A small star of wonder

There are few miracles in Cancerland. Many of today’s treatments are founded on surgeries, chemo and radio therapies that have been around for decades. The concept of mastectomy has existed for centuries, though thankfully surgical practice has improved significantly in that time. Cancer research is resource intensive, costly and for every positive advance there are many more that fail to deliver useful results.  

As a recovering cancer patient, thinking about all of this is a daunting prospect. So many race for the cure because no-one wants their life cut short by cancer. Yet the cure continues to elude us and every day there are tears and condolences as more of our number depart the human race.  This, all too often, is the stark reality of Cancerland. It makes the psychology of cancer equally as challenging as the disease itself.

Science has not given up though and for those of us affected by this odious illness, from time to time there are breakthroughs, stars of wonder that shine a ray of hope into what might otherwise be a very stark world. Since being diagnosed as HER2+ I’ve hunted down as much information as possible about the ramifications of my particular cancer subtype. I am the kind of person who needs to know what she’s up against and until recently it painted a very challenging picture. More aggressive, more difficult to treat and more prone to early metastasis are not the kind of facts I hoped to discover. Without the advent of Herceptin my consult had said our initial conversation, the “yes you have cancer” one, would have been followed by “and we’ll do as much as we can but the outlook isn’t good.”

Unable to resist the urge to undertake my own research, I quickly discovered that members of the HER2+ community seemed to be dying at an alarming rate, even if their cancer was diagnosed early and they’d undertaken aggressive forms of treatment. In 2012 a long knife skewered my heart. The “yes it’s cancer” part was unpleasant but it wasn’t a complete shock. The HER2+ part was a twist of the knife, unknown territory which soon became a gargantuan challenge. Though my treatment is over my quest for research did not subside and as we approach Christmas 2014, the season of peace and goodwill,  a small star of wonder shines for those who are HER2+.

The survival benefits of Herceptin have been assessed in long term research, the first of its kind because Herceptin is one of a handful of cancer treatments that haven’t been around long enough to know exactly what the outcomes might be. Earlier this month the Journal of Clinical Oncology published a study that found Herceptin improved 10-year survival from 75 percent with chemotherapy alone to 84 percent with combination therapy – chemo plus Herceptin. The results also established continued improvement of disease free survival – the addition of Herceptin has seen 10-year disease free survival rates increase from 62 percent to 74 percent. As someone affected by HER2 these increases in 10 year survival and 10 year disease free survival are encouraging. They begin to shine a ray of hope in a landscape where hope is desperately needed – 74% isn’t good enough in my opinion but it sure as hell beats less than two-thirds.

It saddens me that, for my friends with metastatic breast cancer, everyone who is stage four at diagnosis, anyone who isn’t HER2+ and all those living in the wrong geography or an insufficient income bracket this discovery offers no comfort. It’s a small breakthrough with relevance for 15-20% of those with breast cancer. I’m part of that population yet there are no guarantees it will be of help to me either. Breast cancer is like that, no-one knows which straw they’ve drawn and reoccurrences can happen well beyond the 5 year “all clear” period.

Uncertainty and unpredictability are part of the fabric of Cancerland and somehow we learn to adapt to that, to cope with an outlook that’s permanently cloudy, but even for the most optimistic among us this becomes psychologically wearing. Coping is marginally easier if the cloudy outlook is perforated by at least one small star of wonder every few years – it seems that Herceptin may well be that kind of star.

 I

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18 thoughts on “A small star of wonder

    • Thank you Dad. Hopefully by now you know you are my rock, always have been and always will be. I am the luckiest woman alive to have you as my father so will do my damndest to stay healthy and want to make sure you do the same 🙂 I have may wishes for you for 2015, happiness, some time off and good health are at the top of the list, but that’s just the start… Love always, Tracy xxx

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  1. Hi Tracy I am amazed at the writing you do so confident and strong your positive thoughts seem to keep you going ,I wish you Marcus and James a happy new year and pray 2015 will be good to you all love Aunty Linda xxxx

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    • Hello Aunty Linda,
      I think positivity and endurance are part of our genetic make-up. I don’t know many people who’ve been forced to face all the things we’ve all dealt with yet still remain relatively well adjusted, happy and considerate human beings. I know I couldn’t face being miserable or bitter for however long I happen to be here so making the most of it is easy by comparison. I hope you have a much more settled, peaceful and happy 2015 too, you certainly deserve that. Sending much love, xxx

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  2. happy new year to you all,

    for about 2 decades now,maybe longer, it has been known that the F -component in FEC, namely fluouracil is of little or no use in chemotherapy, in many its action is very negative dependent on type of cancer and grade. to the patient and is responsible for brain damage, and also interacts with the epirubicin and phosphamide–to give and worsen that bone marrow suppression and other horrible combined effects including fatigue and others
    that can be life threatening.

    it seems now that we move on to the E C treatment ( WITHOUT THE 5FU)…after 20+ years!…..

    since about 1986, there is a tablet called ormeloxifene, that may treat breast cancer, it is a type of drug called a SERM— i would love to know if it is more effective than paclitaxel I.V l–2 tablets twice a week vs i.v chemo?

    The taxanes themselves e.g tamoxifen ( paclitaxel is a weak liquid version, as it is given I.V , its effects are about 20 times stronger than digested through the stomach and G.I tract.) I am aware that tamoxifen was around in the ?late 1960’s, perhaps earlier, but wasn’t routinely prescribed until
    2 decades later in the UK.

    maybe in another 20 years, we might be told–that there is a “new” wonder drug discovered…..( from 1986)

    I will try to get some answers and post them if you like?, but my Finnish language skills are at present non existent.

