Words That Heal

National Poetry Month, which takes place each April, is a celebration of poetry introduced in 1996. Those of you who follow The Teal Diaries are aware that I don’t often write poetry, however I’ve been inspired during my cancer treatments to pen a small collection.

In writing The Decades Pass I was motivated by a poem called He is Allowed into the Lab by Michael Harris. Like Harris, I’ve chosen to use the microscope as a metaphor for the intense scrutiny of the self and one’s life that occurs when one is diagnosed with cancer. My poem December Night was inspired by my first night recovering from cancer surgery.

 

The Decades Pass

Decades ago in my school’s biology lab I stuck a lancet in my finger.
One or two bright red drops on the slide to examine.
Under the microscope I saw my tiny cells in motion.
I gazed in awe at the unfolding miracle.
Precious in worth, exquisite in their design,
how perfect they were to my innocent eyes.

Astonished then to behold the building blocks of life,
but now what have they offered me in return?
Each one is fragile and prone to malfunction,
imperfect under the oncologist’s microscope.

Beneath that microscope I have suffered far too long,
enduring the relentless scrutiny of my diminutive body.
I am tired of never-ending demands for perfection,
of being another pathology to be cured.

Put away the microscopes, the anticipation, and the longing.
Each day is a blessing for me to enjoy in quiet solitude.
At rest, I ask myself why did I ever demand more?

 

blood_cells

 

December Night

“Were you on Unit 42 after your last surgery?”
I hear the nurse ask as I regain consciousness.
“No,” I mumble in slow motion through a thick fog.
I’m transported on a gurney, oblivious to the fact that
it’s early evening and my destination is the cancer ward.

I arrive and the darkness welcomes me on a deep
winter night, a crushing stillness surrounds me.
A compression bandage covers my fresh incision,
I reach down to touch my surgeon’s trademark.

My mother arrives and I have nurse Crystal.
A morphine pump to control my pain.
My throat is parched and I ask for water.
Not yet, Crystal calmly removes my glass.

For those below it’s simply another December night.
The world is turning, only two weeks until Christmas.
Outside an endless stream of headlights pressing in unison
toward some crucial or important goal.

The Long Road Back: Physical Fitness After Cancer

One of the aspects of cancer that surprised me the most is the physical toll that it took on my body. From my muscle strength to my ability to endure exercise, I noticed a significant decline in what my body could accomplish immediately after treatment. It didn’t help that near the end of my treatment in 2012 I was hospitalized for seven weeks while my doctors tended to a dangerous and extremely painful bowel obstruction. Nothing had prepared me for the length of my hospitalized, and I seriously don’t think my medical team planned for me to have such an extended stay in an acute care bed on the cancer unit. I will always remember the relief and unrestrained joy that I felt when I was finally discharged from the hospital. However, it wasn’t long before I realized that my ordeal had taken a tremendous toll on my body.

For the first time in my life I learned what it’s like not to be able to walk medium or long distances. It took nearly all the strength I could muster just to stand or walk very short distances, and climbing stairs was out of the question for me. I quickly discovered that the muscles in my legs had atrophied during the endless weeks that I was confined to a hospital bed. On the day I went home I had an absolutely helpless feeling as I was transported from my hospital unit to my mother’s waiting car in a wheelchair. As we drove I knew my recovery would be arduous and probably take months.

walking-exercise

Like many cancer patients, I began slowly and took my recovery one day at a time.  As your ability increases, you should begin to expand your activities, looking to improve your aerobic fit­ness, strength, and flexibility. No one exercise or activity is uni­versally recommended over another. The best exercises or activities are the ones that are safe and that you enjoy (or dislike the least). The central pillar of my exercise routine involves taking a 20-minute walk every day. Study after study has extolled walking as a simple, inexpensive exercise with incredible health benefits. From a cancer patient’s perspective, walking regularly has been proven to strengthen the body and ease the mind. Several recent studies suggest that higher levels of physical activity are associated with a reduced risk of the cancer coming back, and longer survival after a cancer diagnosis.

