A Patient's Perspective on Clinical Trials

[My speech given at the University of Calgary on April 8th. Revised for privacy reasons.]

Before my diagnosis, I just celebrated 10 years of a rewarding career in healthcare. I enjoyed educating people and encouraging them to be proactive in their health. Outside of my professional life, my husband and I were avid travellers. Around that time, I had about thirty countries under my travel belt and had plans to add many more. I picked up running at age 14, had completed a half marathon and planned to someday finish a full marathon. Eventually, we had planned to start a family. 

But plans change. My story begins in the fall of 2012, when I started noticing shoulder pain. My colleagues and I thought it was work-related. There was no reason for me to think otherwise. But the pain worsened steadily despite the usual route of therapies: physio, massage, acupuncture, in addition to prescription anti-inflammatories and analgesics. A year later, my symptoms became unbearable. I became susceptible to frequent respiratory infections, and noticed increasing shortness of breath. An MRI investigating my spine incidentally discovered the single lung nodule that would set off a cascade of tests. A month later, in December 2013 at the age of 37, a biopsy confirmed the diagnosis: stage IV lung cancer (NSCLC, adenocarcinoma). The news was devastating and shocking. How can a healthy, young female who's never smoked develop lung cancer? Well, apparently, there’s a little known fact that never-smokers account for 15-20% of lung cancer patients.  But among the despair and grief that come with a cancer diagnosis, came hope. I tested positive for the EGFR mutation, which meant my first line of treatment was oral targeted therapy.  Within a week of starting gefitinib, my symptoms began to improve. Within 2 months, I was back to running on the treadmill.  I was even healthy enough to spend 2 weeks actively exploring and enjoying beautiful Iceland with my husband. This wonder drug gave me my life back. During that time, living with cancer was tolerable, almost normal except for some annoying drug side effects. Unfortunately, cancer figured its way around Iressa. About 11 months after starting gefitinib, my symptoms returned and progression/drug resistance became obvious.

When my cancer journey began, I intended on following my own advice and be proactive. Fortunately, with my health sciences background and connection with family and friends in the medical field, I wasn’t afraid to ask questions, or look beyond established standards of care.  From day 1, I knew the treatment options for stage IV lung cancer were very limited.  The 5 year survival rate was grim. I remember already inquiring about clinical trials the first day I met Dr. B. So, by the time drug resistance was confirmed, I had decided that enrolling in a clinical trial was my next step. Cancer forced me to learn to live with uncertainty. I knew there was never a guarantee of a good response to any cancer treatment and that belief helped me overcome the fear of the unknown that comes with participating in clinical trials. But I also realized that qualifying for a clinical trial requires accessibility, timing, and preparation.  A Phase 3 trial on a new drug was about to open in Edmonton, possibly even in Calgary. To get the ball rolling, a new biopsy was performed in a timely manner in Calgary but because the clinical trial was actually only available in Edmonton, to our disappointment, my husband and I had to make the 6h round-trip journey to Edmonton to meet the clinical trial team and sign consent forms so the tissue sample could be released to the Cross Center, then sent to the clinical trial approved lab for mutation testing. We were reassured that things would move quickly from there. But, a week later, we found out that there was another delay because a payment was required before the sample could be transferred. Finally, 6 weeks after my biopsy, I got the call. "No, I'm sorry, you don't have the mutation to qualify for the study". All that time and effort in travel, needless delays, and subsequent anxiety, only to find out I didn’t qualify. So what options, other than beginning chemo, did I have at this point?  Shortly after the rejection call, I received a follow up call from the Cross Centre. Would I be interested in enrolling in a Phase 1 study? I already have the mutation to qualify but another biopsy may be needed, this time in Edmonton.  Despite the many unknowns with Phase 1 trials, I knew this was my best chance to access a new treatment and hopefully improve my chances of long term survival. After doing my usual research on the trial drugs, I accepted the offer. Chemo can wait.  I knew finding another trial I would qualify for wouldn’t be easy. But again, this meant more waiting!  Wait for another biopsy to be scheduled. Wait for results. Wait to sign papers. Wait for more tests. Wait for more progression and increasing symptoms. Wait for the unknowns. But all this waiting will be worth it if this new drug offers me more time and a better quality of life.

