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Cancer patients and the COVID-19 vaccines

17 Jan
Everybody should get vaccinated – even cancer patients and chorus girls!

In my latest for Fred Hutch, the cancer/virus/disease research center where I work, I dig into some of the questions I’ve seen swirling around on Twitter and Facebook as to whether cancer patients should get one of the two new “double-whammy” vaccines from Pfizer and Moderna.

Short answer: yes and as soon as possible (with a couple of caveats).

Definitely talk to your oncologist about your immune system if you’re currently getting any kind of immunocompromising treatment, such as chemotherapy. (Anti-hormones, which many of us are on for years, don’t qualify as immunocompromising.) You’ll also probably want to get the shots timed so your immune system is at its strongest. People with active cancer (I take this to mean stage 4, newly Dx’d folx) and those in active treatment should be prioritized, per Hutch public health researcher / oncologist Dr. Gary Lyman, since the complications from COVID-19 can be a lot worse for these peeps.

And YES, you still have to mask up after getting vaccinated: we don’t yet know if vaccinated people can infect others or not. BUT we sure know a lot more than we did last year when this creepy zoonotic virus first raised its spiky crowned head. And just so you’re aware, 3 out of every 4 new or emerging infectious diseases in people come from animals.

If you really want to dig in to the COVID-19 vaccine and specifics about mRNA, transplant patients, etc., you can hear a lot more from infectious disease (ID) and cancer experts like Gary and Dr. Steve Pergam on this ASCO/IDSA webinar.

Let me know if you have questions and I’ll try to follow up with more resources. In the meantime, #MaskUp #KeepYourDistance and #JustKeepSwimming

Cancer patients and the COVID-19 vaccines

The initial batch of COVID-19 vaccines are now available in the U.S. following incredibly fast — “warp speed” — development and testing.

Not so incredibly, there’s a lot of confusion among cancer patients — as well as their oncologists and caregivers — as to whether the vaccine is a good idea or a bad idea for somebody dealing with cancer.

The two Food and Drug Administration-approved vaccines from Moderna and Pfizer-BioNTech, each requiring two shots a few weeks apart, were more than 94% effective at keeping this new coronavirus in check in testing on thousands of volunteers in clinical trials. But only a handful of the clinical-trial participants were cancer patients.

Other COVID-19 vaccines are in development and will be available in the months ahead. Additional trials involving subpopulations (think children, pregnant women, people with health issues) are also in the works.  

But what do we do now that states are ramping up the vaccination efforts to eligible groups?

Patients with cancer are particularly vulnerable to COVID-19 because of the immunocompromising nature of cancer treatments. On top of that, progressing cancer itself depletes the immune system and leaves patients susceptible to infection.

Does that mean cancer patients should be first in line for their shot — or last? If they’re in treatment, could a vaccine make them sicker? What about those with metastatic disease who are always in treatment — can they get it? And are survivors the same as the general public? 

Full story here: https://www.fredhutch.org/en/news/center-news/2021/01/cancer-patients-covid19-vaccine-coronavirus.html

Coronacrazy coverage of COVID-19’s impact on cancer patients and POC

7 Jun

cancer and covid

Cancer and COVID-19: double trouble. Illustration by Kimberly Carney, Fred Hutch News Service

Like a lot of people, I’ve been consuming a ton of COVID-19 news and new research. And because it’s my job, I’ve been writing about it for the masses.

Two things seem very clear.

One, the novel coronavirus is more deadly to cancer patients who are older, who have other health conditions — think diabetes and hypertension — and who have active disease.

Here’s a piece I wrote for Fred Hutch that breaks it all down. It’s based on new data just out from the COVID-19 & Cancer Consortium, or CCC19.

Published in The Lancet, CCC19’s data comes from a crowdsourced cancer/COVID-19 patient registry which was put together by a handful of Twitter-savvy cancer researchers in a matter of weeks. Since then, it’s morphed into huge international collaboration with more than 2,000 patients and hundreds of clinicians, researchers and research institutions, all working to gather, analyze and disseminate crucial cancer/COVID-19 outcomes in near-real time.

Here’s a snippet and a link to the full story.

What happens when cancer patients get COVID?

Large new observational study of nearly 1,000 patients breaks down who’s most at risk with coronavirus, highlights need for additional care

The first large observational study of nearly 1,000 cancer patients who contracted COVID-19 was published today by The Lancet and simultaneously announced at a virtual ASCO 2020, the large annual meeting of the American Society of Clinical Oncology.

