Neuroendocrine cancer

NET Cancer Day 2018

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November 10 is World NET Cancer Day, a day set aside to raise awareness of neuroendocrine cancer, the disease that I’ve been fighting since 2013.

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Neuroendocrine (NET) tumours can arise in any organ that contains neuroendocrine cells including the stomach, intestines, lungs, liver, pancreas and appendix. While most commonly found in people over the age of 60, NET cancer can affect both men and women of any age. Though NETs is the fastest growing class of cancers worldwide, the symptoms are usually vague and similar to more common health conditions. As a result, NETs is frequently misdiagnosed as anxiety, menopause, Irritable Bowel Syndrome (IBS), asthma, or diabetes.

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Compared to most cancers, NETs is slow growing. It was estimated that I’d already had the disease for ten years when it was detected. I had been experiencing many of the common symptoms which include abdominal cramps, diarrhea, flushing of the skin, pounding of the heart, and wheezing or shortness of breath off and on for at least seven or eight years . Neither I nor my family doctor had any idea why. Like many general practitioners, he had never encountered a NETs patient before.

Almost 50% of patients visit a doctor 5 or more times before receiving a correct diagnosis! A recent study found that 58% of patients have advanced stage neuroendocrine cancer by the time they are correctly diagnosed. There is currently no cure for the majority of NET cancer patients, including me. Neuroendocrine cancers are complex and unpredictable. Once diagnosed, they require an expert and experienced multidisciplinary team of health care professionals to ensure the best possible outcome. Unfortunately, many patients, even in the world’s most developed countries, have difficulty accessing that kind of care.

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So what’s with the zebra? Everyone recognizes the ubiquitous pink ribbon as a symbol of breast cancer, but not all cancers are pink. Medical students are taught when hearing hoofbeats, to think of horses, not zebras, so the zebra was chosen as symbol of our lesser known disease. There are some patients and advocates who think it’s silly and would like to see us stop using it, but I think we need to take advantage of every opportunity to draw attention to our cause and if that includes zebra stripes, I’m all for it.

What can you do to help? You can help us spread awareness by simply reposting this on your blog if you have one or posting a link to it on your Facebook page. My fellow zebras and I thank you!

 

Still stable!

/ edebock / 14 Comments

Stable has become one of my favourite words! Not the kind you keep your horses in, but the word that my doctors use to tell me that my cancer has not grown or spread!

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I heard that word again today when I sat down with the doctor to discuss the results of the CT scans that I had back on August 21st. Waiting almost a month was difficult and I admit to having some episodes of scanxiety during that time. It was heaviest as I sat in the waiting room early this afternoon not knowing if the news would be bad or good. I had no reason to suspect that it would be bad; no symptoms to suggest that the tumours might be active or growing again, but the knowledge is always there that that day could come at any time.

When the doctor told us that everything continues to be stable, the load was lifted in an instant and I felt lighter than air! All the way home (a two hour drive) I felt as though, had my seatbelt not been fastened, I might have lifted right off my seat!

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And so I keep on hanging on, living life to the fullest, and praising the Lord!

 

Five years and still very much alive!

/ edebock / 13 Comments

Five years ago today I embarked on a new journey. That was the day that I sat on the grass beside a nature trail overlooking a beautiful lake while my doctor reluctantly told me that I had cancer! No, he wasn’t hiking with me. Richard and I were camping with our daughter and her children about three hours from home when Dr H phoned with the results of tests that I’d had done before leaving home the day before. We were planning to drop Melaina and the kids off in Calgary the following morning and continue on to Vancouver, but when I was told “this can’t wait” those plans suddenly changed. It would be another two weeks before I found out exactly what kind of cancer I had and even longer before I learned that it was incurable.

Five years is usually considered an important benchmark in cancer survival. Five years cancer-free or in complete remission has traditionally been seen as a milestone when a patient could say that their chances of having that cancer return was no longer likely. It’s a point at which they can, at the very least, be cautiously optimistic. But what of those of us who, barring a miracle, will never be cancer-free?

Sometime shortly after learning that I had cancer, we read that the average life expectancy for a neuroendocrine (NETS) cancer patient was five years following diagnosis. Well here I am five years later and still very much alive! Not only that, but as far as we know, the cancer has not grown or spread since that time. In fact, thanks to the PRRT treatments that I’ve been receiving, some of the tumours appear to have shrunk and one might even be gone altogether. I say “as far as we know” because I had CT scans last Tuesday and I won’t get the results until I meet with the doctor on September 19th.