Things to take from my experiences:

Why are Clinical Trials & Phase 1 trials important to patients?

As you can see in my situation, Phase 1 trials offered me the chance to access a new treatment where phase 2/3 would not have accepted me. For those of us with limited or less than desirable treatment options, clinical trials offers us new hope. More clinical trials, especially phase 1 trials, means more patients can qualify for more treatment options, potentially finding something that improves quality of life, extends life, or, at least, stabilize disease progression long enough until the next accessible clinical trial or breakthrough treatment becomes available. 

Another lesson I learned from experience, in order for patients to take advantage of Clinical Trials, trials need to be accessible!

1.  According to the Addario Lung Cancer Foundation (San Francisco), 85% of patients are unaware that clinical trials are an option.  Only 3% of patients actually enroll in trials [8% in Canada]. In my opinion, patients ought to be informed that clinical trials are a treatment option before first line treatment even begins. It is a personal choice, but patients can’t make that choice if they aren’t aware. Being informed early will also help patients plan for trials.  From personal experience, it takes strategy, research and preparation to know when and which trial to attempt to enrol in. Am I able to commit to the frequent follow ups, tests and travel time? Am I excluded because of the number or type of treatments I’ve already undergone? Have I progressed too far to enrol? Do I have potential for a good response in this trial? Patients should also know that clinical trials are not meant only for patients who have run out of options. They should consider them when the right trial is available, when they qualify, when they are still physically capable, when the risk of waiting is not life-threatening, etc.

2. Of course, the time needed to get to the clinical trial site can be a significant deterrent. Having to travel 3h to access a trial is not convenient.  Given the option, I would prefer not to ask my caregiver to take a day or two off work to accompany me to Edmonton, I prefer not to be taken away from my daily routines and the comforts of home, I prefer not to be taken away from my support network of family and friends in Calgary.  I prefer to spend what spare time I have enjoying life, not traveling long distances to and from frequent appointments. 

3. Lastly, unnecessary delays in accessing a trial can be stressful enough to make us second-guess our interest in joining a trial. Cancer patients live with a sense of urgency, rightly so. Here I am with worsening symptoms, anxiously waiting for the one and only Phase 1 trial in Alberta that I tentatively qualify for to open, 5 months after obvious tumour progression began.  A cancer patient’s time is valuable, and a lot can happen in a few weeks or a few months.

In conclusion, if more patients are properly informed of clinical trials, and if more trials are available and accessible, more patients can enrol and help pioneer new cancer treatments. With the growing prevalence of cancer, Calgary, with its population of over 1million, and the rest of southern Alberta need better access to clinical trials, and thus more potentially life-saving opportunities closer to home.  Despite all the challenges cancer patients face, those like me still choose to take a chance on clinical trials. We stray from established standards of treatment because we believe there is something better out there; effective treatments that have yet to be discovered, ones that give us new hope for a better outcome.  

As One Door Closes, Another Opens

Victoria's cherry blossoms in full bloom

I received the unfortunate news shortly after my last blog post. I don't have the T790M mutation so do not qualify for the AZD9291 Phase 3 trial :(. The news was upsetting since I had so much hope in this new drug. At the same time, I almost expected it. Call me crazy but I had a dream two nights in a row of a woman telling me I didn't have the mutation. I thought it was odd but I think it prepared me for the bad news. What made the bad news even more bearable was that we were vacationing in beautiful Victoria, BC, which was in full spring time mode, at the time. The fresh ocean air, lush greenery, and cherry blossoms would uplift anyone's spirits. I truly believe that everything happens for a reason. I wasn't meant to enter that trial. So ok to close that door.

A day after the "bad news", the head clinical trial researcher called me and asked if I would be interested in a Phase 1 trial available at the end of April. The nice thing about phase 1 trials is they have less strict qualification requirements. The bad thing is, you have no idea what you're getting yourself into, sort of. I researched the trial drugs and deemed it as having a decent potential for a good response. I opted to get the information from the trial nurse and will decide from there. A new biopsy may be needed if there isn't enough tissue left from the previous mutation testing.  Hopefully, there's plenty good tissue remaining for this trial to test! Waiting to hear back on that status...

