread. While waiting for results my research led to making an appointment at Brigham and Women’s thoracic department. They gave me an appointment quickly, Jan. 27, 2016.
In the meantime my diagnosis was confirmed. From Brigham I was sent that very day to Dana-Farber. There we met the first of many angels in the form of expert thoracic oncologists and their teams. Dr. Leena Ghandi.  She decided to do radiation as palliative care as my breathing was impaired, my heart was racing, and I had a cough that was coughing up what I decided was pieces of me. The hope was to relieve my symptoms while testing was conducted. I was mapped, tattooed, and a cast made. (I also had a liver biopsy Feb.2 to determine that the lung cancer had traveled to my liver. It was assumed the place in my colon was also the same. A stage IV lung cancer confirmation.) The next days were crazy for us as we tried to keep me alive long enough to get me help. Nada stayed with us those first few days to take notes and help us process what was being said. Then once radiation was set, Dan and I stayed at a Hope House in Worcester, drove to Dana-Farber every morning, and then came home (to camp) weekends. In the midst of the radiation treatments (every week day for three weeks) that were not shrinking the tumor but causing the typical side effects, the test results came back.
It was just like we had won the lottery! The thoracic oncologist, Dr. Ghandi, and the radiation oncologist were beside themselves with joy. I was ROS1+, young and healthy (so said Dr. Ghandi) and there was a targeted therapy drug that had shown success in treating that cancer. I would take a pill every day, and if it worked the tumors would be reduced quite quickly. ”You mean I can take it forever?” ”Well, probably not forever. The cancer usually finds a work around. But by then there should be a next treatment.”
March 2, 2016 (after working out how to get the med) I took my first crizotinib. Up it came. With anti-nausea meds (3 at one point), it stayed down and Queen Crizotinib worked her magic. Within days I was feeling so much more human. I began to breathe more easily, and gain some of my weight and strength back. In April we moved into our newly renovated home. By summer, with steroids on board to fight the fibrosis caused by radiation, I was ready to do Camp Gramma (a modified version). That’s when we got our naughty Dottie and sweet Matilda. (Never did I think I would outlive them.)
Things settled into what people call the “new normal”. There is nothing normal about it and I don’t feel like it should be normalized. I call this our life now and the time before cancer our other life. But yes, things moved forward in a more even, routine way. Then in early March 2017 I started have odd headaches, unlike any I’d had before. At that time, because I didn’t have cancer in my brain, MRIs were at 6 months. A brain MRI was scheduled for my March day of tests and appointments. By that time I had a different oncologist, Dr. Janne, Director of Thoracic Oncology at Dana-Farber. The brain MRI showed something a tiny bit suspicious. The CT scans of my chest/abdomen were still stable. I would have another MRI in May, but call if the headaches worsened. In May it was determined that that nasty little ROS1 had driven through a red light, crossed the blood-brain barrier, and settled in the lining of my brain (meninges). While it was scary, and I regretted googling what that might mean, we were filled with hope because of the people at Dana-Farber. Yes, Dr. Ghandi had been right. Crizotinib had protected me well (and still was mostly) and carried me far enough to give researchers time to create another drug that may target ROS1. Designed to target ALK+, there was a clinical accepting ROS1+ patients. After a spinal tap determined the cancer had not yet spread further throughout my central nervous system, I began the process of being accepted to the trial. Once everything was completed (including a washout period), I began lorlatinib in July 2017. It’s side effects are unpleasant, really unpleasant. But, bearable and manageable. It began reducing the brain cancer immediately, stabilizing by late August, even with a dosage reduction due to neuropathy. I have remained on it since. I am a long timer now. And, thanks to Lady Lorlatinib pinning down little ROS1 with her sparkly red high heels, this gift of time has meant that, yes, there are new drugs in trials that show hope for controlling ROS1+. Hope. Hope for me, hope for all cancer patients. Hope that one day, not so long from now cancer will be a managed, chronic disease. Not yet a cure perhaps, but hope for life.
So there it is, the Reader’s Digest Condensed version (for those old enough to get that reference) of my cancer journey so far. My blog posts provide more details about what living well with stage IV cancer can look like. My best advice for anyone with a cancer diagnosis is FIND AN EXPERT, someone who treats patients with your cancer, preferably at a cancer treatment center/hospital. Then make sure there is biomarker testing done, even if your insurance says no to it. Those two things are the reasons I did not die in the spring of 2016. Look at all the joy I’ve had with this gift of time and believe me. It is worth the “inconvenience” and the expense to do those two things. And, try to stay hopeful. Hope and inner strength will help you to find joy in the simplest of everyday things every day as you face the challenges ahead.
When I reached 50 I stated I was middle-aged and would have the goal to live to be 100. When I was diagnosed at 58, I set much closer goals and milestones. The next family event often. Then I passed my dad’s age that he was when he died of lung cancer (no, mine is not hereditary). And then I reached medicare age. (I was not excited about figuring that out with my health.) And now? One moment, one day at a time. Make plans for the future and hope. Always have hope. My best wishes and hopes to you all is for your year will be filled with moments of joy, good health, and peace. Love to all. Finding joy in the everyday every day in our winter home on the side of the mountain.