Return from Washington

Photo taken from NPR piece.

Dear Family and Friends,


Jake and I returned from Washington DC on Thursday after giving public testimony at the Avastin hearing. It was interesting and emotionally draining all at the same time. If you want a challenge, try condensing my complex medical history into 3 minutes while convincing a panel of experts who have already made up their minds. I can't really box up the arguments into a short post, so grab a cup of coffee, this is a long read.

For starters, the FDA is convinced there is no benefit from Avastin and that it's a dangerous treatment. This did not sit well with patients in the audience, especially the ones who have been living on Avastin alone for years. If patients' anecdotal evidence is not enough, consider that the National Comprehensive Cancer Network (NCCN), an alliance of the world's leading cancer centers, has unanimously affirmed the use of Avastin for metastatic breast cancer looking at the same clinical data. The NCCN is comprised of breast cancer experts, quite a contrast to the FDA panel, who had no breast cancer expertise. Thankfully for us, the NCCN, not the FDA, sets the reimbursement guidelines, so Avastin will continue to be covered by insurance at least for now. Still not convinced? Consider that the European equivalent to the FDA not only affirms the use Avastin, they just expanded their clinical guidelines to use it with additional chemotherapy partners, again using the same clinical research data.

The FDA argued that Avastin does not improve overall survival (we agree) but, importantly, does not improve progression-free-survival to a statistically significant degree (we disagree). Genentech argued that the progression-free-survival benefit is demonstrated by the data, statistically significant, and, more importantly, clinically meaningful. Jake and I could not agree more.

So what is progression-free-survival (PFS)? It is the time it takes for the disease to get worse. Stated another way, it is the amount of time it takes for the cancer to outsmart treatment and start growing again. I have yet to experience my first progression since being diagnosed 21 months ago, which is far longer than the median statistics, particularly given my situation (heavily tumor burdened, aggressive disease including multiple large tumors in my liver, considered the most deadly). I am nearly symptom-free from my cancer, which is amazing considering the round-the-clock pain I was in when I was diagnosed and the broad extent of my recurrence. Progression-free-disease translates into quality of life. To drive home this point during my 3 minute testimony, I put up a photo of me standing on top of Mt. Adams. Experts might argue over the extent of progression free survival benefit, but all of the studies have concluded their IS a PFS benefit with Avastin.

Regarding safety, the FDA was relentless in talking about the dangers of Avastin, which was so frustrating for the patients and breast oncologists in the audience. Avastin does cause a rise in blood pressure (easily managed) and causes bleeding (i.e. nosebleeds). Avastin has fewer, less toxic side effects than most of the chemos I've received over the years. A very small number of patients may have serious side effects such as pulmonary embolism, but that goes with the territory of cancer treatment. All cancer drugs are poison. You just have to hope the poison is more effective at killing the cancer than it is at killing you. As many of us joked during the trial, we prefer the side effects of Avastin to the side effect of death.

My cancer is incurable and very few if any treatments have proven, statistically significant survival benefit. The best we can hope for is to increase time between progressions.

Here's a quote from MD Anderson that sums it up..

The woman whose breast cancer has metastasized or who has been diagnosed initially at Stage IV must live with the reality that her breast cancer can no longer be cured, and that the disease is very likely to take her life. Consequently, the length of the remaining time she has to live, and the quality of that time, become issues of paramount concern. For her, access to the best care can make a significant difference, both in length of survival and in quality of life. With luck, excellent care, family support, personal motivation, and a skillful oncologist, her disease is likely to respond to a number of lines of treatment that can serve to extend her life-many of which may be quite costly. She may join a clinical trial, or try to get compassionate access to experimental drugs prior to their approval through single-patient INDs or expanded access programs.
Whatever path she chooses, she will be in treatment for the rest of her life, and she will require close follow-up, which will include costly scans and other tests. As her disease progresses, she will need pain-management and control of her other symptoms, and she is likely to undergo several hospitalizations to deal with particular crises in the course of the illness. Eventually, she will need hospice care.

The hearing was really frustrating in that the FDA was indifferent to our pleas. Several of the folks on the panel were so rude during the hearing they were literally reading their blackberries during the public testimony. As Jake commented, "I would have appreciated being patronized because at least we would have been acknowledged." So true! We were completely ignored on the first day and treated like we were wasting their time.
Much has been made about the cost of Avastin. Like other treatments, it is expensive, but certainly not outside the norm for oncologic therapies. When I was receiving Avastin, it was about the same price as paclitaxel (Abraxane) on a monthly basis. Cancer treatment is expensive, but we are thankful that it is available since the benefits in terms of quality of life are easily justified.
http://www.foxnews.com/on-air/journal-editorial-report/index.html#/v/1035619

TESTIMONY TODAY

Those of you who have registered for the FDA hearing, Nancy is #4 and will provide testimony at approximately 8:15 AM EST this morning. The links are provided in the post below.

Nancy to give testimony at FDA hearing on Avastin

We are all so proud of Nancy and are thinking of her and Jake as they travel to Washington DC this morning because Nancy will provide testimony at the FDA hearing on Avastin. The hearing will take place tomorrow, and Nancy will have three minutes to tell her story. There will be a live webcast of the testimony for us to watch, but in order to gain access, you need to pre-register.

We are all with you in spirit and are confident you will be remarkable because you ARE remarkable, Nancy!Her acceptance to participate in this important event was based on the following letter:

Hello Ms. Williams,



I am living with stage 4 breast cancer and was successfully treated with Avastin and Abraxane (paclitaxel). I am interested in publically testifying in June and am trying to understand whether I would be assured a time slot. I will be flying from Seattle at my own expense and don’t want to book flights/hotel unless I’m certain that I’ll have a chance to speak.


I’m 41 years old and have extensive metastatic disease, with multiple tumors in my liver, lungs and spine. At the time of my stage 4 breast cancer diagnosis in September 2009, I was in agonizing pain, had 42 tumors in my lungs, 14 tumors in my liver, and 2 in my spine. After 8 months on Avastin/Abraxane, my tumors were reduced significantly, my pain was nearly eliminated and my quality of life is excellent. I tolerated Avastin extremely well, with very minimal side effects. Even while on this treatment, I actively participated in vigorous hiking with a group of cancer survivors and even climbed to the top of Mt. Adams, elevation 12,276 feet.


I would welcome the opportunity to share more about my experience as I believe I may need to use this treatment again when my cancer progresses and I run out of other treatments. I’m also concerned for the woman diagnosed tomorrow who won’t have this powerful treatment available.