Once home, we went to see my oncologist to discuss the options. Phase 1 clinical trial? Chemo? Afatinib? If I were to stay qualified for the trial, Afatinib was out. My pains were steadily worsening and tumours continue to slowly increase in size so I wondered if I could wait for the trial to open. Then the option of palliative radiation came up. We met Dr. H on March 31st and, after a good discussion, decided to proceed with palliative radiation. The goal: reduce or stop the pain from worsening. Possible other benefit: tumour shrinkage. Possible side effects: sore throat, skin burn, fatigue, radiation pneumonitis (most serious). But because this treatment is palliative not curative, the radiation dose is much less and I will only undergo 10 treatments (ie 2 weeks) vs 7 weeks (curative but much more risky). The discussion was so simple that I wondered if I was missing something. The radiation oncologist reassured me it was that simple. Forgot to mention that he looked like Doogie Howser, fresh out of school! But he seems trustworthy enough. So another cancer treatment adventure awaits! Wish me luck! ...again. 

I was asked by Dr. B to share my experiences at a research meeting where the goal was to bring in more Phase 1 trials into Calgary.  This was something that would benefit me and possibly so many other patients in southern Alberta, so naturally I agreed.  It wasn't a stressful task until I received this statement from my oncologist by email: "Don't underestimate the impact of your words". Yikes, no pressure. I presented my short talk today (April 8th), a little nervously, and the response was great! The audience was comprised of oncologists, researchers, ethicists, pharma reps, psychologists, and all their support staff. I met a few more oncologists who thanked me for sharing my experience and opinions, especially  because it was done so in a concise scientific manner (helps to have a health sciences background).  I just hope it was impactful enough to motivate them to actually bring more clinical trials to Calgary.  I will post a shortened version of my talk as you may find it informative also. 

In the meantime, I have to figure out how to make traveling to Edmonton work if I were to enrol in that Phase 1 trial. And prep (do nothing?) for my first palliative radiation treatment which begins tomorrow!

Trials, Tribulations & Outliers

A lot has happened since my last blog entry. The core biopsy went well; uneventful thankfully. Unfortunately, it's been over a month since that occurred and the sample is just now being tested thanks to clinical trial red tape. The clinical trial will not take place in Calgary so all samples must go through Edmonton and its clinical trial approved lab. S and I took a day trip to Edmonton awhile ago to sign consent forms to allow the release of my biopsied tissue sample for testing. We are now waiting to find out if I have the T790M mutation which will qualify me for the AZD9291 Phase 3 trial. One risk entering a Phase 3 trial; they will be comparing the trial drug to the gold standard. This means I may be randomized to enter the chemotherapy arm. Such is life. I have learned to accept whatever cards I am dealt. I just have to play those cards well enough to stay in the game!

In addition to clinical trial stuff, February was quite busy. I decided to challenge (or punish) myself by taking on a 30 hour continuing education course to keep my professional licence up-to-date. This concluded with a 2 day, 16h seminar, interrupted by... food poisoning!!! Damn you Thai food! Or was it the sushi? I haven't had a craving for either since. Oy, that was a rough weekend! 