The amount of exercise you require or that is medically advisable differs among individuals and you should always consult your doctor before establishing a fitness routine. The American Cancer Society recommends that cancer survivors get 30 to 60 minutes of moderate to vigorous exercise at least five days each week. They also give some suggestions for fitting exercise into your day:

  • Start a daily walking routine.
  • Wear a fitness tracker, and try to go a bit farther each day.
  • Walk or bike to your destination, when you can.
  • Exercise with family, friends, or co-workers.
  • Use a stationary bicycle or treadmill.

The evidence linking physical activity with improved quality of life in those undergoing active cancer treatment and those who have completed it is incredibly strong. There are proven emotional and psychological benefits in addition to the physical ones. The most robust evidence is for people who have completed active cancer treatment, notes Dr. Kerry Courneya from the University of Alberta, who has led a number of clinical trials of physical activity in cancer patients. What experts have long suspected has now been proven. As a cancer survivor, exercising could help you live a longer life—free from recurrence.

Essentially there are three main types of exercises that can help cancer patients get back in shape.

  1. Flexibility exercises (stretching). Virtually everyone can do flexibility exercises. Stretching is important to keep moving, to maintain mobility. If you’re not yet ready for more vigorous exercise, you should at least stay flexible.
  2. Aerobic exercise, such as brisk walking, jogging, and swimming. This kind of exercise burns calories and helps you lose weight. Aerobic exercise also builds cardiovascular fitness, which lowers the risk of heart attackstroke, and diabetes.
  3. Resistance training (lifting weights or isometric exercise), which builds muscle. Many people lose muscle, but gain fat, through cancer treatment. For those with a high fat-to-lean mass ratio, resistance training can be especially helpful.

It’s recommend that you consult with your physician or a fitness expert to learn more about which exercises are the best for you. Personally, I know that the road to fitness after cancer can be long and difficult, but it can also be extremely rewarding. Within a year after finishing my treatment, I had progressed from pushing an IV pole down a hospital corridor to completing five kilometres in the Ovarian Cancer Canada Walk of Hope!

Poetic Discourse

Those of you who follow The Teal Diaries are aware that I write prose, however I’ve also been inspired during my cancer treatments to pen a small collection of poetry. Here I’ve chosen to share two of my short poems in honour of National Poetry Month. My compositions Patient’s Lab Results and A Visit to the Emergency Room both explore the life altering power of a cancer diagnosis.

 

Patient’s Lab Results

The sun is preparing to set on a late autumn afternoon,
its rays hold me together as I fall asleep dreaming of
my immaculate incision. Scarcely a week since my surgery.
I almost laugh to think I was such a novice.
Such a common virgin.

I pass through sliding doors to a point of no return.
Then I enter a vacant waiting room,
a place that is sinister, foreboding.
How many women have waited in these chairs?
How many innocent lives transformed?

“The ultrasound shows a growth on your ovary.”
“You need surgery to remove your uterus and right ovary.”
“You have cancer.”

Ultimately, he arrives, seeming anxious to print the pages.
“Here, this is for you.”
His words turn to ice as he offers me the pathology report.
Warmth as he grasps my hand, lending some reassurance.

My world dissolves as I take ownership of a disease.
The rapidly dividing cells, the cancerous tumors,
the abhorrent malignancy.

“Adenocarcinoma of the endometrium”
“The uterine cavity is completely filled with light tan neoplasm.”
“Right ovary with synchronous endometroid adenocarcinoma”

 

Immunotherapy one

 

A Visit to the Emergency Room

Riding unending waves of pain and nausea,
I take a secret pride in my endurance.
The sign over the door says MINOR EMERGENCIES.
Should I draw attention to this irony?

The young nurses seem aloof, peering out from
behind their curtain. I sense that we are to be
endured until morning comes. Around me
are the homeless, the destitute the addicted.

The fluorescent lights have been turned low,
casting a pale greenish tinge across the room.
Beeping monitors and moaning
patients provide the soundtrack.

I wonder if these souls feel entirely unaided,
abandoned, alone amid the chaos.
Each of us is fighting a singular
and solitary battle.

A torrent of frustration, then drowning I panic.
I want to scream that I’m a cancer patient
and my bowels are blocked.
I long for them to have evidence.
When will they be convinced?
I’m a bloated organ about to rupture.

The pre-dawn hours break like a fever
and I emerge from my delirium.
The kind eyes of the doctor and the
contrite look on the nurse’s face.