The findings, gleaned from over 100 institutions participating in the international COVID-19 & Cancer Consortium, or CCC19, patient registry, underscore how deadly the new coronavirus can be for patients with active cancer and other underlying health conditions.

“If you have active cancer and are older or have multiple comorbid conditions that require therapy, you are likely at much greater risk from complications of COVID-19,” said co-senior author Dr. Gary Lyman of Fred Hutchinson Cancer Research Center.

“That’s one of the major findings and one of the most concerning findings. However, the risk is greatest in those with progressive disease and poor performance status and less when the cancer is stable or responding.”

The second thing, and this will come as no surprise to anybody who’s been paying attention to the Black Lives Matter speakers the last few days, COVID-19 is also disproportionately deadly to people of color.

It hits African-Americans, Hispanics, Indigenous people and other people of color much harder, just like cancer and chronic conditions like diabetes, hypertension, cardiovascular disease, etc.

With COVID-19, though, it goes deeper: it’s hitting black and brown populations harder because they’re more likely to be essential workers. They’re the ones working elbow-to-elbow in fruit and meat-packing plants. They’re the ones nursing COVID-19 patients in clinics and ERs. COVID-19 has exposed who’s privileged enough to safely shelter at home, safely work at home. And who isn’t.

It’s a new disease that’s underscored an age-old foe: racism and the systemic racism that’s baked into every one of our institutions.

Again, a snippet and a link to the full monty. Thanks, as always for the read. This is an important one.

COVID and cancer expose society’s health care gaps

Fred Hutch researchers work to disrupt health disparities and misinformation as coronavirus ravages the medically underserved

Disease hits black and brown people harder. Same for indigenous people, folks in rural areas, members of the LGBTQ community and others who are medically underserved. It’s what the research shows and what many of us have experienced firsthand.

These disparities aren’t the result of genetic predispositions, but societal ones. It’s the person’s socioeconomic status, their insurance and immigration status, the neighborhood where they live and whether they have access to (and can afford) health care, nutritious food, social support. It’s how people treat them based on their looks or their heritage. These are the things that truly dictate who gets sick and who dies.

It’s true for cancer, for cardiovascular disease and diabetes and in these times, for COVID-19.

“The disparities we see in COVID-19 are very consistent with most forms of cancer and most health conditions in the U.S.,” said Dr. Christopher Li, an epidemiologist with Fred Hutchinson Cancer Research Center at a recent Hutch Town Hall on health disparities.

And it’s crucial, especially as racial inequality has launched yet another national crisis, to understand them “within the context of the significant economic and social differences that exist in our society,” he said.

Finally, one last story from April (yes, I’m the world’s slowest blogger) on Treating Cancer in the Shadow of Coronavirus. It outlines what oncologists and cancer policymakers are doing to keep newly diagnosed cancer patients and those in treatment safe from infection with COVID-19.

Stay well, my friends. Keep wearing those masks, keep washing those hands, keeping lifting up the voices of those who matter and just keep swimming.

Cancer and the coronavirus: hard prep

3 May

COVID19 image double whammied blog

Ghecemy Lopez of Los Angeles, a two-time cancer survivor who now has immune issues. She dons plenty of PPE for her doctor’s visits. 

It’s pretty much been corona, corona, corona these last few months — even in Cancerland — and I don’t imagine that will change much moving forward.

States are starting to open up — Washington will get there eventually —and I pray everyone out there stays safe as we slowly creep forward with our masks and mad soap & water skillz and (hopefully) enough sense to stand far enough away from people that we don’t accidentally breathe in any virus particles they may be talking, sneezing, laughing, singing, coughing or farting our way.

Sadly, it looks like we’re going to be here a while. Yet another new normal.

Like everybody else, I’m hoping science can find or fast-track better treatments than remdesivir (the Tamiflu of COVID-19, just emergency approved by the FDA) and that other drug combo the orange guy in the White House keeps chatting up, along with sunlight and bleach, as a fabulous miracle cure.
FaceSlap
Like everybody else, I’m praying a vaccine isn’t too far off in the distance. First time I typed that, I wrote vacuum, by the way, which may tell you where my head is.

I used to blame that sort of thing on chemo brain; now I think it’s more quarantine brain. It’s Tuesday, right? June 32?

As soon as we started hunkering down in early March and I saw how freaked out people were about the epidemic — all the uncertainty, the life or death odds, the extra precautions we all had to take to stay safe, the lack of a cure — it struck me as weirdly familiar. So I wrote about it for Fred Hutch News Service.

 

For those who’ve been diagnosed with cancer, the onset of the coronavirus pandemic has felt a little, well, familiar. The frantic Googling and data-gathering. The denial and disbelief. The uncertainty and panicky behavior. Cancer patients have been there.