On a good note, with all this talk of my cancer progressing, it was time I made a trip to Chicago. Awhile ago, I discovered the book "Life Over Cancer", by Dr. Keith Block,  an integrative medical oncologist who established his own integrative cancer centre in Skokie, Illinois (north of Chicago). His philosophy is to complement conventional medicine with diet, exercise, bio-behavioural techniques, herbs and supplements, etc. His recommendations are based on biomedical/scientific research; stuff that the average oncologist or physician tends to overlook. In my opinion, a physician who combines conventional medicine with effective complementary treatment, including nutrition and exercise, is a powerful resource.  It has always been my belief that a successful cancer treatment involves looking into all aspects of one's lifestyle, body, mind and spirit. The Block Centre followed this philosophy so, after news of my cancer progressing, we arranged a full consultation (private pay for us Canadians). We met Dr. Block and his team in mid-February. Unfortunately for us, this was also when Chicago was having one of its coldest weeks (just like much of the east coast)! Brrrr!!!  Anyway, the appointment took half a day, plus the following morning for blood tests. I spoke to a dietician (Block trained so totally agreeable!), a biobehaviourist (Dr. Block's wife, Penny), one of Block's oncologists (not needed) and finally, Dr. Block himself. Dr. Block is a fountain of anticancer knowledge!! He has been researching integrative cancer care for 30 years. For the most part, based on the consultation, I seem to be on the right track, only needing to make a few tweaks to my wellness routine. Here's some points you may find interesting or helpful:

1. In addition to my (selective) fish friendly vegetarian diet, I need to give up all milk and milk products completely. I was eating goat milk products, which is better than cows milk, BUT all milk, regardless of source, contains growth hormones. For a growing calf, growth hormones are great. For a cancer patient, growth hormones promote the growth of cancer cells! Bye bye dairy! (The same reasoning goes behind eliminating meat on an anticancer diet). 

2. A well rounded exercise program, which includes aerobic exercise, strength and flexibility training, will help your body avoid injury, and recover faster from illness or trauma, in addition to boosting your mood. I was asked to see a physiotherapist to strengthen my left side, which has significantly weakened over the past two years. This certainly does make me more prone to pain and injury. It pays to stay in shape! 

3. "Sugar feeds cancer". This supposed myth actually has some truth to it. The statement is just oversimplified. The real problem is hyperglycemia. High blood sugar and high insulin levels have been linked to tumour growth. So instead of just cutting out "sugar", we really ought to be regulating our blood glucose. Eat 4-5 small meals a day instead of 2-3 large meals to avoid insulin spikes. White potatoes, white flour, white rice are all high glycemic index foods so cut those out. Drink green juices (which lack fiber to help regulate sugar spikes) with nuts or other high fiber/high protein foods. Eliminate all processed sugars. If you need to sweeten drinks or foods, use maple syrup or stevia but do so sparingly.

4. Mindful meditation may be helpful for pain control. Dr. Penny Block even suggested hypnosis. Being in pain negatively affects one's state of mind. Take the pain away and your mood and outlook improves immensely. Interesting fact, regular meditation can alter gene expression. Block recommends meditating at least 20mins in the morning and 10mins at night. 

5. The best thing the Block Centre gave me was HOPE. There are indeed longterm survivors of stage 4 lung cancer, despite what the statistics say. These people are outliers. I am determined to be an outlier... 

13 Month Health Update

I'll cut to the chase. It's time to move forward. My latest set of tests showed further progression, albeit small. Unfortunately, my shoulder and back pain seem to coincide so I wasn't surprised to hear the results. After a lengthy discussion with my oncologist, we decided to proceed with a biopsy as long as the radiologist can safely access one of the nodules. The intention is to have my biopsied tissue sample ready once the clinical trial opens up in Calgary, or we find out we need to go to Edmonton. I am currently waiting for the phone call to arrange the biopsy. Fingers crossed for a successful sample! If this falls through, I proceed with chemo. As much as I don't like the idea of infusing toxins into my body, I have come to realize it's no big deal. In the meantime, I wait, get my pain under control, and try to sleep. I restarted the iv Vitamin C to boost my energy and immune system (horrible flu season seems to have affected everyone but me! Knock on wood) and my acupuncturist started me on some Chinese herbs, which also helps with my energy. Staying positive. Staying hopeful. Still enjoying life the best way I can. 

One Year Ago...

December 28th was my first "cancerversary". One year ago, I was given my lung cancer diagnosis. I am happy to say, despite beginning with hopelessness, despair and grief, this past year turned out pretty amazing after all. 

