Progression

As a neuroendocrine cancer (NETS) patient for the past ten years, stable became one of my favourite words. After each set of tests and scans, stable was the word that my doctors used to tell me that my cancer had not grown or spread. Unfortunately, when I saw my specialist on Friday, that was not what I heard. Instead, I heard the word progression.

In the cancer world, progression is the word that is used to describe growth or spread of the disease. It didn’t come as a shock to me. Over the past few months, we’ve been carefully watching test results that appeared to indicate that my tumours were likely becoming more active again. The news we heard on Friday was actually better than I feared. There has been a tiny bit of growth to a couple of tumours on my liver, but no spread anywhere else. That part is very good news!

Thankfully, I’m a cup half-full kind of person. I think I’d be a basket case by now if I wasn’t!

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So, what’s the good news in this? What happens next and what’s there to be optimistic or hopeful about?

After 126 monthly injections of a drug called Sandostatin, it would appear that it’s no longer doing its job and I’ll be switching to a different medication. Since Lanreotide is also given as an injection every 28 days there will be little change to the routine that we’ve become accustomed to over the years. There are, however, some real benefits to this medication.

Unlike Sandostatin which is know to suppress the production of the hormones that these tumours produce and thus reduce symptoms, Lanreotide is also known to actually delay their growth. Secondly, Novartis, the company that produces Sandostatin, cut out their in-home injection program over a year ago and I had to arrange for my family doctor to begin giving me my injections. Lanreotide is produced by Ipsen and I’ve been assured that once again, a nurse will begin visiting my home to administer my butt jabs. Not only is that more convenient for me, but it frees up my doctor’s time for other patients which is an important issue in a rural area where there’s a doctor shortage. Perhaps the most exciting part of all this for me, if there can be excitement in receiving news of progression, is the fact that hubby and/or I can be taught to administer the Lanreotide injections ourselves! Why is that exciting, you ask? Why would I want to poke myself if a visiting nurse could do it for me? For someone who loves to travel, as I do, the idea that I might be able to pack my medication and leave the country for more than 28 days at a time is actually quite exhilarating!

I’m already somewhat familiar with the new drug because many people in my online patient groups are on it and seem to tolerate it well. Hopefully I will too. I’ll have tests and scans again in late October to see if it’s having the desired effect. In the meantime, it’s summer in Alberta. There’s camping, hiking, and kayaking to be done and golf to play. In spite of the change from stable to progression, I still feel 100% and I’m determined to keep on living life to the fullest.

What I wore for a walk by the sea

Logo by SamWhether you like to read about travel or fashion, there’s something in today’s post for you. I seldom write “what I wore” posts, but I figured that that was the best way to squeeze in a Fashion Friday post this week!

For the past eight and a half years, since being diagnosed with neuroendocrine cancer, I’ve had an injection of Sandostatin every 28 days. Until two months ago, a nurse came to the house to administer theScreen Shot 2022-04-06 at 9.35.43 PM jab, but that service has been discontinued. Now, I get my monthly injection at my doctor’s office, but I can still easily arrange to have it done anywhere in Canada. Yesterday’s appointment, for injection #110, was at a clinic in West Vancouver.

One end of the popular 1.7 km West Vancouver Centennial Seawalk is just 3 blocks from the clinic. The weather was beautiful, so as soon as I was done, we went for a walk.

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Along the way, we saw a couple of harbour seals poking their heads out of the water some distance offshore and this long-legged heron standing guard closer in.

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At the end of the Seawalk, we made an unexpected discovery, The Beach House restaurant. The restaurant’s beachfront patio opened for the season yesterday and we were the first to sit at our table for two overlooking the shore. The service was impeccable and the food delicious!

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And now for what I wore…

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Everything I’m wearing has been in my wardrobe for quite awhile. The olive chinos were purchased almost two years ago at Mark’s. They’re a nice alternative to jeans and perfect weight for spring and fall. I’ve had the short-sleeved animal print top from Laura for so long that I don’t actually remember when I bought it. In spite of the fact that it’s been in my closet for a long time, I haven’t actually worn it a lot, but it’s been coming out more often lately. I added the anorak from Reitmans to my spring/fall wardrobe three years ago. It’s wind and rain resistant making it a perfect jacket to wear here at the coast, but it gets lots of use at home too. My white leather sneakers, also from Mark’s, are two years old and still like new. They’re super comfortable for long walks like yesterday’s.

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Though you can’t see it in the previous two photos, I wore my Shirttail Cardigan from cabi under the jacket. Layering is key to staying warm at this time of year. The sweater is over five years old and still going strong. It has been an absolute workhorse in my wardrobe and has appeared on the blog many times before. I don’t know what I’ll do if it ever wears out!

Before I go, did you notice my new Fashion Friday logo? It was designed especially for me by my 12-year-old grandson, Sam! He’s one of the young artists in our family. Thank you, Sam!