Same goes for all the handwashing and hypervigilance. People who’ve been through surgery or radiation or chemotherapy or bone marrow transplants or other immunocompromising treatments are routinely forced to hunker down at home, avoiding crowds and friends with colds, skipping weddings and air travel and ordering their groceries online.

As one Seattle survivor put it, “I’ve sheltered in place lots of times.”

Did your cancer diagnosis and treatment ‘prep’ you for the COVID-19 pandemic? Certainly feels that way to me, same for the enforced quarantine after my ankle break last August.

Will the losses we’ve endured as cancer patients — family, friends, fellow advocates gone to another invisible enemy — help us bear the inevitable COVID-19 deaths ahead? It’s tough stuff, but as with cancer, we all have to somehow keep powering through.

But right now, it’s all feeling pretty old.

I’m getting corona-cranky after two months of hiding out at home. I’m angry about the people who’ve died and who keep dying because of our country’s clown car response to a deadly pandemic. I’m getting homesick (ironically) for restaurants and yoga studios and my old boring cubicle at work.

So I’m going back to peruse a few of these lessons from cancer patients in the time of coronavirus. Feel free to join me. Or send along your own. I’m having way too many arguments with my cat (and the little snot keeps winning).

#StayHomeStayAlive
#JustKeepSwimming
#FUcancer #FUcovid19

The elephant in the bedroom – yeah, I talked about sex after cancer treatment

3 Aug

elephant

Illustration by Kimberly Carney / Fred Hutch News Service

Sex after cancer is complicated. You know what else is complicated? Writing about sex after cancer.

I tackled the topic last week in a two-part series for FredHutch.org. And even though it felt like I was walking around in my underpants when the stories came out (I talked a little bit about my own experience in this realm), I’m glad I covered it because it’s a big issue for cancer patients and it doesn’t get a ton of attention.

As I said in the story, cancer cuts us to our sexual quick. We lose body parts. We lose our libido. Oftentimes, we lose our sexual selves. Men struggle with impotence; women are plunged into menopause decades before they would naturally arrive; and many are left to sort it all out on their own.

Why? Because people often don’t feel comfortable talking about this stuff – not doctors, not patients, not even their partners. Sex after cancer has become the elephant in the bedroom.

Here’s a link to Part 1, which covers the sexual aftermath of cancer treatment and how surgery, chemo, radiation and hormone treatments — all those things they do to keep us alive — can cause all kinds of sexual side effects, from fatigue and body image issues to erectile dysfunction and vaginismus.

And here’s Part 2, which offers a few experts tips and tricks that we as patients can use to hack our post-treatment sex life.

As I said, it’s not easy to write about this stuff or talk about this stuff. So I’d like to give a huge shout out to two amazing patients: stage 4 anal cancer patient Michele Longabaugh and testicular cancer patient Jon Dibblee. Both were kind and courageous enough to talk about the sexual challenges they’ve faced since treatment and I can’t thank them enough for their candor and insights. Many thanks, also, to Nicki Boscia Durlester and her private breast and ovarian cancer Facebook group, Beyond the Pink Moon. It’s so important to have safe, supportive places like this where patients can bond and bare all.

Did your cancer and treatment lead to sexual side effects? Did your doctor downplay the damage or mention it at all? Let me know in the comments section. Still have more to say? Please join me and the folks at Fred Hutch  tomorrow (August 4) at 10 a.m. (Pacific) for a tweetchat on the topic. Use #ChatFredHutch to join the conversation.

tweetchat image.png

Coming to terms with your post-cancer body

7 Mar

Photo by Robert Hood / Fred Hutch News Service

Photo by Robert Hood / Fred Hutch News Service

Once you’re flagged as somebody who might have cancer, you’re basically strapped onto the world’s worst carnival ride.

The ride starts off slowly at first with biopsies and consultations but then once you’re diagnosed, it picks up speed. Then there are scans, MRIs, surgery appointments, oncology consults and shopping excursions to buy things you’ve never heard of like surgical camisoles. Suddenly, the Merry-Go-Round or Tilt-a-Whirl or whatever it is starts going at breakneck speed. You go through surgery, you go through chemo, you go through radiation, you do it all. You get used to this new reality, this tumultuous spinning wheel of blood draws, port infusions, belly shots of Neulasta, daily blasts of radiation. You go around and around, back and forth, up and down, over and over. You’re strong and on top of things one day; you’re addle-brained and couch-bound the next. You spend all of your time in pajamas and patient gowns. You forget how to talk to people. You forget who you are. You’re bald, boobless, beaten down and burned to a crisp. And then suddenly, you’re pushed off the Tilt-a-Whirl or Octopus or whatever it is and told to go back to your normal life. The ride is over.

