Lung Cancer and the Canadian Cancer Society

In my earlier days advocating for people affected by lung cancer, I heard rumours that the Canadian Cancer Society (CCS) didn’t give a fair amount of funds for lung cancer research. I did not know if that was true and believed it was important to find out. I determined to investigate, and learn how to advocate about this, but the Canadian Cancer Society seemed so big. I felt intimidated at first and did not know how to start.

Advocacy is relational work, and with encouragement from Chris Draft I worked on getting to know people at the CCS (and other organizations) and building relationships. People from the CCS reached out to me also and asked me to participate with them in various ways. They were interested and listened empathetically as I informed them about lung cancer.

For several years now I have been working with the Canadian Cancer Society. I have served as a panel member, speaking into the decision-making process about which research gets funded. I’ve shared my story quite a few times to raise support for cancer research in Canada and to inform and increase support for people affected by cancer. And of course there have been many conversations with thought-provoking questions and honest dialogue.

This year my lung cancer story is being used again as part of their holiday fundraiser, and also another big fundraiser in the new year. I’m glad to be part of significant cancer research fundraising as a multidisciplinary team member and that my advocacy training and life experience can make a difference.

Earlier this Fall I was also invited to be part of a panel member for the CCS Breakthrough Team Grants: Transforming Low Survival Cancers, specifically lung cancer and pancreatic cancer. (More info here.) It was very exciting to be asked to be part of this, especially due to the lung cancer focus, and I quickly agreed and submitted my “paperwork” to sign up.

Since advocacy is relational work, like so many other advocates I have worked hard to build relationships and partner with researchers and advocates from coast to coast to coast (and around the world). This has gone so well that when I filled out my Conflict of Interest form for the CCS Breakthrough Team Grants I realized that I knew and had partnered in research with a very large number of the research team members who had applied for funding. It was not a huge surprise, but very disappointing that the CCS team (after careful review) determined that I know and have worked with too many applicants to be a panel member this time. This time did not work out, but I’m definitely open to future opportunities.

The Canadian Cancer Trials Group (CCTG) is a national program of the Canadian Cancer Society. I’ve been part of the patient representative committee and lung executive with the CCTG since 2018. I’ve also spoken about lung cancer at CCTG Annual Meetings several times. Very grateful for the good work the CCTG does.

For quite a few years, I have been continuing to have conversations with people from the CCS about things related to lung cancer. They are generally eager to engage, and we are thrilled that this year there is special lung cancer specific funding available and that lung cancer researchers have applied. This increases hope and potentially can make a huge difference for many people affected by the deadliest cancer.

On average, 82 people in Canada are diagnosed with lung cancer every day. Lung cancer is the deadliest cancer, killing more people than the next three deadliest cancers combined.

More research means more survivors and better survivorship. Here’s to more research!

November is Lung Cancer Awareness Month (LCAM). What is your Cancer Centre doing for #LCAM?

Challenges and Choices

I won’t lie. This past month has been a challenging season, due to pain, nausea, fatigue and breathing challenges. Living with cancer can be very challenging, but thankfully the pain, nausea and fatigue are improving. I’ve had to hunker down and rest a lot, but am thankful to still be able to spend a little time with people, get some exercise and continue to do some advocacy work. We don’t get to choose all of our life circumstances, but we often get choice in how we respond. We can control the things we can control. Choosing to give thanks even in the midst of challenges can be a real game changer.

The upper endoscopy which happened the end of September (mentioned in the previous post) went well. We learned that my esophagus (food pipe) had narrowed to the size of a pin prick. No wonder swallowing was so challenging! The next day the phone rang with an appointment for a stent to be inserted in my esophagus the day after. A stent is a flexible tube to help keep the esophagus open to make it easier to swallow food and drink. I was very thankful for the opportunity to take advantage of a cancellation and get this taken care of quickly. That procedure was harder on me than I anticipated, and I slept for some time in the hospital afterwards. I’m thankful for Jackie Manthorne, President and CEO of Canadian Cancer Survivors Network (pictured below) who waited patiently, helped get my prescription meds and got me home safe and sound. So many people have supported by driving to and/or from appointments. What a good gift! Because this time was such short notice I put a request out on facebook, and had multiple offers within a few minutes. Thanks also to Robyn Denis who drove me to the appointment. So many have offered and have driven, and you have no idea how much it means. Thank you!