As you know, most cancer therapies have dangerous side effects and can be extremely expensive. I’ve had many chemotherapies and treatments over the past 9 years since my original stage 2 diagnosis in 2002 including Adriamycin, Cytoxan, Taxol, Methotrexate, 5-FU, Zometa, and radiation. All of these treatments have had dangerous side effects and required additional medications and medical monitoring to ensure the treatments themselves didn’t cause my death rather than the cancer. I’ve had the usual list of side effects, neutropenia, nausea, hair loss, fatigue, peripheral neuropathy, and so forth. Damage from the Adriamycin and radiation treatment is still visible on my scans today. When my oncologist had me sign the consent form for Avastin, it frankly seemed pretty mild compared to other therapies. My blood pressure did go up a couple points and I did have a few bloody noses, very trivial side effects compared to what I have experienced from other drugs. From a cost perspective, Avastin was about the same price as these other treatments and was thankfully covered by my insurance. I estimate that I’ve had close to $2M in treatment, surgical, and diagnostic expenses over the past 9 years, the cost of Avasin was perhaps 1 - 2% of the total (rough estimate).


Thank you for your consideration. I am happy to provide more details if needed.


Sincerely,
Nancy Haunty

Jake's Speech

Hello family and friends,


As some of you know, I have participated in the past in a fashion show for a local breast cancer organization, but this year, Jake took the stage and gave a beautiful speech. The video company that recorded the event was kind enough to post it to YouTube for us. Here's the link. http://www.youtube.com/watch?v=F1SKlbQOaUE

National Breast Cancer Coalition NBCC - Washington DC

The trip to DC was energizing, educational, but also discouraging and frustrating. I met lots of amazing women and I was able to network with scientists, doctors, and public policy makers, not the least of whom was Susan Love, MD. ALL women should sign up at Dr. Love's website The Army of Women, regardless of whether you have breast cancer. The goal of her organization is to enroll large numbers of women into research studies, so if you enroll there is a chance you'll be called upon to participate in a study.


The National Breast Cancer Coalition (NBCC), the group who put on the conference and organized lobby day on Tuesday, is an influential, albeit controversial group. They are trying to change the conversation away from pink ribbons, awareness, and early detection to prevention and ending the disease once and for all. I was surprised to learn their position on several issues including Avastin (they applaud the FDA's decision), they are opposed to screening mammograms on women under the age of 50 (yes, 50), and they even oppose breast self exams. Pretty shocking, right? Conventional wisdom about early detection is not the answer, women are dying from breast cancer at the same rate they were 20 years ago. I found myself going back and forth in throughout the conference, trying to decide if I can get behind this group or not. In the end, I am throwing my support behind them and, in fact, am trying to wiggle my way into a position of being able to provide leadership and influence.

During one of the workshops led by Dr. Love, I was able to ask my question, "I have metastatic disease with liver, lung and bone mets. I am a super responder to Avastin, help me understand the FDA's decision." She handled the question well, citing cost (I appreciated her honesty) and said public policy cannot support a very expensive, potentially lethal drug that shows no benefit in overall survival. I argued back that a small number of patients do seem to benefit from the drug, including me. I later learned just how political the Avastin debate really is. The Avastin decision is a shot in the wheel house of Genetech/Roche. The FDA is trying to send a message to Big Pharma to encourage them to figure out who will respond. Too bad individuals like me are getting caught in the crossfire.

There was a lot of bashing of the pharmaceutical industry and our current broken healthcare system. As we all know, there is plenty of blame to go around. The universities and academic medical centers are part of the problem since researchers' incentive is to publish papers, not help patients. Likewise, government funding of research discourages innovative ideas and encourages safe research with predictable results. Biotech and drug companies have an incentive to produce treatments that are profitable, not necessarily those that will end the disease. The only party at the table interested in ending breast cancer is the advocacy community, so I plan to do what I can.

Lobby day was especially disappointing and I left feeling that our government is completely impenetrable. I don't think I'd bother to do that again and don't even feel compelled to send letters or emails to lawmakers because I think it is a waste of time. It was interesting to be on Capitol Hill and walk the halls of the Senate and House office buildings, but that was about it.

I'll end on a brighter note. The highlight of the conference was the Emerging Leaders program of the NBCC, a group of young, articulate women who are future leaders of health policy. It was refreshing to see gals in their 20's using their talents and energy to support the mission of NBCC. Next steps for me will be to connect further with these young women and encourage them to continue fighting. I also might go back to DC in June for the hearing on Avastin. Even the most staunch Avastin opponents at the conference encouraged me to do this, saying that there has been a precedent of the FDA overturning their decisions based on patient feedback, so we'll see.

Long post, sorry about that, my brain is just so full of new ideas I had to share.

Update and a Face on the Avastin Debate

Dear friends and family,

Sorry it has been so long since I've posted an update, we've been busy! Lots of good things to report. For starters, my health is great. I had another PET/CT scan last week and the results were positive, no changes in the tumors and everything is stable and "quiet" according to Dr. Rinn. I will meet with her on Wed and have my monthly Zometa infusion, so she'll go over the results in detail then. I went back to work in October and things couldn't be better, I even managed to get myself promoted. My energy level is great and I'm having a lot of fun being back in the swing of things work-wise. I went snow-shoeing a couple weeks ago with my friends from Team Survivor, which was great fun (photo attached - I'm in front wearing the bright red jacket).

In other news, I attended a symposium at the UW Law School a couple weeks ago called, "Regulating the Treatment of Cancer: Who Decides and How." It was an amazing opportunity to hear from experts in the field, including one of the four decision makers from the FDA on the use of Avastin. The format for the day was a series of lectures and panel discussions with time for questions from the audience. About midway through the conference I overcame my fears and decided to ask a question to the panel. My question was along the lines of "I have advanced breast cancer and I'm alive/healthy as a result of taking Avastin for 7+ months, help me understand why the FDA is taking it away as a weapon in my oncologist's arsenal?" I wanted to put a face on the Avastin debate and hopefully was successful. It was a fascinating day from a public policy perspective - I wish it wasn't so personal - but am excited to get involved in the fight. I was so fired up after the conference I decided I want to do more and am headed to Washington DC in early May for a conference and session on Capitol Hill. Stay tuned for more!


One of the speakers at the symposium (probably my favorite panelists from the day) was Robert Erwin, who is president of Canceractionnow.org, an advocacy group who keeps a careful eye on the FDA and was founded in honor of his late wife, Marti Nelson, MD. Mr. Erwin shared a letter with me, sent to the FDA, regarding Avastin (text from the letter is below). I urge all of you to read up on the issue and let me know if you have any questions or want to get involved. The Avastin issue is complex and certainly controversial, but I truly believe it is worth fighting for. Mr. Erwin's letter articulates this well. The Avastin appeal is scheduled for June and I'm hoping to get more involved.-Nancy

Marti Nelson Cancer Foundation
1520 East Covell Blvd. B5#103
Davis, California 95616

February 14, 2011

Re: Comments on FDA Docket No. 2010-N-0621

Dear Dr. Hamburg,

We encourage the FDA to hold a public hearing on its proposal to withdraw approval of the metastatic breast cancer indication for bevacizumab. We believe there are at least two issues of relevance that are best considered or debated at greater length in a public forum.