The only problem is, you’re still spinning.

Ever see somebody get off a high-speed carnival ride that’s suddenly stopped short? They stagger. They lurch. They might even walk into a pole. Or do a face plant onto the sidewalk.

That’s what life after cancer treatment was like for me: a great big WTF. I couldn’t trust the ground under my feet. I couldn’t trust my own body. I couldn’t even trust the reflection staring back at me in the mirror.

I tried to capture what it was like coming back from that and coming to terms with my new body and my “new normal” in this latest essay for FredHutch.org.

Writing about post-cancer body changes – and body image — has, by far, been the hardest thing to put into words and share with others. To be honest, it feels a lot like showing up at work in your underwear. But as vulnerable as it makes me feel to put this out into the world, I think it’s important to let people know about the collateral damage of treatment. And let other cancer peeps know they are most certainly not alone.

As always, thanks for the read, people.

Reconstruction is not a boob job and other scary stories

31 Oct

October has been a bit of a crazy month for me. I had my second reconstruction surgery at the end of September – followed by a couple of post-op complications – so for weeks, I’ve just been trying to bootstrap my way off the couch and back to normal life. But since it’s Breast Cancer Awareness Month – aka Pinktober – I’ve also been busily cranking out essays and stories about the crab monster and the various ways it messes with our lives.  

Two of those essays went live today.  The first, for TODAY.com, is about how Reconstruction After Breast Cancer Isn’t a Boob Job. Anybody who’s been down the long road to recon knows this (and how), but there are still many people who think reconstruction is something that’s done as simple day surgery in a plastic surgeon’s office. Breast cancer? No problem! Here are your new magical boobs!

For all of those people who think building new breasts is as easy as baking a cake and all my BC sisters who’ve been through hell and back just to regain what cancer stole from them, a few thoughts on the subject:

It’s been nearly a month since my last surgery and the new girls are still a little scary looking. Righty’s recovering from a post-op infection that had me in the hospital on IV antibiotics for two days. Lefty’s missing most of her nipple, a casualty of my first surgery back in May.

They’re bruised and bandaged and look a bit like they’ve been in a bar fight. But they’re mine, thanks to the wonders of breast reconstruction surgery. Or as it’s popularly known, my “free breast cancer boob job.”

I’m being sarcastic, of course. Only a fool would confuse breast reconstruction with a boob job, but sadly, there seem to be a lot of fools out there.

I should know; I used to be one of them, until a radiologist uttered those three little words that have made such a difference to so many peoples’ lives: You have cancer.

After that, everything changed, including my understanding of what women have to go through to get their girls back. And trust me, it’s not easy and it’s not quick.

Unless you’re lucky. Or Angelina Jolie.

And here’s a link to the full essay.

The second piece, written for the Fred Hutchinson Cancer Research Center’s website, doesn’t specifically focus on breast cancer. In fact, many of these tips could apply to anyone diagnosed with a debilitating disease. It’s on 8 Things You Shouldn’t – And Should – Say To a Cancer Patient.

As always, I’d love to hear about your experiences, either with reconstruction or cancer comments that have left you speechless. Sorry for the short post but as I said, this month is crazy.  And it’s not over yet – today’s Halloween! Take care and thanks for the read, my friends.

Climbing back into the mouth of the beast

24 May

attack of the crab monstersFor those of you who haven’t noticed (as far as I can tell, there are about three who have),  I am the world’s worst blogger.  Or maybe I should say, the world’s most sporadic blogger.

When I was going through treatment, I blogged about the breast cancer beast a lot. Probably because treatment is pretty frigging surreal and you have to write about it and talk to other people who’ve gone through it, otherwise, you start to feel like maybe you’ve gone slightly insane. Nurses purposefully injecting you with poison? Technicians tying you up and easing you into a machine, then fleeing the room while they blast you with radiation? WTF? Who would do such a thing?

But that’s cancer and what the docs like to call cancer “treatment.” You come out of that crap and your hair starts to grow back and your strength returns and you just want to keep walking — or in my case, running — as fast and far away from Cancerworld as humanly possible. You want to forget it all and just live your life, worrying about the trivial crap you used to worry about BC (before cancer). I can’t meet any decent single men. Hrmph. I’ve got fun plans this weekend and now it’s going to rain. Waaaaaah!