Awesome advocate Jackie September 2022
Kim Andrea and Robyn – awesome advocates. Photo credit: Chris Draft 2019

I’m very grateful that swallowing is so much easier than it was in September. In addition to liquids and puréed foods, I can carefully chew and swallow soft foods. This helped make (Canadian) Thanksgiving Dinner much more enjoyable. Very thankful for my middle child and her boyfriend who cooked a delicious vegan dinner for us. There was tons of food, mostly on the kitchen counter since it would not all fit on the table. I still eat very small portion sizes, and could not finish all the yummy veggies on my plate that evening.

Canadian Thanksgiving 2022
Canadian Thanksgiving 2022

I’m also incredibly thankful for the gorgeous weather we’ve enjoyed this Fall. I went out walking as much as I could, often with my youngest who I’m so grateful for, and our big sweet dog. Here is some of the beauty we’ve been able to enjoy this past month.

Today I’m especially thankful for two dear friends who popped by this afternoon. We are blessed with so many good people who generously support us. Love and support can make a world of difference, especially during the challenging seasons, and I can’t tell you how much that means.

Could I challenge you to choose a friend or neighbour to reach out to with love and support in the next few weeks? This does not need to be someone affected by cancer, but could be someone going through a difficult season. Please never underestimate the difference you can make for someone!

November is Lung Cancer Awareness Month! What is your Cancer Centre doing to celebrate survivors and raise awareness?

Scan Results, Swallowing and Advocacy

Time for another health update (with a bit of an advocacy update)!

I had another regularly scheduled CT scan, and like all the scans since I started chemo it showed that the cancer has either shrunk or remained stable. Good news! Amazing news, actually! Even while on a treatment break the cancer is held at bay. So very grateful! Seems like a miracle! My symptom management (palliative care) doctor thinks that perhaps my immune system now recognizes the cancer as something to attack. Really great news!

I haven’t heard a recent update, but it seems the clinical trial I’m hoping for probably won’t open up in Toronto until maybe December or next year. Ottawa probably won’t open it until the Spring. There are many hoops to jump through, and COVID has affected cancer research which affects so many people. The good news is that it does not seem so urgently needed by me right now. Of course urgency matters tremendously, as things can change very quickly. We never know how long we may be able to wait, and there are many people who need more treatment options urgently. Survivors matter!

More research means more survivors and better survivorship! I continue to pursue a variety of advocacy efforts, including cancer research and fundraising for research. Today, among other things, I connected with the Canadian Cancer Society who want to share my story again, and people from the Ontario Institute for Cancer Research and Canadian Cancer Trials Group. I also messaged Prime Minister Trudeau about lung cancer.

But back to the health update … I’ve faced swallowing challenges since the summer, even though I’m very careful when eating or drinking. I lean forward and place my chin on my chest when I swallow. I’m eating a lot of soup and some other very soft foods, one very small mouthful at a time alternating with sips of water. I only eat very small, very healthy meals, and try to eat four or five times per day to get as much nutrition as I can manage.

I reached out to the Speech-Language Pathologist who helped me a couple of years ago when I was having swallowing issues previously and did the swallowing study. She is lovely and we had an online appointment last week where she gave me a lot of helpful tips and reassurance.

A referral to an Ear Nose Throat doctor was made, with an upper endoscopy scheduled for this afternoon. I’m looking forward to learning what the procedure will tell us, though a little nervous about having a camera stuck down my throat. There will be sedation, and I think my kids are looking forward to seeing if I’ll still be feeling the effects when I get home. Apparently some people don’t remember anything about the procedure, so I’m hopeful it won’t be as difficult as the similar procedures I’ve had before.

November is Lung Cancer Awareness Month. What is your Cancer Centre doing to celebrate? #LCAM

Steroids

Dexamethasone, a.k.a. decadron, is a steroid commonly used by many people for many health conditions including cancer. I’ve been taking it in various doses daily since my hospital stay in February, almost six months ago. Something very important about this drug is to not suddenly stop taking it. It is critical to taper down before stopping. My care team has been working to find the best dose for me, and in process I’ve learned a few things.

First, can you tell these two pills apart?