First, we would like further consideration of an apparent lack of data directly contradicting the results of the E2100 clinical trial, the primary basis for the accelerated approval of bevacizumab for metastatic breast cancer. The results of subsequently published clinical trials testing bevacizumab in combination with other chemotherapeutic agents have certainly been disappointing, and they suggest that bevacizumab is not as valuable a clinical tool for the treatment of breast cancer as many of us had hoped it would be. However, the specific combination of bevacizumab with paclitaxel has clearly been of benefit to some patients with metastatic breast cancer and may offer benefit to many more in the future. We are concerned that fully withdrawing the breast cancer indication at this time will deprive some future patients of meaningful clinical benefit and believe this is an issue worth further public consideration.

We are disappointed that despite substantial resources committed to various bevacizumab clinical studies, Genentech and Roche have not obtained sufficient data to definitively replicate or invalidate the results of the E2100 study of bevacizumab specifically in combination with paclitaxel. However, we do not think this failure alone, at this time, is adequate reason to deny the possibility of clinical benefit from this drug combination to breast cancer patients who cannot afford to obtain it off-label and unreimbursed while we wait for the results of planned clinical trials.

It is clear that many patients treated with bevacizumab may suffer its side effects without receiving benefit, while a minority may receive significant benefit. Unfortunately, no one can predict which patient is which prior to initiating treatment. Ultimately, we believe these difficult regulatory decisions need to be made with the individual patient in mind, both the person who is harmed and the person who is helped. Legal arguments and procedural arguments should take a distant back seat to issues of science, medicine and patient well-being. In the face of substantial uncertainty, each patient, as a valued individual, must make an treatment irreversible decision in consultation with one or more individual physicians. Under these circumstances, more information is always better; thus, our exhortations to the FDA to conduct thorough and even redundant public analysis prior to taking final action and to Genentech and Roche to deploy the necessary resources to answer open and critical clinical questions about bevacizumab as rapidly and unambiguously as possible.

A second issue of broad public health and public policy importance we believe justifies a public hearing is the need to further consider, and more objectively define, clinical significance versus statistical significance in the context of the use of progression free survival versus overall survival as clinical trial endpoints to support drug approval applications. Although such a broad issue would not be the primary purpose of a public hearing, and the issue has been, and will continue to be, debated in other venues, we believe a public hearing on the immediate bevacizumab issue may contribute important understanding to this important technical policy issue.

We believe that a clinically meaningful and statistically significant improvement in progression free survival provides an important clinical benefit to patients, even in the absence of a demonstrated statistically significant improvement in overall survival. Many intelligent and well-informed people disagree with our view on this issue. The bases for agreement and disagreement on this topic are complex and beyond the scope of this letter, but we believe those who disagree with our view would agree that more extensive public discourse on this topic could be valuable.

We understand that the decisions the FDA makes are not easy and are made carefully. We do not have access to all the expertise or data available to the FDA, nor does the public at large, nor does the individual patient or physician in the exam room or hospital room. We believe a public hearing will enhance public understanding of the difficult work performed by the FDA and also provide this specific issue with the careful, complete and public analysis its importance warrants.

Very truly yours,
Robert Erwin

President

Marti Nelson Cancer Foundation

December update

Team Survivor Benefit, November 2010

Hello family and friends,

Sorry it has been a while since I've sent an update, all is well. I am back at work now and feel great. I feel very healthy and my cancer continues to be stable.

December is a big month in the world of breast cancer as it is time for the annual San Antonio Breast Cancer Symposium, which is the most prestigious convention for researchers and doctors who work in the field. I met with Dr. Rinn today and asked her if there was anything new and exciting from the conference. She was frank with me and said most of the recent research studies demonstrate how little they really know. Breast cancer is a complex disease and seems to outsmart the scientists at every turn.
On a related note, it seems we have lost the battle to keep Avastin available as a treatment in the US. The FDA officially rules tomorrow, but early press releases say they will withdraw support of this important treatment. Here is an excerpt from the Wall Street Journal update:

Yesterday the Food and Drug Administration moved to revoke its regulatory approval of Avastin for metastatic breast cancer. Withdrawing a cancer treatment is almost never done, and though the decision was expected, that does not make it any less reprehensible.

The FDA said in a statement that it is removing Avastin's breast cancer indication because the biologic does not provide "a sufficient benefit in slowing disease progression to outweigh the significant risk to patients." Ponder that "sufficient." The agency is substituting its own judgments about clinical meaningfulness for those of practicing oncologists and terminally ill cancer patients.

The risks of Avastin are real, but manageable. Clinical trials do not show that the drug extends life overall in the aggregate, but they have shown that it allows women to live longer without their disease getting worse. Avastin improves progression-free survival by about four months on average. Different patients respond differently, and the drug is far more effective in some than in others, for reasons that researchers still do not understand. There aren't any perfect therapeutic options in end-stage oncology, and Avastin ought to have remained one of them.

Looking at the same data, the European Medicines Agency-the FDA's counterpart in the European Union-decided on Thursday that it would continue to approve Avastin for breast cancer in combination with chemotherapy. In October, the U.S. National Comprehensive Cancer Network-a consortium of 21 leading cancer centers that issues evidence-based medical guidelines-reaffirmed its position that Avastin is valuable in some cases.

Cancer treatment advances incrementally. Every year doctors are better able to pair medicines with the biomarkers pointing to the individuals who are most likely to respond and learn more about tumor angiogenesis, which is the process of cancer growth that Avastin helps to choke off. The FDA's assault will make it harder to conduct and enroll patients in further clinical studies, to say nothing of its message about the regulatory risk for drugs still in development.

The greatest tragedy will fall on the women who are suffering from an incurable disease and whose caregivers are trying to improve their quality of life in the months they have left. The FDA is taking away one of their only options.

FDA's decision on Avastin

Dear Friends and Family,

Some of you may have seen press coverage recently on using Avastin for metastatic breast cancer and you might recall that I was on Avastin from September through April with amazing results. Jake and I are quite concerned about the FDA's decision to disapprove the use Avastin for patients like me. The argument of the FDA is that Avastin doesn't show enough clinical benefit and it is extremely expensive.