Five-Year Survivor: On Reaching Another Cancer Milestone

timepiece

In just a few weeks I’ll face an emotional and bittersweet milestone, the fifth anniversary of my cancer diagnosis. Above all I’m grateful that I made it through the grueling medical treatments that I had in 2011 and 2012. There were moments when I felt so sick and physically weak from surgery or chemotherapy that I was afraid I might die. I thank God for my oncology team; they were always there and never stopped encouraging me. It turns out they were right to be optimistic about my prognosis, or at least to be confident that I could achieve remission. I’ve been in remission from ovarian cancer, a disease that many refer to as the silent killer of women, for four years now.

As my cancer anniversary approaches, I’ve been thinking a great deal about how much things have changed for me. Personally, I’ve discovered that physical attractiveness, material possessions and social status all matter less to me now. These things frequently seem to fade into irrelevance as I confront a life-threatening illness. Meanwhile, my relationships with other people, discovering ways that I can make a difference in the world and learning more about the essence of who I am are currently at the forefront of my agenda and have an extremely high priority to me.  Most of all, I’m aware of time and of the immeasurable value of each day that I’m alive. Here are some powerful meditations that I though I would share.

“I ask you to imagine that there is a bank account that credits your account each morning with $86,400. It carries over no balance from day to day. Every evening the bank deletes whatever part of the balance you failed to use during the day. What would you do? Draw out every cent, of course.

Each of us has such a bank, its name is time. Every morning, it credits you 86,400 seconds. Every night it writes off at a loss, whatever of this you failed to invest to a good purpose. It carries over no balance. It allows no overdraft. Each day it opens a new account for you. Each night it burns the remains of the day. If you fail to use the day’s deposits, the loss is yours.

There is no drawing against “tomorrow.” You must live in the present on today’s deposits. Invest it so as to get from it the utmost in happiness and health. The clock is running. Make the most of today.”

 — Marc Levy, French novelist

“It’s being here now that’s important. There’s no past and there’s no future. Time is a very misleading thing. All there is ever is the now. We can gain experience from the past, but we can’t relive it; and we can hope for the future, but we don’t know if there is one.”

― George Harrison

“You must live in the present, launch yourself on every wave, find your eternity in each moment. Fools stand on their island of opportunities and look toward another land. There is no other land; there is no other life but this.”

— Henry David Thoreau

 

dead-poets-society1

In the film Dead Poets Society Robin Williams plays an unconventional English teacher named John Keating. In one of the movie’s most memorable scenes the teacher stands with his students gazing at some vintage school portraits. As they view the photographs of previous generations, this is what Keating tells the group of young men in his class:

“They’re not that different from you, are they? Same haircuts. Full of hormones,  just like you. Invincible,  just like you feel. The world is their oyster. They believe they’re destined for great things,  just like many of you, their eyes are full of hope,  just like you. Did they wait until it was too late to make from their lives even one iota of what they were capable? Because, you see gentlemen, these boys are now fertilizing daffodils. But if you listen real close, you can hear them whisper their legacy to you. Go on, lean in. Listen, you hear it?   Carpe   hear it?   Carpe, carpe diem, seize the day boys, make your lives extraordinary.”

Because it’s 2016: A New Era for Cancer Patients

One of the most stunning realizations that I’ve had since being diagnosed with cancer is how much cancer impacts the whole person—the disease can undermine almost every aspect of a person’s life. The field of oncology acknowledges this, at least more than it did four decades ago when my grandmother survived her breast cancer diagnosis. Today most cancer patients, including myself, have access to social workers, psychologists, dieticians and other skilled professionals. Treating the whole person and recognizing that each patient has unique issues and needs have become firmly entrenched and are part of the philosophy of cancer care.

At my cancer centre there are now two forms that patients are asked to fill out at every checkup. The first contains questions to gage a patient’s physical wellbeing as they go thorough treatment, but a second questionnaire was recently added. This latest form is used to gather information about the various psychosocial issues that are associated with cancer. Certain social, financial or mental health issues may need to be addressed. While I sometimes resent having to answer what I consider highly personal questions, I realize the importance of asking cancer patients about almost every aspect of their lives.