If you look closely enough, yes you can, but don’t they look very much alike? These are both the same drug, but one is 4 mg and the other is 0.5 mg. How easy would it be to make a significant, health-altering mistake?

Dexamethasone is a steroid that people frequently vary the dose of, so often have both 4mg and .5 mg pills in their home, and frequently need to cut the 4’s in half. One of the two main issues I’ve bumped up against is how similar they look. It is possible to tell them apart, but very challenging. If you’re taking 3mg, for example, you would cut a 4 in half and add two .5’s, but if you accidentally got that backwards, you would ingest 8.25 and that could really hurt a person. The second is that it is very difficult for the ordinary person to break one in half. These seem like simple fixes with a design change on the 4 mg pill.

I’m feeling a little more energized and today I reached out to a dear friend who has a good friend who is a pharmacist to ask for contacts and advice on how to proceed it I’m seeking to drive change here. I don’t know how much energy I have for this, but could perhaps send an email.

Also really want to give a shout out to my pharmacist at the Glebe Apothecary who cut a whole bunch of 4mg pills in half for me last time I had the prescription filled. I asked about the cost of the pill cutter, but chose not to buy it, and when my pills were delivered they came like this. Such a good gift! This makes taking 2.5 mg daily so much easier! Very grateful.

#hope

#advocate

#living

#steroids

#decadron

#dexamethasone

#pharmacist

#pharmacy

Virtual / Reality

We have a carport and it’s a great place for visits most of the year. A dear friend from High School ordered a heater for us and had it delivered shortly after a chilly visit last Fall, and that has extended the carport visiting season. So grateful!

It’s very special to be able to meet with people in person, and this summer quite a few friends are coming to town and making time for carport visits. Yesterday a childhood friend (we used to play piano duets together) came from the Seattle area and her Mom (who still lives in the same home with the same phone number (which I and so many others still remember)) came to visit. Such a treat! It’s so good to see people in person, even from 6 feet apart outside. In my opinion, it’s better in person than at a distance. Better in reality than virtually, in my opinion.

Don’t get me wrong, virtually is good, and in some circumstances it can open doors and provide opportunities that would not otherwise be possible. This is one of the silver linings of COVID and don’t get me wrong, I am grateful. It’s so good to meet “face to face” virtually when it’s too challenging (for a potential variety of reasons) to really meet face to face. There are good reasons for both. There is a season for everything. So grateful for a variety of options.

This is one of the reasons I’m such a fan of and advocate for CRAFT, 3CTN’s framework to make clinical trials more accessible for Canadians living in remote and rural parts of our geographically huge country. So important! 

Here’s a short video about CRAFT with some great quotes from a few people which was made over a year ago. CRAFT has now been rolled out and is serving people at several locations.

Zoom and other similar platforms have enabled many of us to speak at international conferences and other events the past couple of years. I’ve spoken at so many virtually, and we recognize the upside of not having to travel and spend time away. This has been a good gift which has also been a real difference maker for many of us.

Speaking personally, these visual platforms have also transformed much of my patient research advocacy in other ways. I used to have so many phone call meetings prior to COVID, and some of them with quite a large number of people. Initially I hadn’t met all the researchers in person and I did not always recognize all the voices. Sometimes some of the people did not introduce themselves when they started speaking and it could be challenging to figure out which person (from which place) was speaking. It’s so much easier with platforms that can show faces and even list their names. So much easier to get to know people and be better able to contextualize their comments. So  much better for community building than a mere large group phone call. So grateful for this!

In recent months, many members of the lung cancer community and other friends have sent gift certificates for our family to order food in. It means so much to receive this support that comes with love and appreciation. One ordered pizza for us, several have brought food, and many friends including our church community has brought much food and sent food in various ways as well. It’s such a treat and very much appreciated. Twice people have sent fruit bouquets which are so delicious, and so many other yummy things have arrived at our door – too many to name, and received with tremendous appreciation whether sweet or savoury. Thank you!

I’m very grateful for local friends who have done things this week – again, too many to name – like offer to pick up a walker for me, or regularly walk our dog. The reality is that there are times when we need real physical, local support. So many people here in Ottawa have offered and/or given support when needed, for example, rides to appointments, picking up groceries etc. Where would we be without our local people?