You don’t want to think back to how hideous it was dealing with those drains after the double mastectomy or how your bones felt like they were being ground into powder by a giant during chemo or how horrifically ugly and dehumanized you felt every time you looked in the mirror when the doctors were finally through with you. Bald, board flat, chest burned to a crisp, I looked like a stand-in for Gollum from Lord of the Rings. Not something you want to keep on speed dial when it comes to calling up memories. I wanted to forget.  And part of forgetting for me, has been ignoring the fact that I’m supposed to be writing a breast cancer blog.

If you’ve been there, I’m sure you get it.

Also, if you’ve been there, I’m sure you understand how difficult it is to suck it up and climb back into the mouth of the beast yet again.

Don’t get me wrong – I’m not experiencing a recurrence or anything like that (knock wood). Instead, I’m currently going through the joys of breast reconstruction which for me has been every bit as difficult and painful and worrisome as the original surgery and treatment. And I’m just getting started.

I’ve had one surgery so far and am still very much in recovery from that. At this point, things are a little iffy and I’m hoping to write more about my recon and what’s happening with that in days to come. And that just might happen since my doctor has advised me to forget exercise and activities and basically just lie around my apartment like a three-toed sloth doing this incredibly boring thing called healing.

What the hell, might as well fire up the blog again, right?

For the moment, I can tell you that I went with a new type of recon known as Brava / fat transfer. Here’s a link to a story I wrote about it for TODAY.com last year. This type of recon is supposed to be less invasive than traditional recon, particularly those flaps, where the plastic surgeon cuts a slab of tissue, muscle and blood vessels from your stomach or your back or your inner thigh, sews it to your chest and magically turns it into a boob. 

I knew reconstruction was serious business going in, which is why I put it off for a year and a half after treatment. I wanted to make sure my body – and particularly my left radiated breast – had healed. I boxed three times a week to stay fit – and to keep those pectoral muscles full of healthy blood flow. I ran to keep my weight down (more accurately, to keep those tamoxifen pounds from glomming on) and to keep my heart rate good and strong.

I exercised to keep the beast from catching up with me again. And to get into shape for recon surgery. But it still kicked my ass.

I had my first fat transfer procedure two weeks and two days ago (May 8) and if this is the less invasive kind of reconstruction, I don’t even want to think about what my BC sisters who’ve had flaps and tissue expanders and implants have gone through. Seriously, the next time some moron refers to breast reconstruction as a “boob job,” I’m just going to coldcock ‘em – literally, metaphorically, whatever. As soon as I get my left hook and my right cross back, that is.

Anyway, I know this post is somewhat scattered. A little weak in some places, a little angry in others. A bit purple here and quite dark there. In fact, worrisomely dark there. But it’s also a pretty accurate reflection of what’s going on with my body right now. At present, I’m on antibiotics and don’t appear to have an infection. Yet. But things are starting to go sideways which, as anyone who’s dealt with cancer can tell you, is par for the course.

I’m trying to hang in there; I’m trying to be patient. And though it’s difficult, I’m trying to remember back to what I went through two years ago – the surgery that took my girls, the chemo that took my hair and my strength, the radiation that turned me into a crispy critter – taking comfort in the fact that I made it through all of that. I’m pretty sure I’ve got the strength – or maybe just the sheer orneriness – to get through this, too.

Hope you’re all doing well. Thanks, as always, for the read. And for those who might be interested in what I’ve been working on lately, here are a couple of links to recent stories I did for nbcnews/TODAY.com on breast cancer-related topics.

Mom’s virtual cancer family helps daughter cope with loss
Like an idiot, I wrote this story one day after surgery. I do not recommend this.

Breast cancer bras a no-go for Victoria’s Secret
The latest on the push (no pun intended) for a Victoria’s Secret “survivor bra.”

Boxing, blogging and trying to ignore the breast cancer beast

30 Oct

Photo courtesy of Jim Seida / NBCNews.com

Yes, I know it’s been a while since I posted anything. I’ve had a busy summer — hiking, baking, boxing and most of all doing this thing I like to call “pretending I never had cancer.”

But summer’s over and fall is here and with it, October, the month when it’s pretty much impossible to forget your breast cancer because everywhere you look people are dressed like gigantic pink ribbons and/or talking about their battle with the beast. And I suppose I’m no different.

I wrote a series of essays last October about my BC diagnosis, my double mastectomy and what it was like to go “out there” and date while going through breast cancer treatment, to try to find love in the time of chemotherapy.