As I reflect on those early days of uncertainty when I had no real expectation that I’d still be here today, I realize how very much I have to be thankful for. Immediately after diagnosis, I prayed for two very specific things: that I would live to see Melaina’s unborn baby (she was 10 or 11 weeks pregnant when I was diagnosed) and that I would see our youngest son married. I was definitely going out on a limb with that one as there was no young lady in his life at that time! Not only was I in the delivery room for Simon’s birth, but he’s now four and a half years old. I call him my “velcro” boy because whenever we’re together, he practically attaches himself to me. In addition, Nate has been married to our beautiful daughter-in-law, Colleen, for over three years.

So how does one celebrate five years of living with an incurable cancer? After all, it’s my cancerversary! I thought about planning a trip, something really momentous, but that didn’t happen. In fact, I’m not actually doing anything very special at all. The more I thought about it, the more I realized that whether you have cancer or not, every day is a gift. Every day is worth celebrating! The nurse was just here to give me my monthly injection. In awhile we’ll go out for lunch at The Wooden Spoon and then if the weather warms up a bit and the wind doesn’t blow too fiercely, we’ll take the kayak out on one of the lakes not too far from here.

A voice has been silenced

/ edebock / 4 Comments

Neuroendocrine cancer (NETS) has claimed yet another world renowned figure and again many of the press reports are failing to report it accurately. I was saddened to learn this morning of the death of Aretha Franklin, the Queen of Soul, at the age of 76.

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Though many of the news reports are calling the cause of death pancreatic cancer, it really wasn’t. That would be exactly like saying that I have colon cancer because my primary neuroendocrine tumour is located in my colon. According to a family statement, the “official cause of death was due to advanced pancreatic cancer of the neuroendocrine type, which was confirmed by Franklin’s oncologist, Dr. Philip Phillips of Karmanos Cancer Institute in Detroit.”

A powerful voice has been silenced by a little known and insidious disease. We who suffer from the same disease need our voices to be heard. We need the medical profession and the population in general to be aware of NETS, to recognize the symptoms and to put more resources into the search for better treatments and ultimately for a cure. We do not need it to be misnamed and ignored.

 

Good news and then…

/ edebock / 11 Comments

I’ve held off on writing this post for a little while because of the “and then” in the title, but here’s the latest update on my health. I had my tenth Lutetium treatment on Wednesday afternoon, spent the night in seclusion at the Cross Cancer Institute, and underwent follow-up scans early yesterday morning. After lying perfectly still under a warmed blanket (I love those warmed blankets!) while machines whirred around me taking detailed pictures of my insides, I sat down with Dr. Kounma to review the images.

These moments always stir up a bit of scanxiety. Rather than diminishing over time, I think that this has actually increased a bit in recent months. Shortly after I was diagnosed, we read that the average life expectancy for a NET cancer patient was five years following diagnosis. Better than a lot of cancers, I know, but I’m just a few months short of that now. Thankfully, the numbers have changed since that time. Last fall, Dr. MacEwan, head of my treatment team, presented at a NET cancer conference in Europe. By then, the time from diagnosis to disease progression (in other words, the cancer begins to grow and spread again) for patients who are part of the same clinical trial as I am, was 55 months. I passed that milestone a month ago.  This, too, is an ever changing number as more and more of us are meeting with success on this treatment plan.

Once again, the news was good! The post treatment images are not detailed enough to give exact measurements, but it was clear even to me that my cancer is not growing or spreading. In fact, if there has been any change at all in my tumours over the past few months, it appears to be for the better. We left the clinic rejoicing and praising the Lord!

AND THEN…

We were back home and it was four o’clock in the afternoon when the phone rang. It was Dr. Kounma. Apparently, when the radiologist reviewed the morning’s images, he saw something that appeared to be a partial obstruction of my small bowel. This was new since the CT scan that I had in February. Though I have exhibited absolutely no symptoms, Dr. Kounma’s instructions to me were “Go to ER for further evaluation today!”