Jake and I (and my oncologist) disagree with the notion that it doesn't show clinical benefit and we're fighting to sway the FDA. If you want to help, you can sign the petition located here. http://www.thepetitionsite.com/3/stop-the-fda-from-disproving-avastin-to-treat-metastatic-breast-cancer/

You can also email the FDA and encourage them to reconsider their decision.

margaret.hamburg@fda.hhs.gov
patricia.keegan@fda.hhs.gov
janet.woodcock@fda.hhs.gov
richard.pazdur@fda.hhs.gov

If you want to read more background on Avastin, here is a link to an opinion piece from the Wall Street Journal. http://online.wsj.com/article/SB40001424052748704271804575405203894857436.html

There's a lot of controversy about the clinical benefit, but I'm living proof that it is a powerful drug. Avastin seems to help certain patients, not all, but I think it is important to know it is improving the time between progressions for lots of patients (translation, it provides better quality of life even if it doesn't improve overall survival). It is extremely expensive (I think mine was about $24,000 per month), but chemo is expensive (Abraxane was something like $32,000 per month). It has potentially serious side effects, but so do all the other chemo drugs.

-Nancy

One year mark

It's been a while...here's a quick update and photo.

Hello again friends and family,
It has been exactly one year since we got the horrible news of my recurrence. We've adjusted to our new normal and all is well.

Thank you so much for all the support on my Mt. Adams climb. It was truly an amazing experience and an accomplishment cancer can never take away. I've learned over the past year that even though life isn't always fair, it is good. Jake and I are really happy and we continue to be so grateful for all of you.

My health continues to be stable. I'm having some aches and pains here and there, but who doesn't? I see Dr. Rinn on Thursday for my monthly Zometa treatment and I'm sure it is about time for another scan. I'll keep everyone posted if there is any news to report. Thanks again for your prayers and support! - Nancy

She Made it!

More photos and stories to come... Nancy, you are an inspiration!

Somewhere on the Mountain

Nancy is preparing for the summit later today now. There has not been any communication, but I hope she is feeling our thoughts and prayers. More Blog-worthy words to come...

(photo taken on Mt. Rainier training hike)

Two weeks to Mt. Adams

Hello friends and family! I had a great birthday on Saturday, thank you for all the emails and phone calls. I celebrated with my group from Team Survivor with another beautiful training hike. My favorite hike so far this year was a couple weeks ago when our group climbed to Camp Muir at 10,200 feet, the base camp on Mt. Rainier. It was a perfectly sunny, clear day and we had so much fun! Hiking on a giant snow field was really amazing and the most fun of all was glissading down the mountain (hiker-speak for sliding on your butt).

I have been off work for almost 10 months and it has really been therapeutic, but I am planning to go back the first of October. My energy level and health are good as Femara continues to work its magic while giving me a more normal quality of life compared to chemo. I'll continue getting monthly Zometa treatments (forever I guess), but the side effects are virtually non-existent and stay on Femara for as long as it continues to be effective.

THANK YOU again to everyone who has donated to my climb. There is still time to donate if you are interested.

Here is the donation link to Team Survivor

...and here is the link to our team blog where you can follow our progress.

Looking up

Hi everyone,

Things are going really well these days. My latest PET/CT scan shows the cancer continuing to diminish, so we can safely assume that Femara is working and we are continuing to gain ground toward remission. As I've said in previous posts, the goal is that I can stay on Femara for a long time (possibly years) before the cancer outsmarts it and we have to switch to something else (i.e. back to chemo). I continue to get monthly Zometa treatments, which are really easy and I have no side effects. It is amazing how the body adjusts - my first couple Zometa infusions back in Oct/Nov were pretty rough, but now I have a treatment on Friday and am out hiking on Saturday.
Speaking of hiking, THANK YOU to everyone who has contributed to the Team Survivor Mt. Adams climb. Everyone has been extremely generous, but there is still time to give if you haven't already. Go to http://www.teamsurvivornw.org/http://www.teamsurvivornw.org/, click on Mt. Adams Climb, and the link to the donation page is about half way down the page. We have a little team blog that documents our training hikes and eventually I'll use it to post pictures from the summit. The website is http://tsnwmtadamsclimb2010.blogspot.com/. The big event is Aug 9th - 12th. Please send prayers/vibes/wishes/thoughts/etc. for warm, dry weather. I am still trying to imagine how I'll be warm enough sleeping on a glacier, but as I keep telling myself, others have done it and lived to tell about it. Our base camp is at 9,000 feet, so it is likely to be below freezing at night, even in the middle of August.
Final comment - the woman standing behind me in the photo is the amazing Dr. Rinn. She is doing the Mt. Adams climb with the July group and will be a sherpa with my group in August, which will be really special. You can also read a little more about her and some of my fellow climbers by clicking on the Team Profiles link on the Mt. Adams blog.

A mountain to climb

I am continuing to train for the Mt. Adams climb in August and it is going really well. Last weekend we hiked 8 miles with 3,300 feet elevation gain. I hiked with a 22 pound pack, which was challenging but not impossible, so this week I'll increase my pack weight to 30 pounds. Eventually I have to carry 50 - 55 pounds, which is still mind boggling to me. Yesterday, I loaded a 40 pound bag of dog food in the car and thought about how heavy it was...can I carry that plus another 15 pounds on my back up a huge mountain for 4 days?!? I'm hinting to Jake that I may need a little sherpa help for the climb up to base camp.


Anyway, the photos are from last week's hike at the top of Mt. Si. From the top, we had a great view of Mount Rainier (middle photo).

I'll tell you more specifics about the Mt. Adams hike in future posts, but here's a link to our guide service, NW Mountain School. They have a great web site if you want to check it out.

-Nancy

Team Survivor NW

For those of you haven't heard, Nancy has hooked up with Team Survivor Northwest, an organization which provides physical activities free of charge to cancer survivors in the Seattle area. She is working hard to be ready for this, despite missing some training because of being knocked down by illness recently. She needs to raise $2000 for the endeavor, so if you did not know about this opportunity to support her, here is the link. Just scroll down to her name.

This past weekend Nancy teamed up with her fellow survivors and had a bakesale. That's a lot of muffins to get to 2k! Todat she is having a CT scan, and if she gets positive results, she'll be rewarding herself with a brand new ice pick (engraved, ofcourse)! Our prayers and thoughts are lifting you up, Nancy!

(Nancy is on the far left in the front row).

An update

Hello friends,



I transitioned to hormone therapy (as opposed to chemotherapy) about 6 weeks ago and so far, so good. The treatment is much easier to take since it is only a pill a day, though I still go in for monthly infusions of Zometa to treat my bone mets. I'll likely also have a scan this week to double check that the cancer is all stable or improving and will post something when we get results.