 

Research Breakthroughs

 

immunotherapy two

Dr. Barbara Vanderhyden, one of Canada’s preeminent ovarian cancer researchers, recalls that when she began her work she was one of the only people in Canada researching the disease. Over a decade ago Vanderhyden started the Canadian Conference on Ovarian Cancer Research and now the community has grown from three people to more than 60 ovarian cancer researchers across the country. This flourishing research community has led to a number of recent discoveries. For instance, it is now known that ovarian cancer is not one disease but a spectrum of diseases with different responses to treatment.

I’m frequently amazed at the lightening speed at which new cancer treatments are being discovered and implemented. For example, immunotherapy is an emerging approach to treatment that boosts the immune response to cancer. It enables the body to target and destroy cancer cells. There are three main areas of immunotherapy that are showing promise.

  • Vaccines that enhance immune system response
  • Inhibitors that affect how the immune system regulates itself
  • Adoptive T-cell transfer, which removes a patient’s cancer-fighting T-cells and activates them before returning them to the bloodstream

Although gynecological cancers, such as mine, have seen only modest breakthroughs in immunotherapy, melanoma and lung cancer are areas that are witnessing great progress.

 

New Targeted Treatments

 

Immunotherapy one

According to many scientists a new era of cancer treatment is beginning in which patients get drugs matched specifically to their tumour. Patients experience longer survival and fewer toxic effects through this approach, which is being made possible by advances in genetic profiling of the tumour itself. Conventional chemotherapy and radiation treatments have both short-term and long-term side effects and can be absolutely brutal for patients to endure. These treatments kill a significant number of healthy cells in addition to the cancer cells. “At the moment it’s more like using a cannonball to kill an ant – and creating a whole lot of damage at the same time,” explains professor Roy Herbst, chief of medical oncology at Yale Cancer Centre.

Meanwhile a UK trial, called Optima, is being run by University College London and Cambridge University and funded by Cancer Research UK. Beginning this summer, it will recruit 4,500 women with breast cancer. The women’s tumours will be genetically tested as soon as they are diagnosed to establish which will respond to chemotherapy and which will not. Of the 50,000 or so women diagnosed with breast cancer in the UK each year, about 40 per cent, or 20,000, are currently given chemotherapy but only half of them do well as a result of it; in the other half, the benefit is unclear. The researchers hope to find out which of the latter group actually need chemotherapy. As one oncologist emphasized: “In some ways it is simple – it means that you can make sure you are giving the right drug to the right person at the right time. In others it is very complex, because there are so many pieces to the jigsaw. We need to put the puzzle together.”

Unit 42 Haiku

National Poetry Month, which takes place each April, is a celebration of poetry introduced in 1996. Those of you who follow The Teal Diaries are aware that I don’t normally write poetry, however I’ve been inspired during my cancer treatments to pen a small collection.

There are few experiences in life as distressing or traumatic as being hospitalized for cancer surgery. In December 2011, I underwent surgery and was cared for on Unit 42 at Calgary’s Foothills Hospital. Many of the events that transpired are represented in the poetry that you will read here. In this case I’ve chosen to write haiku because of the format’s simplicity and

Blue slippers and gown
An eternity passes
in the pre-op room.

When he cuts me open,
no tumour for my collection,
crave smooth healthy organs.

Anesthesia mask
A few deep breaths are drawn
on my way to oblivion.

Recovery room
The bright lights overhead.
I’m dropped into darkness.

Conscious, I arrive.
The darkness welcomes me
on a winter night.

The room is spinning.
I long for perfect stillness,
let this voyage end.

van-gogh-starry-night

I have nurse Crystal.
The post-surgery hours pass,
finally the dawn.

They manage my pain.
Senses are dulled with morphine,
the standard dosage.

Compression bandage
covers my fresh incision
my surgeon’s trademark.

First blood transfusion
My outstretched arm is waiting
for type O to come.

My blanket is thin.
Comfort of warm flannel sheets
during the still night.

This building is old,
mid-twentieth century,
these rooms are vintage.

Generations past
have walked slowly down these halls
now I follow them.

19th Century Surgery

I have a roommate,
a Dutch Lutheran woman.
Her prognosis is grave.

New complications,
nausea, fluid leaks out,
doctors seem unsure.

Hard recovery
My progress has been so slow,
a mountain each day.