As much as we appreciate the virtual reality, we recognize there are some things that obviously cannot be done from a distance. Even for those who are part of strong virtual support groups, it seems obvious that it’s important to make sure we are also cultivating relationships with people in our own geographic community. We never know when we might need local support.

Please let me say again that we are incredibly grateful for the reality of this local support as well as the support from a distance.

#love

#hope

#support

August 1 is World Lung Cancer Day. What is your cancer center doing to celebrate?

Advocacy highlight

One of many advocacy highlights happened at the AACR Annual Meeting in Atlanta in 2019. I was at the Convention Center, working on a presentation about immunotherapy for the Scientist <–> Survivor Program, while hanging out with several people, including Rhonda Meckstroth and Chris Draft. Chris knows just about everyone, and was talking with many of the researchers who were passing by there. He introduced some people to us, especially if they would be good people to interview about immunotherapy. Chris is a great connector and loves to share his resources with others. The lung cancer community has benefited so much from him. He’s always available to us.

Suddenly Chris nudged me and pointed to a small crowd walking by. In the midst of this crowd was a man who looks kind of like your stereotypical scientist. He looked very familiar to me. He looked very much like Dr. Jim Allison, Nobel Prize Laureate for his work on immunotherapy. I felt very excited and very shy. I asked Chris if it was really him. Yes, it was. (Of course it was – he was there presenting.) I wondered if I should go talk with him. Yes, I should! I went running after his entourage and tried to get through the crowd. They weren’t letting me, but when Dr. Allison heard that I was a lung cancer survivor advocate, he told them it was ok to let me in. He warmly welcomed me into his circle and a big wave of gratitude washed over me for this man and his team who were history makers, who had changed so many people’s stories and extended so many lives. I was very excited to be able to tell him that he had made a huge difference for the lung cancer community, saving many lives including some of my friends. I thanked him on behalf of the lung cancer community, telling him we were very grateful for him and his team. Expressing gratitude matters

#gratitude

#hope

Please note: some of my previous posts have not been saved as expected, so keeping this blog updated has been challenging. Also, a fairly recent post published before it was intended, so many edits were not made. The main correction to make clear is that we are not stopping treatment, just taking treatment breaks.

Jill’s Hope Mango Smoothie Recipe

Choose hope

I’m excited to share this recipe with you because this has been my favourite smoothie for many years. When swallowing was challenging in the winter of 2020-21, I was not even able to swallow this smoothie. I did some tests, then some exercises given by Emilie (pictured below), a lovely Speech-Language Pathologist. (Those who are interested can read more here: https://throughthevalley.ca/2021/01/20/health-and-advocacy-update/.) Swallowing improved and has been good ever since. For some time I’ve been able to eat just about everything. I still really enjoy this smoothie and want to share the recipe with you. Thankful!

We can go through times when it’s hard and we can start imagining that things will only get worse, but that’s not necessarily true. We can ask for help. Things can turn around. We can choose hope and hold onto hope!

Jill’s Hope Mango Smoothie Recipe

  • Approximately 1/4-1/3 cup of mango
  • 3-4 celery stalks, chopped
  • 1 Tablespoon peanut butter
  • 1 scoop plain protein powder (unsweetened, unflavoured)
  • Milk to fill it to the max level

Blend it all together and enjoy!

Keep holding onto hope!

What is your cancer centre doing for World Lung Cancer Day August 1?

#TheWhiteRibbonProject www.thewhiteribbonproject.org

#hope

Presenting at ASCO (American Society of Clinical Oncology)

Presenting at ASCO, the world’s largest cancer conference, was a great opportunity to strategically represent lung cancer survivors and cancer survivors worldwide.