With a break from chemo, Jake and I decided to take a badly needed vacation. We ended up spending 8 days in beautiful Spain, where were did loads of site seeing and relaxing, but also celebrated with our friends, Brit and Jenny, who were married in a beautiful little fishing village on the coast. Their destination wedding was the main reason we picked Spain as a vacation spot and it was absolutely wonderful.
Unfortunately I caught a really awful bug on the trip home and have been sick for the past week including two visits to the ER. Thankfully, it is nothing cancer-related, just a horrible case of sinusitis. As of today, I'm finally getting a little better.

On a more positive note, I have joined up with a group of women cancer survivors through an organization called Team Survivor NW and have started training for a mountain climb later this summer. The goal is to climb to the summit of Mount Adams, the 3rd highest peak in Washington State at 12,500 feet. If I can stay well enough, I should be able to make it to the top! If anyone is interested in sponsoring me (this is a fund raising event for Team Survivor), you may do so at http://teamsurvivornw.org/index.php?pg=66. Click on the line "Click here to make a donation towards the Mt. Adam's Fundraising Climb" hyperlink and scroll down until you see my name. For those of you who have already donated, thank you very much!! The climb has given me a great goal to work toward and I believe physical activity is one of the best things I can do for my health.

-Nancy

Hi everyone,

After 6 long months of weekly treatment, I am officially done with Abraxane and Avastin. Hooray! My mom joined me for the 5-hour marathon chemo trifecta on Thursday, which went fine. She snapped a photo from my iPhone to mark the big day. I have felt a little sick this weekend, but once I get back on my feet we will celebrate.

I have to say a quick thank you to Jake. I think it is harder to be the spouse than it is to be the patient and he has been amazing. He handled a lot of the really hard things these past 6 months, not the least of which was dealing with our adoption agency, who disqualified us based on my health. Losing our Nina has been the hardest part of this journey, but as he continually reminds me, "Our family is complete."

We have such a great family and such a great life. Thanks everyone for following along and for your continued love and support.

-Nancy

Important day

Today Nancy had her last "triple crown" chemo treatment. I haven't heard from her yet, but these are very long days, and she tends to feel pretty cruddy following an entire day in the hospital. She'll begin a much milder (less side effects) treatment regiment. More details to follow....

Congratulations Nancy! This has been a long hard fall and winter, but spring is here!

CT RESULTS GOOD! Next step...

We had a good conversation with Dr. Rinn today regarding my latest CT scan. The scan shows all the tumors are either stable or improving. Based on that, she is comfortable with me switching from chemo to Femara in April. I will still come in for monthly infusions of Zometa for my spine, plus have scans, lab tests, and so forth, but at least I will be done with the weekly chemo routine. She was optimistic that Femara will continue to reduce the tumors and I'll be able to stay on it for a long time to come (possibly years). While I'm excited to have an end-date for chemo, it is a little daunting to think about "what next" since once I start feeling better I need to figure out if I can go back to work, etc. It is always hard to transition to a new normal and nothing about our current situation was part of our plan, so it'll be an adjustment for sure.



Thanks again to everyone for your continued support and encouragement. I imagine I won't be posting as much to this blog starting in April/May since there won't be quite as much going on (which is good!), so don't worry if you don't see updates from me. Another big thanks to Kate and Molly for keeping the blog going as it has been such a great way for us to communicate.

Steady in the fight...

Last week was another chemo triple crown of Abraxane/Avastin/Zometa. It went well, but does make for a long day. My blood counts were quite low, so Jake gave me a couple extra shots of Neupogen this week and as a result I've been quite achy, though I'm pretty well recovered now. I had a fun/relaxing breakfast with my mom yesterday (photo attached).

I'm scheduled for a CT scan tomorrow, which will hopefully show another drastic reduction in the tumors. We'll review results with my oncologist next Thursday and make a plan for transitioning to the next therapy, which will likely be Femara.

In other news, I have signed up to exercise with a group of other cancer survivors, which has been really fun. The group is going to climb Mt. Adams this summer and they have allowed me to tag along during the training. Dr. Rinn didn't clear me to do the actual climb, so I won't be able to participate in the big event, but I'm having a great time meeting other women and having a little structure to my exercise routine.
Thanks again to everyone for your continued support, it really keeps us strong having such an amazing network of family and friends. -Nancy

Note from Nancy

Hi all,
After a restful weekend in Palm Springs two weeks ago, it was back to chemo the past two Thursdays. As you saw from the pictures, Jake shaved his head in solidarity with me and now we are growing our hair back together. My hair has started growing even though I'm still on chemo, which I don't really understand, but I'm not complaining.

Chemo continues to go smoothly and we are doing well. This week I'll have another trifecta of Abraxane, Avastin, and Zometa, which has gotten easier to tolerate, then I'll enjoy a week off on March 4th. I'll have another PET/CT scan in the coming weeks and, depending on the results, we may be able to set the end date for Abraxane and Avastin. I don't want to get my hopes up too much, but I am crossing my fingers I might finish this chemo in March or April. After that I'll continue to have monthly infusions of Zometa to heal the bone mets in my spine (bone is the slowest to respond to treatment) and I'll switch to hormone therapy (still very powerful, but much easier to tolerate) and I'll stay on that treatment as long as it continues to work. I'm having a little trouble with my port-a-cath and there's a chance I'll have to have it removed/replaced, but I'm crossing my fingers that won't happen. It is no big deal medically, but it would be another procedure and another scar therefore a bit of a bummer.

Thanks again to everyone for your support!

Beautifully bald

Another chemo down... fighting this moving forward

Hello friends,

Another week, another chemo complete. I had the chemo Trifecta today of Abraxane, Avastin, and Zometa and it all went smoothly. The cancer center went live on a new on-line computer system this week and things were a little slower than usual. Wendy was sweet enough to join me again for a marathon session (we didn't finish up until after 6:30 tonight), but she kept me entertained with a card game and the time passed quickly.