Once I got over the initial shock and devastation, I spent the year trying to find ways to live a better life--physically, emotionally, mentally, spiritually. Cancer gave me a different outlook. I destressed, detoxified, decluttered, unburdened, simplified, connected.  I learned to let go of obligations. I became truer to myself. I slept... a lot and don't regret it. One of the more important things I learned was to accept the fact that I have limited time on this earth, as we all do. I think all cancer patients are forced to realize this earlier than we should. So be it. Accepting that I have limited time on this earth is not to say that I have less of a drive to live. Quite the opposite actually. I now have a better appreciation for the life I have been given and try to live everyday to the fullest. I've come to understand that living life to the fullest doesn't mean dropping normal daily routines to achieve everything I ever wanted to do or spending every second with those dearest to me. No, to me it means taking better care of myself, listening to the needs of my body and soul. Allowing my mind time to linger in the peacefulness of silence.  Waking up grateful for every new day. Being constantly amazed by the beauty of this Earth. Learning not to feed the fear in me but rather focus on my hopes and dreams. It also means learning to accept people for who they are. Understanding that compassion means believing that every person on this earth is trying to live their best life, to whatever capacity they can. It means realizing that my purpose in life doesn't need to be anything grand. It could be as simple as being happy with who I am, sharing what I have learned with others, or using my abilities to contribute to a better world.  Yes, the devastating diagnosis of cancer made me realize all the above. For that, I thank you cancer.

Thank you friends and family for helping me enjoy another holiday season, and I look forward to many more with you! Any monetary gifts to us will be donated to the Lung Cancer Translational Research Initiative, because helping to fund lung cancer research is more important than anything we can ever buy ourselves. Thank you so much for your generosity! Anyone looking to donate to a charity or worthy cause before the end of 2014, please consider the University of Calgary's lung cancer program (netcommunity.ucalgary.ca/lungcancer).

With much love and gratitude, we wish you all a very healthy, happy and extraordinary 2015! 

Bermuda Shorts and Shores

I added one more country to the list of places I've been :).  I was dreading the cold winter weather even before it arrived, probably because of bad memories from last fall/winter when it was quite uncomfortable for me to breathe in cold air, and, frankly, the travel bug was biting me again;). This time, I felt no hesitation because of my health. Regardless of what the CT scan would reveal, I felt healthy enough again to travel abroad especially for some sun and relaxation! 

Bermuda seems but a distant memory now that we are entrenched in this cold "fall" weather. This small subtropical island is only 22 miles long and 1 mile wide in most places.  It has a population of about 65,000, not counting tourists. The currency is the Bermudian dollar, although I never saw it since they also readily accept the US dollar at par.  Bermuda weather is not too hot (about 30 degrees Celsius at the peak of summer) and not too cold (no colder than 10 degrees Celsius at the peak of winter). In November, Bermuda averages about +25C which is just right for us! November is also the end of cruise ship season for Bermuda so we didn't have to contend with the crowds anywhere we went... although, there's only so much one can see and do on a 22 mile long island. The residents all speak a fluent dialect of English.  I don't really know what Bermudian English is, but a lot of the locals seriously sounded like New Yorkers! Because Bermuda is a British colony, they drive on the left-hand side of the road.  Tourists are only allowed to rent scooters, not cars, apparently for the safety of the island residents. The main industry here is actually insurance and banking, not tourism. 

Note red Bermuda shorts with suit!

Men like to wear bright coloured knee length shorts, pulled up dress socks with dress shoes, a tie and blazer as their business attire. That's when the term "bermuda shorts" made sense to me! One other interesting fact about Bermuda, every house is mandated to have limestone white roofs designed to direct rainwater into an underground water tank, which is used to supply homes with their water needs--a very green idea! We initially wondered if our accommodation would run out of water but, as it turns out, we didn't need to worry... It rains a lot in Bermuda!