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That must have been one of the quickest ER visits in history! I left immediately for our small rural hospital, about ten minutes away and was back home again in little more than an hour. When I explained the situation to the intake nurse, she immediately picked up the phone and called my family doctor. He came over from his office, which happens to be housed in the same complex, and immediately reviewed the radiologist’s report online. His first comment to me when he saw me was, “Well you certainly look healthy for someone with a bowel obstruction!” He quickly determined that we were likely dealing with a red herring; that this was probably simply a false alarm. He was also quick to assure me that if there really was a blockage, it had absolutely nothing to do with my cancer. That was very reassuring. In fact, I wish that Dr. Kounma had thought to mention that.

Dr. Hanton decided that rather than jumping the gun and sending me back to the city for a CT scan, we would be best to take a wait and see approach. He told me the symptoms to watch for: vomiting, belching, abdominal pain, abdominal distention, lack of appetite, lack of bowel action, inability to pass gas. All of these would be pretty hard to miss if they began to happen. If need be, come back anytime, night or day, he told me and he even gave me his personal cell phone number in case I needed to get in touch with him!

18 hours have passed since the scans were completed and I’m still pooping and passing gas. (I bet you really wanted to know that, didn’t you?) It’s possible that there might be a partial blockage, but both doctors also assured me that these things sometimes resolve themselves. In the meantime, I’m thankful that my cancer is still stable and that, other than the usual post treatment tiredness, I’m feeling fine. Praise the Lord!

Great news!

/ edebock / 12 Comments

Just a quick update concerning my health. As many of you know, I live with NETS, a little known and incurable cancer. I’ve been waiting all week for the phone to ring with the results of routine CT scans done early last week. I wasn’t anticipating bad news, but I do live with the reality that it could come at any time. Thankfully, today wasn’t that day!

Today, the news was good! Almost four and a half years after diagnosis, my disease continues to be stable with no sign of growth or spread.

Today I also learned that my last two 5H1AA tests have been normal! What does that mean, you ask. While the injection that a nurse comes to the house to give me once a month and the radioactive treatments that I receive twice a year aren’t expected to lead to a complete cure, the hope was that they would render my tumours inactive or dormant. Neuroendocrine tumours (NETS) produce and release excess amounts of hormones, particularly serotonin. 5HIAA is a 24 hour urine test that measures the amount of 5-hydroxyindoleacetic acid, a product of serotonin, found in the body. The normal test results show that my tumours are no longer active; no longer producing serotonin. It’s the serotonin that can cause symptoms including abdominal pain and cramping, diarrhea, joint pain, wheezing, fatigue and flushing of the skin. Because my levels have now been normal for several months, I was told today that I probably won’t have to repeat the 5H1AA test again unless I begin to experience symptoms again! That’s great news as it involves 3 days of dietary restrictions prior to the test and then 24 hours of collecting urine which can be quite a nuisance.

I’ll have my next treatment on May 23. Until then, with the exception of my monthly injections, I can forget about having cancer and get on with the business of living!

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If you’re curious about why the zebra is the symbol of neuroendocrine cancer, check here or here.

On being radioactive

/ edebock / 8 Comments

10991307_10153055708750915_6654881605691342497_nThough we often laugh and joke about it, there’s nothing fun about being radioactive two weeks out of every year. I don’t glow in the dark and I don’t have any special powers. I simply feel tired and have to limit the time I spend in close contact with other people. It’s not that bad really, but when I sit alone and watch Sunday morning’s sermon online and when my husband is out at a social event while I’m at home alone, it’s easy to start feeling a bit sorry for myself.

People often compliment me on my positive attitude and I think they’re right that it has a lot to do with how well my cancer battle is going, but there are moments when it’s hard to remain positive, when I’m tempted to invite myself to a private pity party.

For those who are new to my blog, I have neuroendocrine tumours (NETS), a little-known cancer that is often quite advanced at diagnosis due to the fact that its most common symptoms are very similar to more common ailments such as Irritable Bowel Syndrome, Crohn’s disease, lactose intolerance, asthma, and even menopause. Though it’s incurable, it is slow-growing and often treatable. I have the good fortune to live 2.5 hours by car from a state of the art treatment centre, one of the very few in North America that offer the latest and best treatment available for this type of cancer.

At this point, I am treated with radioisotope therapy once every six months. This involves an overnight stay at the cancer clinic followed by a week of semi-isolation at home. During that week I have to have my own bedroom and my own bathroom and I have to limit my contact with other people because I’m highly radioactive. I pose an especially high risk to pregnant women and children under the age of 12.

I had my most recent treatment on Wednesday. Scans the following morning showed that my condition continues to be stable. My cancer has not grown or spread. That’s exceptionally good news and when I start to feel sorry for myself, I have to remind myself of that!