The last couple weeks my doctor has been talking with me about participating in a clinical trial of a new protocol that sounds very promising, but as it turns out I don't qualify due to my previous recurrence/treatment in 2007. We were both a little disappointed because one of the drugs on the trial is only available if you are on the study. The nurses involved with the investigation apparently spent hours going over my chart trying to find a way for me to qualify, but in the end it just didn't work out. Bottom line, I will continue with the current treatment plan of chemo for a few more months then switch to hormone therapy, which is easier to tolerate and won't require weekly visits to the treatment center. We have every reason to be optimistic the treatment will be effective for a long time to come. Once I switch to the new treatment I'll only need to come in every month for my Zometa infusion, the remaining treatment will be a pill I take at home. I'll still have PET/CT scans about every 3 months and lab work, but compared to the current schedule of weekly treatment it should be a walk in the park. In other news, I seem to have developed a slight infection in my port-a-cath, which has caused a pain/irritation in my right shoulder/neck, so I'm starting a round of antibiotics. This is one of those normal little bumps in the road we've grown to expect.
Next week we are off for some relaxation and warm weather in Palm Springs with our friends, Nate and Luanne. We've timed my chemo so that I have next week off so I'll be able to enjoy the weekend even more. Can't wait! -Nancy

A couple days with Nancy and Jake (by Nancy's dad)

I’m Bill LeBoeuf, Nancy’s “Dad” and my wife Mary and I visited Nancy and Jake for a few days this week. Of course it’s great to visit their beautiful Shoreline home but the best part is to see Nancy as beautiful, enthusiastic and just plain nice as ever. We brought the Warm Sunny Southern California weather with us and had a chance to take some really pleasant exercise walks with her (unfortunately Southern California was hit with torrential rain, thunder, lightning and even a few tornadoes while we were gone!!). I got a chance to go with Nancy to a “chemo session” and got updated on all the things she and the bulldogs are doing.

Nancy and Mary collaborated on some delicious suppers at home and Jake set up the equipment for “Rock Star” and we all rocked out! Nancy and Jake were the true rock stars with Nancy on vocals and guitar and Jake on drums, but Mary was certainly right in there on vocals too. Poor Jake had to work but Nancy, Mary and I had a memorable lunch at Edgewater hotel after a beautiful walk through the sculpture garden overlooking the water in Seattle.

Blessings

"One of the silver linings of having cancer is that it shines light on what is most important." - Nancy Haunty a.k.a 'Mojo'

Faith. Love. Family. Friends. On my recent trip to be with Jake and Nancy, it was heartening to witness the outpouring of love and caring that surround Jake and Nancy. From the unknown neighbor who brought "sunshine soup" to their dear friends who provide a post-chemo resting place or those sweet friends who meet Nancy at the hospital to keep her company. You are their blessings!

I wanted to post some photos of some of Nancy's Seattle friends who threw a "Love Shower" for Nancy. It was a creative, memorable, uplifting afternoon of tender words, laughter, tears, (and song!) Thank you Kim for being so loving. (this says it all)

2010 first post

Dear friends,

I hope everyone had a wonderful holiday and New Year. We are still doing well and are encouraged by the scan results from Christmas Eve. We had family in for the holidays, which was wonderful and very low-key/relaxed (pics attached, you can even see a rare photo of me with a wig or "hair helmet" as I refer to it). I had the chemo triple crown of Abraxane, Avastin, and Zometa on New Year's Eve and then took this week off just to take a little break. I feel great (considering I'm on chemo) and am trying to continue exercising every day and get lots of rest. My previous two times on chemo (in 2002 and 2007) I worked (though on a reduced schedule), but I am a strong believer that not working is more beneficial to my health and I don't regret it. People keep asking me if I'm bored, but truly I am not. It is amazing the number of projects I can find to work on at home. Plus, let's not forget my favorite bulldogs, who love having someone at home all the time.

Thanks again for all the support and I hope everyone had a wonderful New Year!

Update from Nancy

Christmas Eve update from Nance with very good news ... Happy Holidays!

We met with Dr Rinn today to review the PET/CT scan from Tuesday and the results were as good as we could have possibly hoped. Overall, the cancer has been knocked back by about 50%, if not more, after only 3 months of treatment. Dr. Rinn took us down to meet in person with the radiologist to look at the before and after images, which were fascinating. He showed us how the liver tumors have decreased in size and activity, the largest has decreased from 28x25mm to 17x16mm. Other liver tumors have decreased as well (there were 14 when I had my scan in September). The tumors in my lungs have also decreased in size and number. I had over 40 small tumors between my two lungs back in September, some of these are no longer visible, others are smaller, and some are unchanged/stable. The cancer causing my back pain, which was actually in the lining of the lung, is gone even though I still have some lingering pain in this area due to nerve damage. The cancer in my spine is showing healing as well. All together this is really great news and cause for celebration! Dr. Rinn indicated I would probably stay on the current chemo for another 3 months or so, then we'll switch to an aromatase inhibitor. She is looking into some clinical trials for which I might be eligible, so stay tuned for more on that.

We are obviously thrilled with the results and are going to relax and enjoy the holidays. Merry Christmas everyone! Thanks for your continued love, support, and prayers.

"NANCY" bringing hope to far corners of the world

A note from Patrick Dolan:


I visited India in November and did some volunteer work for Child Family Health International. I’ve done so before in Bhutan and South Africa, as Nancy knows. CHFI’s primary mission is to place health science students in areas of medical need to enable them to gain experience while supplying crucial health delivery services to underserved populations.

The organization runs clinics under the moniker of ChildCare where they have medical volunteers from all over the world conduct pediatric health assessment and women’s health/reproductive health clinics in underserved regions. While in India, we did clinics in a remote region in the far north near the Tibetan/Chinese border called the Nubra Valley. The valley itself is at 12,000 feet. We started out in the city of Leh, and we traveled over the Khardung La pass which, at 18,300 feet, is the highest motorable pass in the world. It was quite a journey! We were also delivering a new mammography machine to the subdistrict hospital in Diskit. It is the only hospital for about a 500 square mile region and the only mammography machine in the area. Previously, patients would have had to travel to Leh over the Khardung La for this service.

After hearing Nancy’s story, our team decided the machine should be named Nancy. We obtained some sticky labels and have spelled “NANCY” across the base of the machine. Nancy had a rough ride over the pass and a tough landing, but our Australian radiographer was able to recalibrate it and get it up and running for the first women’s clinic. One of the nurses in the group from Vancouver Island made all of we men in the group have pictures taken with our heads between the mammography plates since “everyone knows that all men are boobs anyway”! I hope to get some of those pictures soon to share (well – maybe not!!).

It was an amazing trip and a wonderful way to acknowledge Nancy in a foreign land. She is now doing great work 12 and a half time zones away! We’re not allowed to take pictures in the clinics themselves for privacy purposes, but I will try to send along some photos of children on the hospital grounds that we had seen in the clinic.

Women in Diskit dressed up in their fineries to welcome us to the subdistrict hospital. They were also seen in the women’s health clinic, and a the second from the right was the first recipient of a mammogram from Nancy.

Buddhist temple in a town called Sumar where they lit candles for Nancy’s recovery.

Two Indian Army trucks that transported many of our supplies. The second one contains Nancy – the mammography machine –as it works its way over the 18,000 foot pass.