It was a terrific experience, so good to work with awesome co-presenters and bring significant contributions along with them on our panel discussion:

Where Do You Go When You Put Your Best Foot Forward? Challenges After Upfront Use of Next-Generation TKIs in Driver-Mutated NSCLC. We gave a 60 minute panel session during which we discussed cases in an interactive manner with the audience. Here is the multi-disciplinary team:

ModeratorLyudmila Bazhenova
An International Academic Oncologist PerspectivePilar Garrido
North American/Community Oncology PerspectiveMakenzi Evangelist
A Patient PerspectiveJill Hamer-Wilson
A Radiation Oncologist PerspectiveMatthias Guckenberger

As far as we know, only two lung cancer survivor advocates presented at ASCO, and this is the first panel discussion with a patient/survivor/caregiver advocate. Here is a tweet from our moderator:

I echo our moderator’s Tweet: Great job, ASCO! Thank you for including this survivor advocate as a co-presenter at #ASCO22! May there be many more of us to follow! Well done, team! Thank you for caring about your patients. A real pleasure to present with you. An extra big thanks to ASCO for changing things up to including me in an online format when health would not allow me to present in person. This shows that ASCO values the survivor voice. #grateful

Here are some of the things we spoke on … biopsies, holding targeted therapy during radiation, questions about increased toxicity with potentially no clear benefit, different kinds of lung cancer like ALK, EGFR, EGFR C797S …

Before the presentation, I reached out to some people affected by lung cancer from here in Canada as well as the United States and around the world to bring their input into the presentation, to be able to represent them as best as possible. They brought a lot of good input, and the time was definitely too short to say it all. Here are a few of the things I said …

Each patient is unique, and every patient-doctor relationship is unique. I urged oncologists to not make assumptions (e.g. that we can’t afford it), but instead to ask questions, discuss options with us. Please inform us of the pro’s and con’s. Empower us to make good decisions with you. And always be empathetic, because getting a lung cancer diagnosis can be traumatic.

Here is the link if you’re interested: https://meetings.asco.org/2022-asco-annual-meeting/14236?presentation=205915#205915https://meetings.asco.org/2022-asco-annual-meeting/14236?presentation=205915#205915 You may need to sign in, and I think it’s free for survivor advocates but I’m not sure about others. You may have to ask the good folks at ASCO and I’m sure they’ll help you out.

A number of cancer researchers and organizations are working on figuring out how to engage with people affected by cancer. Some are effectively including patients/survivors/caregivers at the table. This is best practices.

Many of our advocacy efforts have been about strategically creating pathways to make it easier for others to also do advocacy. Two lung cancer survivor advocates presenting at ASCO this year? Let’s work for many more in years to come!

#hope

#pathways for advocacy

#strategic

Together with some terrific panel members, we’re presenting at ASCO Tuesday morning

ASCO, The American Society of Clinical Oncology Annual Meeting, is the world’s largest cancer conference, and it’s happening now, in Chicago and also with online sessions. This year’s theme is: Advancing Equitable Cancer Care Through Innovation #ASCO22. You can check out the program, which features over 200 sessions, here. The online platform includes 85 livestream sessions and more than 2,500 poster presentations.

Our session is Tuesday morning: Where Do You Go When You Put Your Best Foot Forward? Challenges After Upfront Use of Next-Generation TKIs in Driver-Mutated NSCLC. We have a 60 minute panel session during which we will discuss cases in an interactive manner with the audience. For example, we’ll have Question and Answer, Multiple Choice Questions for the Audience, and a “Likely Scale”. Should be fun! Here is the team:

ModeratorLyudmila Bazhenova
An International Academic Oncologist PerspectivePilar Garrido
North American/Community Oncology PerspectiveMakenzi Evangelist
A Patient PerspectiveJill Hamer-Wilson
A Radiation Oncologist PerspectiveMatthias Guckenberger

Last Fall when I said yes to this exciting opportunity, the ASCO organizers emphasized that it was important for all presenters to be physically present in Chicago for ASCO, but since my health declined I’m now unable to travel. I reached out to the ASCO team to ask if it would be possible in this case to present virtually. Very grateful that the ASCO team highly values the survivor advocate perspective and is willing to work for a process for virtual participation. It’s great to have good teammates!

Speaking of good teammates, a big shoutout to Chris Draft who has been making The White Ribbon Project Ribbons and delivering White Ribbons in multiple languages to many people at ASCO this year, including some of my co-panelists. Thank you, Chris and Team Draft!

#ASCO22

#ResearchMatters

#hope

#targetedtherapy

#nsclc

#lungcancer

#ASCO

#team

#survivorship

#grateful

#chicago

Happy Cancer Survivors Day! advocacy + brief health update

Happy Cancer Survivors Day! Cancer affects so many of us, whether directly or indirectly, and it’s exciting that right now the biggest cancer conference in the world (ASCO) is happening in Chicago and online because more research means more survivors and better survivorship.