The first couple of days of radioactivity aren’t bad. I spend a lot of time in the armchair in the corner of our guest room (which becomes my room for the week) or curled up on the love seat in my den. I’ve read almost two books in the past few days and drank copious cups of tea. By today, however, I’m beginning to miss human contact and I’m itching to be set free!

I did go for a short walk this afternoon. It’s a gloomy, grey Sunday afternoon in our very small town and the temperature is -5ºC (23ºF). Two vehicles went by, one at a distance and the other close enough for the driver to wave. Other than that, I didn’t see a single soul. Definitely no danger of radiating anyone! I could hear traffic out on the highway, my own feet crunching on the snow, and the occasional winter bird in the trees. It didn’t do a great deal to lift my spirits, but I’m sure the fresh air and exercise were good for me.

When I start feeling a little mopey, perhaps it’s a good idea to once again remind myself of the things that cancer cannot do.

What Cancer Cannot Do

Cancer is so limited…

It cannot cripple LOVE

It cannot shatter HOPE

It cannot corrode FAITH

It cannot destroy PEACE

It cannot kill FRIENDSHIP

It cannot suppress MEMORIES

It cannot silence COURAGE

It cannot invade the SOUL

It cannot steal ETERNAL LIFE

It cannot conquer THE SPIRIT

Author Unknown

It may leave me radioactive for a little while and feeling a bit sorry for myself. It may even eventually destroy my body, but as the poem says, it cannot conquer MY SPIRIT! 

As the old saying goes, “This too shall pass!” Two more days and I’ll be free again!

NET Cancer Day 2017

/ edebock / 3 Comments

Net Cancer DayMy weekly Fashion Friday feature is taking a break today as I have something much more important to share. November 10 is World NET Cancer Day, a day set aside to raise awareness of neuroendocrine cancer, the disease that I’ve been fighting since 2013. Those of us who have been affected by NETS (neuroendocrine tumours) hope that for today our voices will rise above those of all the more well-known and prominent diagnoses. Today is our day to be heard by decision makers, health professionals and the general public. In addition to raising awareness, we want to encourage more funds for research, treatments, and patient support; and to advocate for equal access to care and treatment for NETS patients around the world.

So as not to disappoint those of you who came looking for a fashion post, here’s what I’m wearing today… my CNETS Canada t-shirt. I don’t usually wear graphic tees, but the message on this one is a vital one.

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If you don’t suspect it, you can’t detect it. 

So what’s with the zebras? Medical students are taught when hearing hoofbeats, to think of horses, not zebras. Neuroendocrine tumours are difficult to diagnose. Though they are the fastest growing class of cancers worldwide, their symptoms are usually vague and similar to more common health problems.  Many family doctors have never encountered a NETS patient. When presented with symptoms like stomach pain and diarrhea, they naturally think of things like Irritable Bowel Syndrome, Crohn’s Disease or lactose intolerance. They think of horses, not zebras. Hence, the zebra became our symbol.

As with all cancers, early diagnosis is important. Sadly it doesn’t happen often. If the initial tumour is found before any secondary growths occur, it can often be removed surgically and the patient is considered cured. Once it has spread, however, the disease is incurable.

NETS arises from neuroendocrine cells which can be found anywhere in the body. The most common types are found in the lungs, bronchi, thymus, pituitary, thyroid, adrenal glands, intestines, pancreas, appendix, and rectum. They may also occur in other areas including the ovaries, cervix, testicles, and spleen. NETS is a slow growing cancer that is often misdiagnosed. By the time a correct diagnosis is made, the cancer has often spread. In fact, 60 to 80% of NET cancer patients are diagnosed with advanced disease.

My primary tumour was in my colon. At the time of diagnosis, I also had three tumours on my liver and one in a lymph node. It was estimated that I had already had the disease for ten years when it was detected quite by accident! Off and on for at least seven or eight years I had been experiencing most of the common symptoms which include abdominal cramps, diarrhea, flushing of the skin, pounding of the heart, and wheezing or shortness of breath. Neither I nor my family doctor had any idea why.

Today coffee shops across Canada and around the world, including The Wooden Spoon here in Sedgewick, will be raising awareness about NETS by using special coffee cups bearing the slogan “Lets talk about NETS” and handing out promotional material to help educate their customers about the disease.