The white limestone rooftops

Hurricane Gonzalo ravaged Bermuda two weeks before we were to depart. They experienced extensive tree damage, floods, and a week-long power outage. But there wasn't much damage seen by the time we arrived. Anyway, no long story here. We opted for a small studio apartment in Southampton, a friendly community 40 minutes cab ride from the airport and 20 minute bus ride from the capital city of Hamilton.  An older Canadian couple on our flight warned us to expect things to be expensive. We agree! Our first  dinner (nothing to write about) cost us over $100 USD! Most restaurants didn't even offer anything gluten-free so it wasn't easy to stick to our diets when we dined out.  Instead of our gluten-free vegetarian diet, we had to be "flexitarians", someone who has to be flexible with their diet restrictions especially when traveling. Our best meals were had at the Gibbs Hill Lighthouse Dining Room and the Southampton Fairmont Hotel (they were the only place that catered to gluten-free diets! The waiter even brought us rice snacks instead of bread to start!). Not surprisingly, Bermuda is known for its seafood (rockfish, spiny lobster, and wahoo fish [tastes like chicken], and fish chowder seasoned with black pepper rum). Our favourite food stop was the Juice n Beans Cafe in Hamilton. They make yummy vegan power smoothies and vegan breakfast burritos! We ended up cooking our own meals most of the time, which our wallets and my stomach really appreciated. But enough about eating! ... The touristy things to do in Bermuda include the Royal Naval Dockyard (shopping mall, rum cakes, glass art gallery, arts centre, and a large mini-golf centre which I was looking forward to but didn't get to do since it was closed when we arrived--darn off-season!), the Crystal Caves, Gibbs Hill Lighthouse, and St. George's (picturesque old town). We walked (more like bushwhacked because of extensive tree damage that had not yet been cleared) the Railway Trail, and, of course, explored the many pink sand beaches! Public transportation (buses) was frequent and reliable so we opted not to rent a scooter, since it unfortunately rained almost every day. We saw the entire island from tip to tip via the bus and lots of walking! Frankly, most of our time was actually spent sleeping in, deciding what to eat, walking up and down hills to find beaches, and watching old movies :). It was a whole week of time well wasted! How I miss thee, Bermuda!

I'll let the photos tell the rest of the story. Hopefully, they get you out of the winter blues. Enjoy :). 

The many fallen trees on Railway Trail

Gibbs Hill Lighthouse

The local bus stop

The Victualling Yard at the Royal Naval Dockyard

The beautiful Crystal Caves

Why did this stray rooster want to cross the road? We did notice there were stray hens on the other side;)

Colourful buildings in historic St. George's

The famous Horseshoe Bay Beach 

Church Bay

Arch on the beach! A great place to practise my levitation :)

Warwick Bay Beach

11 Month Health Update

It's already time for my 11 month post-diagnosis reality health check! A little activity review first! In the past two months, I underwent 11 hyperthermia and iv vitamin C treatments (was too close to the scheduled CT scan to do the 12th session, apparently that can mess up your scans), attended a great friend's wedding in Vancouver (so nice to see the old gang and congrats to S&F!!), quietly celebrated my birthday with our wonderful friends (yum yum dim sum!), savoured several nice long fall walks/hikes in our urban nature reserve, enjoyed a fantastically relaxing vacation abroad (blog post to follow:) to escape the pre-scan anxiety and the increasingly colder weather, came back home to -20 degree Celsius and a pile of snow in addition to a sore back and achey left shoulder :(, and went through the usual bloodwork and CT scans (chest, abdomen and neck). I have to admit my scanxiety was through the roof this past week while I waited to hear the CT scan results. If it wasn't for the back and shoulder pains, reminiscent of my pains prediagnosis, I think I would not have been so restless, irritable and mentally elsewhere. Poor Zoey, who did not fare well after returning from her lovely week at the pet resort (kennel), seemed to pick up on our anxiousness too (or could be because she ate too much dirt and snow in the frigid outdoors). She developed a mild case of doggie flu and now battling doggie diarrhea. I can totally sympathize! She is now on the mend with antibiotics and probiotics, and lots of rest! But I digress... 