There is much talk of new treatment options and potential cures, and I can’t tell you how thankful we are for research and all involved in the research process. Just over a week ago, terrific Canadian ribbon makers, Lisa and Bill Weir and awesome advocate Chris Draft and I were representing The White Ribbon Project, speaking to a group of the lung team members from a pharma company, communicating how thankful we are for the research they do, and how important research is to the lung cancer community. What a difference research makes! #ResearchMatters

This pharma company team did a terrific job all around. They were well-organized and effective communicators who sent a thoughtful and well-written thank you email afterwards including promises of ongoing partnerships. What a great day! The pharma company teammates made White Ribbons together with those three team members from The White Ribbon Project who were able to go in person and be at the same place to make ribbons together. I would have travelled there too had I been able, but instead very thankful that they effectively set things up so I could speak online.

Speaking of my health, I’m still on oxygen and we don’t know why there is still shortness of breath.

Dr. Nicholas, my oncologist, suggested it could be good to take a break from chemo to see how my body responds and also the cancer. Last week’s CT scan showed that the cancer remains stable or improved – great news! I still have shortness of breath, but most days am feeling much better, so that’s a real plus.

Dr. Nicholas has been working on discerning a good path forward. I may be able to participate in a clinical trial which may start in Toronto in the Fall, but there are still more hoops to jump through before this can happen. I’m very thankful for Dr. Nicholas who works very hard for his patients.

Celebrating cancer survival together with the awesome Andrea Redway on her seventh cancer-versary! Over fifteen years of survivorship (and two metres) between us!

Andrea (above) is also a patient of Dr. Nicholas. Here she is, celebrating her seventh “cancer-versary”, also on the same day as the ribbon build! When she was first diagnosed, the cancer had already spread through her body and she was very close to death. She and her husband advocated for her to get the life-extending surgery she needed, and a less experienced surgeon was willing to do it even when a more experienced one was not. Together with Dr. Nicholas, Andrea and Michael looked possible treatment options and talked about immunotherapy back in earlier days when it was not so common. He was quick to get the paperwork done and Andrea is alive and doing well seven years later. She is an amazing advocate and we are so very grateful for her and the good care she has received.

It matters to keep holding onto hope and continue advocating for more research and for advances in research to get to people who need them. Researchers are working hard to find cures. Research advocates have an important part to play, representing survivors, patients, their family, loved ones, and the public. It is important that we are trained and well educated so we act like professionals and work effectively.

Another meeting I got to be part of that same day was with the team that is working on Canadian Cancer Clinical Trial Network’s (3CTN) Precision Oncology Map that some of you may know about. Last Fall the Canadian Cancer Clinical Trials Group earned the Bayer Precision Oncology Patient Innovation Award grant of $25,000 and is using it to improve clinical trials for people living with cancer in Canada. 

This team has been working to develop a map of all the Canadian cancer clinical trials so that patients, caregivers & clinicians can more easily find suitable trials and researchers & sponsors can search for gaps where more trials are needed. We are still looking for feedback on how user-friendly the current test version is, and if you are interested, you are welcome to help.

If you would like to look at the map and potentially give feedback, please click on the link below and explore the map, then send a brief email info@3ctn.ca with your thoughts about strengths, weaknesses and suggestions for improvement. Precision Oncology Map: https://app.powerbi.com/view?r=eyJrIjoiNmM2MmE0NmQtMGI5OC00NDdjLTgxMzMtM2ZmNzQwYjRkMjM3IiwidCI6IjlkZjk0OWY4LWE2ZWItNDE5ZC05Y2FhLTFmOGM4M2RiNjc0ZiJ9

Below are some pictures from that awesome build mentioned above. Thank you to Lisa and Bill Weir (with the great tee shirts), Amy Hayes, Lorraine Hudson, Grace Oha, Lung Ambition Alliance, AstraZeneca and the awesome advocate and photographer, Chris Draft. Great day! Thanks also to Heidi and Pierre Onda, founders of The White Ribbon Project.

Bill and Lisa Weir, Lorraine Hudson, Amy Hayes, Grace Oha

#hope

#The White Ribbon Project

#lungcancerawareness

#sensibilisationaucancerdupoumon