My carcinoma
hides under a microscope
in some nearby lab.

The truth will ooze out.
Why conceal my pathology,
daze me with a pill?

He stops by my room.
Cancer spread to one lymph node.
The truth is laid bare.

Too much of this place.
Even the walls scream go home
find the strength to heal.

Past empty wheelchairs,
through the lobby Christmas Eve
out hospital doors.

It Takes Lady Balls

As an ovarian cancer patient I’ll admit that I often feel overwhelmed by the dismal survival statistics and apparent futility of fighting such a deadly disease. Approximately 2,800 Canadian women are diagnosed with ovarian cancer each year and five women die from the disease every day. Currently, there are more than 17,000 of us in Canada living with the disease. The relative statistics are similar in the United States where 21,000 women will be diagnosed with ovarian cancer this year, and 14,000 will die from it.

Because the symptoms are usually subtle and there is no reliable screening test, ovarian cancer is frequently misdiagnosed or not discovered until it has reached an advanced stage. This makes treatment difficult, which is a key contributor to its high mortality rate. Ovarian cancer has a five-year survival rate of around 46 per cent, compared to nearly 90 per cent for breast cancer.

Each year at the Ovarian Cancer Canada Walk of Hope I’m proud to join a small but dedicated group of teal shirted survivors. Other participants in this key fundraising event wear white shirts— many in attendance at the walk are the husbands, children or grandchildren of those who have recently passed away. Unfortunately, since so many of us diagnosed with ovarian cancer die quickly after our diagnosis, the support network that typically forms around a cancer patient moves on quickly, creating what some have called a “leaky bucket” of advocates for the disease.

ladyballs

I was delighted this January when Ovarian Cancer Canada launched Ladyballs, their boldest and most successful marketing campaign to date. Their marketing team knew that to be successful they would need to create a slogan that could be heard above the din of other national campaigns. So rather than focusing on sad facts to illicit sympathy, the team at Ovarian Cancer Canada chose to focus on the tremendous strength of survivors and the power we all have to do something about women’s most fatal cancer.

Marketing executive and ovarian cancer survivor, Lauren Richards, spearheaded Ladyballs. Richards is a former Cossette Media and Starcom MediaVest Group executive who has operated her own Toronto media consultancy since 2013. She enlisted Canadian broadcasters, newspapers, magazines and online publishers to donate several million dollars worth of space and time for the campaign.

Those behind the promotion knew from the start that they were up against organizations that have become brands in and of themselves. For example, Movember is a brand for prostate cancer and Run for the Cure is an iconic brand in the fight against breast cancer. Knowing they had such low awareness and little money, it was a daunting task.

The Ladyballs campaign’s most visible component is a video spot in which women show their so-called “lady balls” by demonstrating chutzpah in the face of pressure or adversity. “Check out the lady balls on her,” one woman says to her co-worker after a female employee disagrees with a male boss’s decision during a meeting. “Look at the lady balls on her,” says a male announcer when another woman goes all-in during a televised poker tournament. In the concluding voiceover an announcer informs viewers that women have balls–their ovaries–and they’re always at risk. Viewers are then directed to donate to the cause at ladyballs.org.

ladyballs2

As expected, the campaign has been highly controversial. Some critics say the ad insults women by comparing a uniquely female body part–the ovaries–to men’s testicles. They say that women don’t have to stoop to that level to promote an informed discussion. However, I personally disagree with this view. I hold the same opinion as Matt Miggins, a nursing student at St. Clair College in Windsor.

“They are not mad five women a day die from this?  I find it ironic that they are mad about words. People should be mad at the fact this is happening to our mothers, sisters and wives,” said Miggins. He said he thinks people should put things into perspective. “People need to ask themselves, if the word balls saves just one life, is it then worth it?”

According to Ovarian Cancer Canada, the campaign has been instrumental in raising awareness. Ladyballs has been responsible for a significant increase in requests for By Your Side, a resource provided to women diagnosed with the disease. It’s also led to a spike in calls to offices across the country, with callers citing the campaign as their reason for reaching out. One woman who heard a Ladyballs radio commercial immediately pledged $100,000 to the organization, and the campaign has garnered approximately $60 million in earned media impressions since its January debut.