    Best regards
    cancer campaigner, manchester

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    • Happy New Year Rhona.
      I was alarmed when the cancer treatment I received (with the exception of Herceptin) was exactly the same as my Mother received back in the early ’90’s and probably the same as my Aunt received in the 80’s. Most of the chemotherapy drugs have been with us for decades, many stem from experiments during WWII and even the more recent options (like the taxanes) come from Yew which has been known to have various medicinal properties for many, many generations. The UK seems particularly bad at keeping up to date with new treatment regimes – drugs that are available to patients in the US and Canada often fail to become available here for a number of years.Simple things like subcutaneous ports are not offered yet they are probably less infection-prone than a PICC or Hickman line and far less restricting. It’s really not ideal but for the moment it seems its all we can get – the only option we is to take the treatments offered because every day without treatment is a day gifted to cancer – a chance for it to invade further into our bodies.

      I know that drug trials take time and safety is important. I also know that money and power play a big part in what is and isn’t made available for cancer patients. At any level that’s wrong and needs to change.

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  3. dear Tracy,

    having presented with ST IV metastatic breast cancer immediately after biopsy just a few days before Christmas in 2011, I began treatment that included both chemo and Herceptin in the early part of January 2012. I have remained on Herceptin every three weeks since, even through the diagnosis of a second cancer in July, 2013 and throughout the following nine months of treatment. I embrace NED, that darling, and hope we keep dancing the dance of remission for a very long time. I feel so fortunate to not only receive the infusion of Herceptin, but also for the close watch that is kept over me that comes with blood work labs and my oncologist examinations at 3 week intervals. it has certainly helped me with the sudden loss of feelings of safety and security after Hugh died so suddenly in May of 2013. I feel as you do – that for many other different types of breast cancer, there is not much in the way of effective adjuvant therapies to help bring on, nor sustain a robust remission. and it makes me heart sick to think of others who also present with HER-2+ BC but cannot receive it due to financial or geographical constraints. something about that just feels SO WRONG, and I wonder why something can’t be done to remedy that situation.

    I, too, feel an obligation to concentrate upon gratitude, to breathe in every ounce of it and allow it to guide me towards being a better citizen of this planet, to hold each person who deserves to have that same Small Star of Wonder close to my heart and high up into the brightest light of hope that one day it will shine for them, too – either with Herceptin or other therapies to provide long respites of remission.

    it is late at night here across the pond, Christmas Eve in fact. rainy, foggy, and not a single star visible on the mid-Atlantic seaboard. I would have so liked to wish upon a star for so many of us this evening – but we still have so many ways to think of one another, to Love, to wish the best of all that is good in life; so I will raise a Cup of Kindness instead and hope it’s taste is one of comfort, of compassion, of beautiful connectiveness – but most of all sweet Friendship and Love…

    ,,,much love,

    Karen OOXOO

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    • Sending you warmest Christmas wishes Karen, friendship, strength and much love for the year ahead. I have come to the conclusion that the trials we face, the twists, turns and traumas serve only to make us even more determined to cherish the time we have, give thanks for small mercies and appreciate the beauty in the world around us. It may sound strange but I am glad that I’m no longer burdened with the trivia of daily life, the small things that cause annoyances or doubts and lead to moaning and complaints. Those things just pass me by now because there really is so little point in attending to them. Instead I use my time as you do, practicing gratitude and small kindnesses in the knowledge that however long I have on this planet will have been time well spent.

      Sending love on a cold and rainy evening on the other side of the ocean xoxox

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  4. Thank you for your post. Yes, star of wonder, Herceptin…worked its wonders on me too. Also diagnosed in June 2012, and so far, so good. Just got another 6 month NED hall pass and I’m good to go until May. Hair back, energy back. Some days I actually don’t even think about cancer. It’s almost as though it didn’t happen. I agree that it’s hard not to look at the stats, though, and wonder if you will be in the bigger % of people who stay cancer free, or in the other camp. This is the underlying incentive to walk/bicycle every day for an hour, do yoga stretches, eat broccoli sprouts and mushrooms, drastically reduce wine/sugar/meat consumption…trying to do everything possible to reduce the chances of recurrence…but I know it’s all just a big crap shoot. Just like getting cancer was in the first place. Like you, I consider myself optimistic overall and that optimism goes a long way towards dealing with the inevitable worries and fears that pop up every now and then. Writing about it helps. Reading your post and knowing that I’m not alone in feeling this way helps too, so thank you again. I hope your Holidays are joyful and peaceful….and worry-free.

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    • Thank you for your message Jeanie. Though I never wish cancer on anyone it’s always good to meet someone else who has experienced Herceptin and hit the challenges of HER2 head on. I’m glad you are at the point of not even thinking of cancer some days – those days are very encouraging and alongside renewed energy they help lead us into a future which we all hope is much brighter and full of health. Like you I do as much as possible to ensure a cancer-free future but you’re right, it’s a crap shoot and none of us knows how things will turn out. That makes me even more focused on the time I have, how I spend it and those I spend it with. I still don’t think anything good comes from cancer but good things do come from re-engaging with life and making the most of every moment. I wish you a happy, healthy, NED future xoxox

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