Archive | August, 2012

How Long Do We Have on This Planet?

29 Aug

We don’t know.  How lucky we don’t know. What an absolute blessing we don’t know.

Which reminds me of an experiment our Rabbi (ex-Californian, now retired) used on his high school pupils. He asked the kids to raise their hands if they were told they could choose their life expectancy (limited to the age of 99). All, yes all, the kids put up their hands and said they’d be happy to be in control of their life-span.

Then he asked them how they thought knowing your life expectancy would affect day-to-day life. They discussed the problem of motivation, quality of life, living perhaps with disability and approaching their own self-imposed “shelf-life”. On a re-run of the original vote, the hands raised dropped to a hand-full.

I’ve come to the conclusion that dealing with this illness, with all its many facets, basically falls into two categories. The physical challenge and the psychological paranoia.  The first category is something I have to deal with – although hands-on help from the family and the seemingly unending drugs-for all-ailments (except cure) are certainly a great help. But the second category, unfortunately, spills over into my immediate family. At the moment, this is the real challenge.   

I think I wrote of a wish I shared with a cousin a while ago – to be at my daughters’ weddings. “But you were at their Bat-mitzvahs,” he retorted.  “So?” I said. The point was that life has the habit of us always wanting more.

How often, behind very closed doors, we, in the immediate family discuss the differences between what will happen to me and those who survive me. As the rabbi said, lucky that life doesn’t give us the definitive batting order. The discussions are emotionally exhausting moments – but at the same time motivating. They motivate me, they motivate others and as I said in my last blog, I’ve even been moved to try and motivate people who I don’t know.

Reading my last blog I see that there’s a certain amount of repetition. Nothing new; only a few days wiser. And what have I learnt? That life continues to be full of surprises and hope. The discussion came up with my oncologist today.  How lucky that I have a dedicated doctor determined to do the best for me.  She told that there’s yet another trial in the pipe-line. This time by an Israeli Jerusalem based company called Silenseed. See their website on  http://www.silenseed.com/

The Silenseed siG12D LODER enables the targeting of an undrugable target. It’s a miniature biodegradable polymeric matrix that encompasses anti K-RASG12D siRNA drug, designed to release the drug regionally within a pancreatic tumor at a prolonged rate for a period of ~12-16 weeks. Clinical studies of its first target – pancreatic cancer – started at Hadassah, Tel Hashomer and Shaare Zedek medical centers in Israel last year. Today, of the 12 people treated world-wide, 9 are at Tel Hashomer. According to my oncologist they’re having encouraging results. By the way, the Israel Advanced Technologies site, is also worth a visit: http://www.ilsi.org.il/companies_life_science_company.asp?ID=1861. It’s is a font of fascinating Israeli latest developments. One doesn’t have to wait for dark moments to let the sunshine of pride come through from their achievements.

We have to believe a solution is on the way. Yet again, I have to consider how cathartic this blog can be. Tomorrow, I might just embark on another “new Project”. As I’ve said before: Another dip into the savings – long may they both (life and the savings) last!  

 

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Waiting in the Wilderness

21 Aug

I looked in the mirror this morning and perceived that my eyebrows might have started to grow back. It didn’t fill me with the joy or excitement I had expected. I had a long look at my hair – and if this hasn’t yet started to grow back, at least what I had left has got longer. Picking up the paper this morning, I couldn’t decide whether my garden is half flourishing or half dead. Difficult for anything to survive in this summer’s heat.

But survival is the name of the game. Now, I’m taking stock, looking around trying to find out what’s going on with me; surrounded by the same loving family with their same enthusiasm to keep me fighting.  But do I know in which direction I’m going? Do any of us really know? Perhaps I’ve just got more time to think about it.

From the moment I was diagnosed I knew there was no cure – only the hope that I have to hang around long enough until a cure is found. There’s lots going on out there in the field of research but what about what’s going on inside me? How happy I was to know that some Israeli research proposals have just been submitted in time for this week’s deadline of the annual selection process of the Hirschberg Foundation. It also gave me great satisfaction that a faithful blog reader had asked me the other day to contact a pancreatic cancer sufferer. She wanted me to encourage him to rejoin the fight. Hopefully I’ve given him a few clues.