Chemo Day

Week ten, and I am sitting with Nancy as she awaits her labs before having chemo. She's looking as glamorous and beautiful as ever, and her energy is pretty good. I have been with her and Jake all week in the role of support, and it has been such a treasured time for me with the two of them. For those of us who live scattered across the country and don't get to see and be with Jake and Nancy, it is hard not having that touch-- that day to day ability to drop by some soup, give a hug, or whatever.  But I am so encouraged knowing that they are surrounded by so many who love and support them here in Seattle. On Saturday, some of Nancy's Seattle friends threw a "love shower"-- a party to celebrate Nance. It was an amazing outpouring, and I know that all of us left the gathering uplifted by Jake and Nancy's strength and courage. I'll post some photos upon my return to Nashville.

So we are sitting and waiting right now in Swedish Cancer Institute. Everything seems to go very slowly, but that's okay. Life has really slowed down, and this is good. We are able to linger in the moments-- sipping coffee while watching the Olympic mountains turn pink, taking  brisk walks in this cold and bright Seattle sunshine, and enjoying good food and laughter together. Slow is good. Attention is shifted to beating back this cancer into oblivion. "Nancy..." (they just called her)... time for today's fight.

Thanksgiving report from Nancy

After 8 weeks straight of chemo, I earned a week off for the Thanksgiving holiday. It has been nice to relax with family/friends this holiday and get a break from treatment. My brother is in town visiting and we've been having a great time hanging out, cooking, and playing games. I continue to do pretty well as long as I take it easy and don't try to do too much. When I get tired, my back pain flares up and reminds me I still have a long way to go on this chemo. The current plan is to keep me on the combination of weekly Abraxane, every-other-week Avastin, and monthly Zometa indefinitely, though I'll get breaks like this week from time to time.

Seven weeks in... a Nancy post

We had a really nice weekend visit with Lainie (my best friend from high school) and her husband, who flew all the way from Arkansas to see us. I was not feeling great, so we had a very low-key visit, but it was wonderful to see them and spend time catching up. Lainie brought me a couple gifts from NW Arkansas including a handmade prayer shawl and quilt with written blessings/good-wishes attached from my high school friends. It was so encouraging to have uplifting thoughts from my old friends...just awesome.


Chemo went fine on Thursday and I walked over to Nate/Luanne's place after treatment to wait for Jake to finish up with work to drive me home. I might have said this before, but Nate and Luanne gave me keys to their beautiful city loft (only a few blocks from the treatment center) where I can hang out and relax after treatment. I can't believe how fortunate we are to have such great friends.


I had both Abraxane and Avastin this week and I'm definitely feeling the side effects lately. I have neuropathy in my hands and feet, pain in my knees/shoulders, and fatigue. I'm having a little trouble with headaches, which I think is from the Avastin. My blood counts were really low last week, but bounced back beautifully thanks to the neupogen shots Jake gave me. The downside is neupogen make my bones ache like crazy and I will need to keep taking them while I'm on this chemo, so likely for a long time to come. I keep reminding myself this is really powerful medicine and if we can knock the cancer way back, I'll be able to switch to a different treatment down the line that will be easier to tolerate.


Operation dinner continues to be the most incredible help to us. Everyone is so generous and brings us enough for multiple meals. I think I've cooked maybe twice in the past 2 months? Amazing.

Doing Something

This past weekend, some of Jake and Nancy's family members (Jake's Dad, Beverly, Uncle Jack and Aunt Kathleen) attended a fundraiser in honor of Nancy. Young Survival Coalition is an organization which Nancy and Jake are very familiar with. It is an advocacy, action, and support group for young women with breast cancer.

For all of us who love you (Jake and Nancy) and are pained as you are in the thick of this battle, we find comfort in doing something-- giving, standing up for and supporting this cause, and most of all pouring out prayers. We hope you are encouraged and comforted by this support.

We all stand by your side.

Today (from Nancy)

This has been one of those good-news/bad-news days. The bad news is I feel lousy after starting a drug called Zometa yesterday, which causes aches/pains/flu-like symptoms in about 30% of patients (including me). The pain should only last a couple days and I'm getting some relief after taking ibuprofen. Zometa is given once a month, so I shouldn't have this problem every week, but the other bummer news is my blood counts have fallen to the point I need Jake to give me shots, which will make my bones even more achy.

The good news is the CTC test (circulating tumor cell) came back at zero, which tells us the chemo is working! Low scores on this test are associated with longer "disease free progression", which is the amount of time treatment is effective before the cancer outsmarts it and you need to switch to a different drug cocktail. We can assume the tumors are shrinking, which will be confirmed/quantified in a few weeks when I have another PET/CT.

Aside from treatment, I'm enjoying my new little office, which has a beautiful view of the Sound and mountains. The dogs are excellent company, especially Rose who likes to climb up in the comfy chair/ottoman and nap while I read.

Going on Six weeks

Tomorrow marks Nancy's sixth treatment. She sent the following...

Hi everyone,

I'm completely overwhelmed with gratitude for my co-workers who held the "Pink-Luck potluck" in my honor last week. Both Jake and I continue to be amazed at the outpouring of support we have received from everyone. It truly keeps us going and we are so grateful. I had a really nice visit with my sister-in-law, Molly last weekend, while Jake was back in Chicago with his dad and brother. It was great to hang out, watch chick-flicks and catch up on life with Molly and I know Jake and the guys had a really great time back in the mid-West.

I'm starting to feel the chemo effects these days. My chief complaints are numbness/tingling in my hands/feet, pain in my knees/shoulders, and fatigue. Since I'm not working these days, I can easily take naps when I need to, plus I can putter around the house in my sweats. I've been trying to exercise every day, but the pain in my joints is starting to make that a little more challenging. My back pain is improved compared to a month ago, but it isn't gone completely and I'm still spending a lot of time resting on the heating pad, which by far is the most comfortable thing for me. As with everything in life, all symptoms are worse when I'm tired, so I have slowed down to a nice easy pace of life and as a result I feel pretty good most of the time. My pain is very minor and I don't need to take pain medications. For those medically-minded folks (and I know there are a bunch of you), the chemo combo I'm taking is Abraxane/Avastin. At some point, my doctor will also add a drug to treat my bones, which I think is called Zometa. She braced me last week that she intends to keep me on this treatment for quite a long time (maybe a year or longer?) assuming it is effective and I can tolerate the side effects. We will have some insight into the effectiveness when I get the results from my latest CTC test, which we hope will serve as a tumor marker for me. My initial CTC was low, but she's hoping it will go even lower. Additionally, I'll have another PET/CT scan in a few weeks, which will hopefully show the cancer shrinking.
I had my first dose of Avastin last week and it went perfectly fine other than taking a long time. They administer the first dose over a long period of time and check your blood pressure to make sure you don't have a reaction. Subsequent doses will go a little quicker. Once again, my sweet friend, Wendy joined me for the hours and hours of treatment and kept me occupied with Trivial Pursuit and lunch for the afternoon before Jake picked me up after work.

