What Day Is It?
Keeping in step between Epiphany and Quitter’s Day
My original plan was to write this post on December 30, with an update on my white blood count and targeted therapy and some reflections on the giving of gifts and the making of resolutions. Nothing, however, went according to plan: My white count was still too low and I could not go to Dundee to resume targeted therapy … so we decided to cancel the plans we had made for a family outing to see a movie in Dundee that afternoon . . . and we thought we’d reschedule the movie for the next day … but when we bought the tickets online we accidentally bought them for that day after all … so we all had to rush out of the house in 15 minutes to make it.
Instead of going for treatment, we made it to the movie in time and saw “Matrix Resurrections” together. You’ll have to ask me whether the movie itself was better than an afternoon with the tea trolley at Ninewells, but the seating was definitely more comfortable and the company was pretty great. I will say that we have spent (at last count) at least six hours discussing and debating “Matrix Resurrections.” (Lana, call me to help write the next script!)
I did not write any reflections on the giving of gifts or the making of resolutions.
With my bloodwork postponed yet another week, I planned to write this post on January 6, with an update on my white blood count and targeted therapy and some reflections on Epiphany and the new year. Nothing, however, went according to plan: I thought I was supposed to go to Dundee on Thursday to get my aromatase inhibitor medication … but 10 minutes before I walked out the door it occurred to me that I wasn’t sure from my phone conversation with the nurse whether my appointment was on Thursday or Friday … so I called the Chemo Day Unit … and sure enough, it was on Friday and not Thursday.
Instead of going for treatment, I wrote and edited some news articles and profiles for work. No tea trolley appeared at my home office, but I did make a cup of my “Christmas tea” blend that someone gave me and it was delicious.
I did not write any reflections on Epiphany and the new year.
Finally, last Friday I made it back to Ninewells and the tea trolley and Laura, the world’s cheeriest Chemo Unit nurse. My bloodwork was in order, with my white count finally lumbering out of neutropenia into something closer to normal. We’re staying at the half dose again, with hopes that my neutrophils hang in there without crashing. I should have a respite from blood tests until February. It should be a few weeks where everything, including my neutrophils, is something closer to normal.
And now here we are: past Christmas, past New Year’s, past Epiphany. All the think pieces about gifts and resolutions and the holidays have been published, read, and forgotten. Indeed, many of the gifts and resolutions themselves have been forgotten or neglected by now. (We are nearly to Quitter’s Day, according to Strava, the social media network for athletes.) The posts I had started drafting just a week ago feel out of date, or at least out of step, for the middle of January.
This feels like a moment for keeping in step, one foot in front of the other. This feels like a time to remember that executing a perfect plan might be less important than trying to figure out what progress means when all the plans get thrown out the window.
For me, this keeping in step is also literal. At my last rehab appointment, I had another session on the anti-gravity treadmill. And it was great! A session that last time left me winded and sore this time felt like a pleasant warm-up. I still need to continue my balance and strength work, but I also continue to see progress. Is this how I would have defined “progress” in January 2021? No—but it isn’t 2021, is it? For today, in this moment, at this time, this is progress. I keep stepping up on the BOSU ball and I keep taking my meds and I keep trying to notice all the gifts of each day.
So here is my one reflection for today, my one resolution that I invite you to share: Resist Quitter’s Day! Reject stopping and keep stepping! We are in the stretch of time when it can feel hard to keep going. Gifts and intentions feel distant; plans are disrupted by the present. We feel the weight of our worries and the demands of daily life. Gratitude can be ground down by the gravitational pull of distraction. But don’t give up! Keep stepping, one foot in front of the other.
Cheery Cancer News
That might seem like an oxymoronic heading—truly, not much news about cancer can be described as “cheery.” In fact, here’s some decidedly not cheery information about metastatic/secondary breast cancer (MBS):
In the U.S., approximately 168,000 people have MBS; in the U.K., NHS England/Wales announced in October that they would perform an audit for the number of patients with MBS. It is estimated at around 35,000, but they have not previously tracked the numbers.
About 44,000 people in the U.S. and 11,000 in the U.K. die each year from breast cancer—the vast majority of those from MBS.
In the U.S., it receives less than 10% of all breast cancer research funding. I haven’t found that percentage broken out in the U.K.
So MBS is the breast cancer most likely to kill you (which seems intuitively obvious), but it receives a tiny fraction of breast cancer research funding (which seems patently ridiculous).
I have no objection to research on early detection and better screening and adjuvant therapies and better surgical options. (I dislike funding for the purpose of “awareness”—but that’s another conversation.) But I do object to the fact that in the Year of Our Lord 2022, we don’t know how the process of metastasis works, especially in a cancer like mine that was supposed to be a chilled-out little in situ, Stage 0, grade 1 tumor that suddenly turned into a raging metastatic Stage 4 forest fire in my bones. And I object that more funding isn’t being allocated to find out the answers!
And here’s where we get to the cheery part. Thankfully, there are scientists working on this very question. They don’t have the answers yet, and right now my particular case likely falls under their “tumor gone bad” theory. Not exactly scientifically precise, but at least they are paying attention and trying to understand different mechanisms for metastasis. I’ve been able to chat with a couple of them in the past few weeks, and my very favorite cancer researcher, Dr. Alana Welm at the Huntsman Cancer Institute in Utah, just sent me a note to let me know that their grant application to study metastatic breast cancer dormancy has been awarded. They’ll be working with the Fred Hutchinson Cancer Research Center and the University of California at San Francisco in the first large study of its kind.
More and more advocacy and support organizations are developing for metastatic/secondary breast cancer patients and research, both in the U.S. and U.K. And more research funding is starting to flow toward MBS, including a Susan G. Komen Metastatic Breast Cancer Collaborative Research Initiative at Duke University and UNC–Chapel Hill, Dr Karen Blyth’s lab at Beatson Institute in Glasgow, and Dr Olga Oikonomidou at the Edinburgh Cancer Research Centre.
I am cheered that these brilliant women are devoting their talent and time to hours in the lab trying to understand how cancer cells develop and move and hide out and attack. I am hopeful that their work will lead to better diagnoses and treatments and maybe even cures. I dream that the amount of research funding going up will lead to the numbers of people diagnosed with and dying from MBS going down. I pray they don’t give up.
How are you holding on and staying in step? Feel free to share your own commitment to keep going in the comments!
Such perfect words ! I agree -"'don't give up" --praying for you and believe your writing is important for all .......
One of my favorite posts yet! I love this encouragement to simply keep going. Thank you!