Religious Jews might say that this is the time of year when we’re all obliged to get some perspective of our lives before the New Year. I find myself doing this on a daily basis – often at more frequent intervals. Perhaps its just par for the course. It manifests itself in daily decisions. Is it worth saving our Shekels or not? Should we go to the expense of repairing/replacing things in the house or just not bother? Another overseas holiday? – A bit indulgent, no?  Have I got enough things to do, or as my youngest daughter says, am I just manufacturing projects?

Maybe, we all ask ourselves these questions all the time. I just don’t remember that they had the same meaning before I was ill.

At least the Olympics had the positive effect of me trying to rejuvenate something else from my previous life – a proposal for the Maccabiah Games.  I presented a concept three years ago after the last games. Although it was politely, if not overwhelmingly enthusiastically received – it didn’t get anywhere.  But that’s another story.. .  .

At least I’m around to contemplate the answers – and if I can find the energy I’ll perhaps pursue some new avenues. Mytomycine C and Xeloda are challenging me at the moment with their side effects. I’m waiting for the Parps patiently.

Preparing for the Parps

10 Aug

I’ve used the term “roller coaster” several times to describe my bumpy  pancreatic cancer fight. A couple of days ago, two of my daughters danced into my room while I was resting , delighted with news they couldn’t wait to share: “Positive progress on the Parps. Abbott Laboratories[1] are starting Phase 2 trials – and it seems that you’ll be getting their drug”. Good news indeed.

Bad news is absolute – but this news left me stunned. For so long Pam has talked about the Parps as being the “game changer” while I’ve tried to temper her enthusiasm with what she saw as cynicism. I found the good news hard to digest. The concept of stopping chemotherapy for something better – that has “no side effects” – is too much to process. The belief that a cure will come keeps me going – yet just as it seems that we’re one step closer, I still can find no reason to celebrate. Inexplicable.

To think that Abbott is a corporation that grossed nearly US$ 40 billion last year – about a sixth of Israel’s total gross domestic product. That Abbott spent more than US$ 4 billion on research in 2011 – almost as much as Israel’s entire Ministry of Health budget. But it has brought them to Phase 2 trials of their drug Veliparib[2].

Veliparib, or ABT-888, is an orally active poly (ADP-ribose) polymerase potent inhibitor of both PARP-1 and PARP-2 that potentiates DNA-damaging agents in preclinical tumors. In the MX-1 breast model (BRCA1 deletion and BRCA2 mutation), it causes regression of established tumors, whereas with comparable doses of cytotoxic agents alone, only modest tumor inhibition was exhibited. Veliparib has been around since 2008 when trials first started for metastatic or unresectable solid tumors or non-Hodgkin lymphoma. Abbott’s trial version is specifically directed at pancreatic cancer suffers with the BRCA2 mutation.

I’m certainly no scientist, nor do I profess to have a working knowledge of these drugs. But I can recommend any and everyone that has pancreatic cancer to test whether they are a BRCA2 carrier. If so, contact Memorial Sloane Kettering, who are running the trials, (or Tel Hashomer Hospital, if you’re in Israel or your national oncology facility).

I was sitting outside my oncologist’s waiting room on Wednesday, waiting to hear more details of her breaking news the day before. Inevitably I flipped through my phone’s inbox to find an e-mail blinking. To be a messanger of bad news is not easy. A pancreatic cancer sufferer I tried to help had passed away. I couldn’t hold back the tears.

I’ve looked back to see if I mentioned him in a previous blog. On 20th May, 2012, I made a reference to him. He was my source of the trial I referred to in that blog. And here I was waiting for news of another trial.

I looked myself in the mirror this morning and seemed to perceive that my hair has slightly grown back. Is it just longer or is it the result of stopping Abraxane? I can’t wait to find out. 

 


 

[1]   Abbott’s website is worth a visit. Click on  www.abbott.com

[2]  I haven’t found any information through Abbott Laboratories but can direct you to  www.inhibitor2.com for more information.