My latest essay, published today on nbcnews.com/TODAY.com, takes up where those other essays left off, delving into some of the ripples you experience after diagnosis and treatment, as you try to navigate that weird territory known as survivorship.  Here’s a snippet:

There’s nothing like having cancer to make you appreciate the little things in life — like buying shampoo, running a few miles or being able to forget the address of the hospital where you were treated.

After I was diagnosed with breast cancer in February 2011, I felt like I lived at that hospital. Today — a year out from treatment — it’s in the rear view mirror, along with the double mastectomy and debilitating chemo and radiation I wrote about last October on TODAY.com.

Not that there aren’t still plenty of daily reminders regarding my year of living cancerously: chemo brain, adhesion pain, hot flashes (courtesy of my new BFF tamoxifen) and, oh yes, my board-flat Olive Oyl chest.

But there have been good, uh, developments, too.

The biggest one — for me — is that I now have hair. For those of you who think baseball is slow and tedious, all I can say is try watching hair grow sometime.

I disguised my bald head with a wig from mid-June until New Year’s Eve then gratefully ditched it, along with the tape, the itchiness, and the constant fear that I’d accidentally spin the thing around backwards while swing dancing like some character on Gilligan’s Island.

Come January, I let my freak flag fly and began rocking a dark gray micro pixie.

“With the wig, I was trying to pass as a healthy, normal woman,” I joked to my friends about my super short ‘do. “Now, I’m trying to pass as French.”

You can read the full essay — and check out more pics of me boxing! — here.  As always, thanks for stopping by. And please feel free to share your story — or favorite survival tip. We’re in this together, people.

Kicking cancer’s sorry ass

10 Jun

I “celebrated” my one year chemoversary this week. Last year, on June 6, I was sitting in a blue Barcalounger up at Cancertown for the very first time, waiting for the nurses to flood my body with a deluge of drugs: some poisonous, some designed to help me withstand the poison.

Celebrate, of course, isn’t quite the right word. Who celebrates the onset of excrutiating bone pain, nausea, fatigue and hair loss? 

I am thrilled, of course, to be a year away from all of the pain and the powerlessness of last year’s chemotherapy. Although to be honest, I’m sort of going through it again now (sans the hair stuff) thanks to my latest obsession: boxing.

I’m not sure where my fascination with boxing came from. I used to work out at a gym where they had a speed bag tucked away in a far corner and I would play with it in between lifting weights and doing cardio, finally figuring out how to pummel the thing without having it pummel me back. It was therapeutic to pound away at all the stressors in my life — a cranky boss, a misogynistic coworker, a bad boyfriend.

After I quit the gym, I missed pounding away at the bag. So much so, that two decades later (at the age of 51 and a weight of about 190 pounds), I took a couple of boxing fitness classes at a Seattle institution known as Cappy’s. The class nearly killed me — I practically had to use the wheelchair lift to get on and off the bus afterwards — but I loved it. Unfortunately, my Achilles tendons didn’t. The jumprope warm-up exacerbated an old injury so I had to put my gloves on the shelf.

I didn’t shelve the exercise, though. I started walking and then running and then tap dancing and swing dancing. I also began watching what I put in my mouth and, to be honest, put a lot less in my mouth (I even managed to kick a lifelong friend — starchy carbs — to the curb). Within six months, I’d dropped 50 pounds and was feeling a lot better about myself and my body. At least, I was until I found a weird little tuck on one of my breasts.

Cancer had dealt me a firm left hook. And a right hook, as well, as it turned out. I had tumors in both my girls. But I made it through the surgery, the chemo, the radiation, and the recovery and now I’m hitting my one-year cancerversaries fast and furious.

You might even say, I’m knocking them out one at a time, thanks to the punches and combinations I’m learning in my new boxing class at Belltown’s Axtion Club.

That’s where I celebrated my chemoversary on Wednesday. And yesterday, I went back for my sixth session, an amazing feat considering that — just as before — the very first class nearly did me in. Each hour starts with an intense warm-up that begins with jumprope (my Achilles tendons have healed, apparently) and then folds in a slew of other exercises. There are footwork routines, medicine ball drills, punches and my personal favorite — one-handed push-ups. (The first time the trainer — a gorgeous South American demigod of a man — demonstrated these puppies, I nearly did a spit-take. Who does that?)

Thanks to the double mastectomy, the chemo, the radiation, and the fact I haven’t done a lick of upper body work for more than a year, I’m not even close to doing a one-handed push-up or these other ones that involve twisting one leg into some ungodly froglike position. I’m barely able to do two-handed push-ups. Girly style. But I give them my all. Ditto for the rest of the warm-up and the sparring that comes later. And so far, I haven’t embarrassed myself too much. Or at least I haven’t thrown up in class (according to the trainer, it’s happened).