We met the oncologist yesterday to hear the news that would determine my fate. Amazing how one little report can determine my "fate", ergo the scanxiety!!! Results? Not great news. All of my lung nodules have increased in size, especially the two new ones on the upper left lobe. At least no additional nodules formed and other organs are still unremarkable. We discussed with Dr. B, at length, what my next step should be. Long story short, continue with Iressa and, watch and wait... AGAIN. Ugh, I hate watching and waiting. The long list of reasons: the new nodules are still too small and in a difficult location to properly biopsy, the clinical trial in Edmonton has closed recruitment because the trial drug (AZD9291) is now preparing to move to Phase III clinical trials which could be established by March 2015 at my cancer centre (!!!), I shot down the option to try the approved next generation tyrosine kinase inhibitor (Afatinib) because of reports of its toxicity, starting chemotherapy would exclude me from the clinical trial I want to enter into, I am not likely a candidate for radiotherapy since I have too many active nodules for the treatment to make any difference "overall", and we discussed doing a PET scan but its results likely won't change my course of treatment so why expose myself to that much radiation? Massive road block. **[insert expletives]**. So, I have no option but to wait for my lung nodules to grow large enough to biopsy successfully, and hope that my symptoms don't skyrocket waiting for the clinical trial to open, if I am lucky enough to meet their mutation requirement. Yikes. We actually don't know for certain whether my shoulder pains are caused by the new growths or me lugging around stuff while on vacation (my confidence is my weakness!). Let's hope it's the latter. In the meantime, time to pick my naturopathic oncologist's brain. If you can't tell yet, I am not the type to sit around and feel sorry for myself. However, I would be lying if I said this news didn't bother me. Frankly, it's scary waiting to see what happens. But I am learning not to linger in the past or worry about the future--that would be wasting my time. My new favourite quote, shared by our nutritional therapist, "Embrace the present and surrender to uncertainty". Words to (try to) live by...

Now, time to look for our Christmas tree! 

Wear White to Raise Lung Cancer Awareness!

It's Lung Cancer Awareness Month!!!

Thank you to all my family, friends, readers, supporters who have already donated to the Lung Cancer Translational Research Initiative!  You have made a difference!  For those who haven't donated yet, please consider doing so now.  The sooner we can raise the remainder of the $10 million goal, the sooner the program can take off, help find a cure and give hope to the millions of people affected by lung cancer.

As for Lung Cancer Awareness Month, please help spread the awareness!!! Not too many people know what the ribbon colour for lung cancer is.  It used to be clear, presumably for the air we breathe or the invisibility of lung cancer, but it changed to white or pearl. Here's how you can all help:

1. Who says you can't wear white after Labour Day? Put on something white, pearl or clear (!!).  Don't be tempted to buy anything to participate. Use the money you save for donations instead. Be creative. Have fun with it! Take a selfie and post it on Facebook, Twitter, Instagram, etc. Indicate somewhere that "WE SUPPORT LUNG CANCER AWARENESS!".  Invite your friends, family and coworkers to join in and spread the awareness. To all my friends on Facebook, please share your photo with me so I can see how dapper everyone looks in white! Thanks for joining the fight!

2. If you are not a photogenic person ;),  you can help just by starting a conversation:

"Did you know that November is lung cancer awareness month?"

"Did you know lung cancer kills 2x as many women as breast cancer and 3x as many men as prostate cancer and yet still receives very little funding for research?"

"Did you know non-smokers get lung cancer too? In fact, 15-20% have never smoked and another 40-60% quit smoking years, even decades, before their diagnosis."

"Why don't people care about lung cancer? It killed 1.6 million people last year."

"Do smokers DESERVE to get lung cancer? Are they not battling an addiction, one that used to be socially acceptable? What about those who managed to quit smoking but got diagnosed with lung cancer anyway?"

3. Donate! There are many lung cancer specific organizations you can donate to: in Canada, Lung Cancer Translational Research Initiative (via the University of Calgary), Lung Cancer Canada, or, in the US, Bonnie J Addario Lung Cancer Foundation, LUNGevity, Lung Cancer Alliance, or the lung cancer foundation of your choice in your community.  Despite being the biggest cancer killer worldwide, lung cancer research lacks public support and, thus, continues to be very underfunded. Please help change that. 

4. Change your way of thinking. Everyone, despite their lifestyle choices, addictions or bad habits, deserves our respect, support and compassion. Stop the smoking stigma! No one deserves cancer.