100 butt darts!

Every 28 days, without fail, a visiting nurse pulls up in front of our house and comes in to give me an injection of Sandostatin LAR. Today was the 100th of those butt darts!

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Sandostatin LAR is a long-acting treatment meant to reduce or eliminate the symptoms associated with neuroendocrine cancer (NETS) and for me it has been an absolute life changer! No longer do I live with the stomach pains and diarrhea that plagued me off and on for several years prior to diagnosis. Though the effect of Sandostatin on tumour size, rate of growth, and development of metastases has not yet been determined, it is thought that it might also be of benefit in those areas.

Sandostatin comes as a powder and a diluent solution that must be mixed and administered according to very precise instructions which is why I haven’t been taught to inject it myself. Once the diluent is added to the powder, it must be allowed to stand for a minimum of 2 minutes and not more than 5 to ensure that the powder is fully saturated. Then, after gently shaking the syringe for about 30 seconds to ensure that the powder is completely suspended, the nurse has to administer it without delay to avoid sedimentation. Even following these guidelines carefully and using a fairly large needle (19 gauge), it sometimes plugs. On those occasions, she has to quickly change the needle and try again. On a couple of occasions it has taken 4 jabs to get the medication into me! My 100 butt darts has actually involved about 130 pokes altogether.

In addition to the benefits that the drug offers, getting it into me and not wasting it is of vital importance because every one of those butt darts costs $2358.52 CAD! In other words, over the past almost 8 years, we have pumped more than $235,000 into my posterior! You could buy a nice house in our small town for that much.

This is where I’m really glad to be Canadian. I pick up the Sandostatin at my local pharmacy every 4 weeks and don’t pay a cent! The cost is fully covered by the government and that includes the cost of having the nurse come to my home. A Mobile Administration Program even enables me to have my injection administered by a trained nurse anywhere else in Canada. A simple phone call is all it takes to make the arrangements. I have to take the medication, which has to be refrigerated, with me but I’ve found that an insulated lunch bag and a mini freezer pack do the job as long as I can put it in a fridge overnight. So far, I’ve had butt darts administered at all 3 of my children’s homes. Arranging to have it done outside the country would be more complicated and isn’t something I’ve tried at this point.

So, is getting my monthly Sandostatin a pain in the butt? Not really. As a child, I was terrified of needles, but I lost that fear a long time ago. Only once in awhile does really hurt going in. Today was one of those occasions, but it went in on the first try, so I’m not complaining! The injection site often feels bruised for a couple of days and a lump often forms that gradually dissipates over the next few weeks, but these minor inconveniences are well worth it when I consider the benefits. So, 100 butt darts down and here’s hoping that I can have 100 more! Or 200. Or more!

When no news is good news

It’s been quite awhile since I wrote anything about my health as there really hasn’t been anything new to report. That in itself is good news!

As many of you are aware, I was diagnosed with two completely separate and unrelated cancers in late 2013 and early 2014. Yesterday, I finally received the results of CT and PET scans and other tests done three weeks ago. The first good news was that there has been no significant change in my incurable neuroendocrine cancer (NETS) over the last year. I have only had two radioisotope (Lutetium) treatments during that time, one last October and one in April, but that has been enough to keep things stable. The tumours have not grown or spread.

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Neuroendocrine tumours (NETS) produce serotonin which is sometimes referred to as a happiness hormone because a deficit can to lead to depression. An excess, however, can result in carcinoid syndrome which, as in my case, results in symptoms that include abdominal cramping and diarrhea, skin flushing, and periods of rapid heart rate. It can also lead to heart disease and other complications. A 24 hour urine test is used to measure the amount of serotonin in the body. Though I don’t know what units are used to measure serotonin, at the time of diagnosis, the level in my body was 150. Now, it’s down to 40. Though still above average, it is considered borderline and indicates that my tumours, if not completely dormant, are barely functioning. Monthly injections of Sandostatin, meant to suppress this serotonin production, are obviously working and I have had none of the above listed symptoms for the past couple of years.

More good news was the fact that there is absolutely no sign of recurrence of my second cancer which was an acinic cell tumour in one of my saliva glands. It was removed surgically followed by six weeks of radiation treatments, thirty in all. I have now been free of that cancer for over two years!

The best news, however, is the fact that I feel 100% healthy! My energy level is normal and except for the monthly injections, which are given by a nurse who comes to the house, and a treatment requiring an overnight stay in hospital in Edmonton once every six months, I’m able to lead a completely normal life. We haven’t gone on any long hikes yet this summer, but I’m quite certain that I could.

If things continue to go this well over the next year, treatments will then be reduced to one every nine months. I have no idea what the long term outlook is, but then, who really does know what their future holds? I know who holds my future and that is good enough for me!

“I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future.”                                      Jeremiah 29:11