But it ain’t easy. Nor pretty. Not knowing what I was in for, I wore makeup to my first class and by the end of the hour, my eyes were burning from a steady, sweaty stream of foundation and mascara and eyebrow powder (chemo took my brows so if I want ’em, I have to paint ’em on). These days, I go to class with only a hint of lipstick and not much else (yes, people, I am clothed). I even wear a headband, Olivia Newton-John style, because I’m such a Sweaty Betty, either due to the incredible workout my out-of-shape body is getting or the tamoxifen I take every day (it doesn’t give me hot flashes, but I’m definitely feeling the occasional hot flush). 

At the end of the hour, my head and body are sopping wet, my face is flushed and puffy and I look like a small, sweaty version of Billy Crystal, thanks to the out-of-control chemo curls. But I don’t care. Despite my long standing position as a girly girl, despite my overwhelming urge to “pass” (and trust me, the missing eyebrows are a dead giveaway), I’ve decided I’m not there to look pretty. Or normal. Or nice. I’m there to learn how to box. I’m there to get strong. I’m there to do whatever I can do to kick cancer’s sorry ass.

Am I crazy for pursuing a sport that makes me feel as nauseous, as fatigued, as overwhelmed by pain as the chemo I went through last summer? Maybe. It does feel strikingly similar to the infusion aftermath we all know so well, particularly a chemo session capped by one of those nice juicy Neulasta shots. You know, the ones that give you instant arthritis in your hands and feet.

The day after each boxing class, my hands ache from the punches I’ve given (and received). My arms can barely lift the blow dryer to dry my hair (ah, but what a miracle it is to have hair). It even hurts to pull my pants up after I pee. I’m beaten down, I’m bruised, I’m once again grabbing the furniture to hobble around my house. But then I take a few Ibuprofen and drape my body in ice packs and soak in a hot, hot bath filled with Epsom salt.

And then I get back up and do it again a couple of days later. Just as I did with the chemo. Just as we all do. Except this time, I’m going through the pain by choice. And this time, it’s not making me weaker, it’s making me stronger. This time, I’m transforming my body on my terms — through strength and endurance and sheer will as opposed to a surgeon’s scalpel. And this time, I can stop whenever I want. It’s just that I don’t want to stop — not yet anyway.

Not until I can get my scarred and poisoned and radiation-ravaged body to squeak out at least one of those wacky one-handed push-ups. Not until I can pound out a bit more of my grief and frustration and fear and, yes, pure unadulterated rage at being sucker punched by cancer.

It’s my party and I’ll cry if I want to

15 Apr

So I had quite the party last night. There was music, there was wine and there was me, curled up on the couch with a heating pad, an old timey quilt and an ever-diminishing box of chocolate cookies. Yes, as you’ve probably guessed, I was the guest of honor at a good old-fashioned pity party last night, brought to you (or me, rather) by Living with Cancer and My Bad Attitude Productions.  

I’m still not sure what exactly happened or why it decided to happen on what must have been the most gorgeously vibrant spring day in Seattle history. I woke feeling a little under the weather, with fever, chills and a bit of a sore throat and for some reason couldn’t convince myself that going out for a run would be the thing to lift my spirits and clear my head. Instead, I pointedly ignored my running shoes (and the running laptop) and started watching Sex and the City (the movie), which didn’t exactly help my mood. (How could Big do that to Carrie? Why is Carrie reacting like such a dork? And what the hell is with that bird on her head?)

Before I knew it, morning had blended into early afternoon, which then coasted slowly towards late afternoon. And I still hadn’t left the house. I’m not even sure I ate anything, although I did take my medication: the anti-anxiety pill, the tamoxifen, the two tabs of Vitamin D and one tab of Vitamin B12, all chased down by a fish oil tab the size of my little finger. I take all of this crap every day (and more on days when I have bad chest pain or a migraine or can’t sleep), although the only pill that really counts is the tamoxifen, which acts like a hawk-eyed chaperone at a seventh grade dance, perpetually shouldering its way between those two old lovebirds — estrogen and cancer — so they can’t hook up and produce a slew of baby tumors.

And that, I believe, is what was … or is … at the heart of my funk (truth be told, I haven’t quite kicked it yet).

Not that I have any reason to be in a funk. Last Wednesday, I had a stellar one-year follow-up with my breast cancer surgeon, who told me that my left side had healed so well she couldn’t even tell that I’d had radiation there. Plus I’m working as much as I was pre-diagnosis; I just got back from a trip to Arizona and Texas; and spring has finally sprung in Seattle, chasing the constant drizzle and gray away with glorious sunshine and days that stretch on forever (or at least until 8 p.m.).