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What can you do to help? You can help us spread awareness by simply reposting this on your blog if you have one or posting a link to it on your Facebook page. Thank you so much!

 

 

Good news!!

/ edebock / 16 Comments

Good news

Four years post diagnosis, there are times when I almost forget that I have an incurable cancer. It’s no longer the first thing I think of when I wake up every morning and I’m sure there are days when it doesn’t even cross my mind.

Then there are days like today; days when it jumps to the forefront again. This morning started with CT scans of my head, neck, chest, and abdomen. Several hours later, we sat down with my doctor to discuss the results. I had no reason to anticipate bad news, but we’re fully aware that at any time the treatment could stop working. New growths could appear or tumours that have shrunk could start growing again. Someday, we probably will receive that kind of news, but not today!

Today, my doctor called me a “poster child” for the PRRT treatment protocol that I’ve been on since September 2014. He’s as delighted as we are with how well it’s been working for me. The largest tumour on my liver is noticeably smaller today than it was six months ago. The other remaining tumours appear unchanged and there are no new growths!

Quality of life is an important factor in cancer treatment and Dr. MacEwan is always delighted to hear that mine continues to be superb. It’s only days like this one that remind me that I have cancer! The rest of the time I’m busy living life to the fullest and with utmost gratitude to my amazing medical team, my many faithful praying friends, and the God who promised to take care of me on this journey.

Not so rare after all!

/ edebock / 10 Comments

November 10 was worldwide NET Cancer Day. In addition to writing my Let’s talk about NETS post, I read several other articles about neuroendocrine cancer that day and what I learned was quite astonishing.

When I was diagnosed with neuroendocrine cancer (NETS), I was told that it was rare and much of the literature about it seems to agree, but is it really? Is it actually rare, or is it just not very well-known?

You’ve heard of cystic fibrosis, right? And what about ALS (Amyotrophic lateral sclerosis), often called Lou Gehrig’s disease after a hall-of-fame baseball player for the New York Yankees who was diagnosed with ALS in the 1930s? If you hadn’t already heard of that one, I suspect that the famous Ice Bucket Challenge of July and August 2014 brought it to your attention. Unless you’re a fellow patient, however, I’m guessing that you’d never heard of NETS before you read about it here on my blog, but is that because it’s rare?

Let’s take a look at some statistics. I’m using numbers for the United States simply because they were the easiest ones to track down, but I’m assuming that the ratio would be similar elsewhere. In the US, there are

  • approximately 1000 new cases of cystic fibrosis each year
  • a little over 6000 new cases of ALS each year
  • an estimated 15 500 new cases of NETS each year

Do the math! That’s more than 15 times as many cases of neuroendocrine cancer as cystic fibrosis and more than twice as many cases as ALS! It’s also an average of more than 42 new cases a day or more than one every two hours!

So why is NETS not nearly as well-known as the other two diseases and why does that matter? It matters because doctors don’t detect what they don’t suspect and they don’t suspect NETS if they don’t know anything about it. Secondly, more research dollars go to higher profile diseases. According to the US Department of Health and Human Services, $49 million was spent on ALS research in the US in 2015 and $80 million on cystic fibrosis, but NETS wasn’t even on the report!

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I know you’d probably rather read about my travels or my Fashion Friday posts and they’re definitely more fun to write, but unfortunately, it falls upon patients like me to publicize and educate whenever and however we can. It might be easier if we had a Lou Gehrig, someone well-known to put a face to our disease, but that hasn’t happened yet. Our best hope so far was Steve Jobs, co-founder and former CEO of Apple Inc, but Jobs initially chose to reject his doctors’ recommendations and try alternative treatments, a decision that may have hastened his death in 2011. He was also very private about his condition which was, of course, his right, but he could have done so much good had he chosen to be a vocal spokesperson. The fact that the media, left in the dark by his silence, commonly reported that he died of pancreatic cancer rather than neuroendocrine cancer that originated in his pancreas, didn’t help our cause either.

Increasing awareness is a slow process, but I believe we’re making headway. In spite of the fact that it’s still not well-known, NETS is actually the fastest growing class of cancer worldwide! I believe that that’s because it’s being diagnosed more often and because improved treatments are allowing many of us to live longer. Our goal continues to be to raise awareness in both the medical field and the general public, so that research funds are made available that will lead to even earlier diagnosis and better treatment. It’s time for NETS to come out of the dark!