I'm having a rather annoying side effect called anticipatory nausea, which means I am nauseated as soon as I walk in the door of my doctor's office before any chemo is given. This is due to my prior rounds of chemo in 2002 and 2007 and, frankly, it is all in my head, but still very real and problematic. The good news is it is treatable with a wonderful drug called lorazapam, which I take before I arrive. The bad news is I need a ride home after taking lorazapam because I can't drive. Lucky for me, our dear friends, Nate and Luanne, have given me keys to their place, which is a couple blocks away where I can comfortably hang out until Jake gets off work to drive me home.

Okay, I've rambled enough for now. Thanks again to everyone for your love, support and the amazing meals, which are a huge help. We appreciate it so much!

FIX A BUG FOR NANCY

Nancy's project team held an Oktoberfest “Pinkluck” for Nancy today. The 80 member CHARMS team turned out in pink for their beloved project manager and friend. Lots of sweets were consumed in honor of sweet Nancy: the team is channeling their nutrients to Nancy to keep her strong! Over the next two weeks, before the next round of integrated system testing, the project team will be working to knock off some system issues; the team is making great headway under the tagline of "fix a bug for Nancy!” Since they expect Nancy misses the joys of project management, they are developing a “Get Well Gantt Chart” to help her reach her wellness milestones!!

Laughter, smiles and love-- a potent addition to chemo

Yesterday a group of Nancy's friends swept her away for an afternoon of much needed fun. She is feeling the effects of chemo quite a bit now, but she was incredibly touched and encouraged these friends.

My dear friend, Brent, had a great idea to rent a limo/party bus and take a tour of Washington wineries. I was so excited to have an outing with old friends and even more excited that two of my friends, who I hadn't seen in years, flew into Seattle and surprised me for the big event. I decided to try out my long hair wig for the day, then after it got itchy and annoying decided to pass off for everyone to try. I think my friend Al looked like quite the rock star in the Jennifer Aniston wig!

You know how I talk about those unexpected silver linings that come from having cancer? Today was one of those moments. It was so fun to hang out with my friends, most of whom I've known for over 15 years. I ended the day a little tired, but completely uplifted and encouraged. Thanks Brent, Tiffany, Steve, Al, Mindy, Heidi, Rebecca, and Sue! You guys are awesome!

Kindergarten Prayers in Nashville

Last Monday, I took Graham (aka 'Nephew Awesome', deemed by 'Uncle Awesome'-- Jake) to visit his former kindergarten teacher. When sweet Mrs. Anderson heard about Jake and Nancy, she gathered all of her little kindergartners on the floor to pray for them. Little voice after little voice asked for healing and comfort for "Uncle Awesome and Aunt Nancy." One little boy, who is the son of a famous musician who recently underwent chemotherapy and is now in remission, prayed that, "like a bow and arrow, God would shoot the cancer and make it go away." God hears those tender, precious, kindergarten prayers.... 

Chemo Week Three

Dear family and friends,

Thank you again for continued thoughts/prayers and well wishes. I had chemo today and it went smoothly. My friend Wendy was sweet enough to keep me company and bring lunch - thanks Wendy! She snapped a photo of us while we were waiting, so I thought I would send along for Kate to post.


As for medical updates, my back pain has improved a little in the past couple days, which is really encouraging. It isn't gone completely, but feels less intense since Tuesday. This is good news because we assume the chemo is starting to work. The plan is weekly chemo for 4 - 6 months, then switch to a treatment called an aromatase inhibitor (AI) which is easier to tolerate (just one pill a day versus the weekly infusions that last for hours and make me feel crummy). You can see from the picture I still have hair, but it is starting to come out and I'm guessing in another few weeks it will be falling out like crazy. Since this is the second time I've lost my hair, it isn't that big a deal. I have scarves and wigs on hand.


Thanks again for all the encouragment. It truly helps lift our spirits. Love and hugs, Nancy and Jake

Week Two of Chemo- a note from Nancy

Dear family and friends,

We continue to be so encouraged by the amazing outpouring of love and support. We can't thank you all enough for the prayers, cards, flowers, dog treats, emails, phone calls, and meals...oh my gosh, the meals are incredible! We are overwhelmed with gratitude.
So far, chemo is going smoothly. I had my second treatment on Thursday and the side effects are manageable. I am still having back pain from the area of cancer along my spine, but my oncologist thinks I'll have some relief in a few weeks as the chemo starts working.
Thanks again for all the support. We appreciate it so much!

As an aside to this note, I want to say something about Jake, or rather "Uncle Awesome"... According to Nancy, he should win the "husband of the year" award. Nancy relayed a humorous story which was so sweet and tender too ... Apparently on Friday, Nancy discovered a terrible bruise on her back. Perplexed by how it got there,  she trekked downtown to her doctor's office, hoping she could explain the enigmatic sore spot. But she couldn't. They agreed to watch it closely for any changes, and left it at that. It wasn't until that evening when she was relaying the sequence of events to Jake, that he remarked, "do you remember falling asleep?" Apparently, Nancy nodded off at the computer, and  as tenderly as he could, given her awkward position, Jake gently scooped her out of the chair and tucked her into bed. Nancy's guess is that he probably smacked a wall while trying to step over Jojo or something. In any case, sweet Jake, Uncle Awesome, you are so dear!

Biopsy Complete!

Treatment is underway for Nancy, and with the biopsy which was successfully taken this morning, her doctors will be able to better understand her cancer and target it with the most effective drug. Nancy is in quite a bit of pain right now, but with the chemotherapy she is undergoing, her oncologist hopes that her discomfort will subside shortly.

Please continue to shower Jake and Nancy with your prayers and love. The meals everyone has been providing have been a wonderful, real way to support them, and your words mean so much as well.

This morning the Nashville YMCA spin room was packed and wearing pink in your honor, Nancy-- rocking out to some good "girly music". I have done the same class in years past, in your honor, and I always am inspired by your strength. We all thank you for that and continue to stand with you in this fight.

Waiting with you...

Jake and Nancy are at the hospital and waiting to meet with their oncologist this afternoon. Another biopsy will need to be taken because the last one did not provide all of the information they needed. But Nancy will begin treatment today. She has a new port and is ready to start this fight.

We all continue to shower you with prayers and love.

(photos taken last year...)