And yet yesterday (and even Wednesday while talking to my doc), all I could think about was the dreaded R-word: recurrence.

Obviously, with no more “mamm” to gram, that particular method of breast cancer screening is off the table. And in the year since my surgery, I haven’t received an ultrasound or MRI to see if any new tumors have sprouted in my chest. I also haven’t received  any assurances or guarantees that I’m completely out the woods and that I’ll never again have to climb onto the bad carnival ride that is cancer treatment. Instead, I’ve been living in Limbo Land, where ever ache and pain is ripe for a new kind of dark, desperate scrutiny.

My BC surgeon said that a physical examination — which she performed while we chatted about reconstruction, swing dancing and whether or not I could take up boxing — was the best way to determine if I was developing anything hinky in my chest. But what about all the other areas of my body? My liver, my lungs, my bones, my brain — all those places where breast cancer likes to pop up and wreak havoc like a bitter, inebriated ex-boyfriend at your first major book launch.

That’s where things get a little muzzy. According to my oncologist — who’s gone over my recurrence rates with me on more than one occasion — I need to tell her if I start “feeling bad” or suddenly develop a weird persistent pain. Or, I imagine, I end up with a broken rib after getting a hug or a have a seizure while grocery shopping.

Do fever and chills and a sore throat fit within the “feeling bad” category, I wondered yesterday, watching bright sunshine blur into gray dusk. (Or was the fever not a symptom of a cold at all, but one of those infamous hot flashes I was told I’d get as tamoxifen hip-checks me into menopause?) And while we’re on the topic of hinky things developing, what about that sore spot under what used to be my left breast. Was that a tumor starting to sprout or had I knocked myself with the vacuum cleaner handle yet again?

Oh the places you go when you’ve had cancer.

And the things you say. Friday night over drinks with a girlfriend, I casually mentioned that I knew I wasn’t going to live all that long.

“Once you have cancer, you tend to get it again,” I told her, sipping my martini and grazing on a goat cheese, mint and bacon-sprinkled bruschetta. (Might as well live it up, since I’m going to die in ten minutes, ten days, ten years or whatever, right?)

“I’m feeling really blue,” I texted another buddy last night while cancelling plans. “I don’t want to die young and I know I’m going to now.”

Who does that? Who dumps that kind of crap into the laps of their friends? Certainly not me, unless I’m in the throes of a deep emotional funk. Which may or may not be something I should report to my oncologist (Hmmm … I’m normally so upbeat. Perhaps my foul mood is symptomatic of a brain tumor?).

It’s probably just the cold (or allergies) taking me to this dark place. Or the spate of friends and former neighbors who’ve recently lost (or are in the process of losing) a parent, grandparent, spouse or beloved pet. Maybe it’s the one-year anniversary of my double mastectomy, which looms on the horizon like a tax deadline. Or hey, maybe it’s the frigging tax deadline itself.

Whatever the case, I’m blue because I hate not knowing what the hell is going on with my body and knowing that I’ll never really know as long as I live, which I hope will be a long, long time, but chances are it won’t because of this crappy disease.  I’m blue because I’m a bit of a control freak and cancer is not something you can control. Or predict. Or prevent, no matter how much sauteed kale you consume (and trust me, I’m consuming a lot these days). I’m blue because recurrence happens; it’s happened to friends and family members and to some of my cancer buddies on Twitter and while some of these people have been able to stay on top of the disease, it’s not always possible to kick cancer to the curb once it starts “traveling from organ to organ like a gypsy caravan,” in the words of the late, great Dave Hodgson.

I’m blue because it’s gorgeous out and I should be out there celebrating the sun and the spring weather and the life I have while I have it, but instead I’m moping around the apartment “giving in to myself,” as my mother used to say. I’m blue because I’m usually the one trying to cheer other people up when they confess these kinds of dark thoughts and for some reason, I’m not quite able to do that for myself.

I’m blue because I’m angry and scared and don’t feel well and because I have to pay a bunch of money in taxes and I gained like four pounds while visiting my sister in Texas. I’m blue because I don’t have a Mr. Big or a body (or budget) like Sarah Jessica Parker and because despite having cancer, I’m just as shallow and self-absorbed as I ever was.

Oddly enough, though, now that I’ve gotten all this crap off my chest, I actually feel a little better. Thanks for the ear, folks and for stopping by my little pity party, which as of this moment, is officially closing down. Time to go run in the sun. Time to stop whining and live.

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