Wednesday, September 17, 2014

Can Happiness Fight Cancer?

It has been more than a month since I documented my continuing treatment plan for Stage IV, triple negative breast cancer.  In the past few weeks, unfamiliar road blocks have cropped up, teaching me even more about this insidious disease than I ever wanted to know.  Just to clarify, what I’m experiencing is no different than what others with cancer endure everyday, it’s just new to me and my battle.  I'll explain...

Marla, smiling through
chemo treatment #7
Several weeks ago, Dr. Makhoul ordered a routine PET scan to determine how the carboplatin/gemzar chemo cocktail had impacted the small, cancer-laden tumors in my bones, liver and lungs. After the second dose of the chemo drugs, we were all elated that the cancer nodules on my head and back had disappeared.  Dr. Makhoul was in hopes the drugs were having the same effect on other parts of my body. 

Interestingly, the chemo destroyed some of the old lesions, which were not detected at all on the scan; however, new ones showed up, mostly in my spine and liver. Needless to say, I was disappointed that more progress had not been made, as was Dr. Makhoul.  He suggested that we start looking for new drug trials again, especially since the idea of going to M.D. Anderson in Houston fell through. Dr. Mak planned to have his research team investigate various drug trials all over the country to see if there are trials for which I might qualify.  He said he would call me a few days later with an update. 

In the meantime, the good doctor prescribed the third carboplatin/gemzar treatment.  He felt that even though the results were not as good as we had hoped, it was still working – slowly - and should be continued while the search was underway for a drug trial. 

My brother, Mike, and sister-in-law Barbara faithfully traveled to Little Rock, once again, and accompanied me to Infusion 1 for the treatment.  Unfortunately, the chemo treatment and the medical team that administers it have become routine.  Each week, with a nod of the head, we acknowledge familiar faces awaiting their turn for treatment. We smile and cordially speak to one another as we patiently wait for the poison concoction to trickle into our bloodstreams and silently pray that remission, or better yet, a cure, is just a drip away.

The week following my third treatment, I noticed that the fatigue was more prevalent than usual.  I actually became winded when I made the walk from the parking lot at work to my office, which was unusual.  Mid-afternoon became a challenge for me to stay focused and awake.  I assumed that the third treatment of chemo had built up in my system, just as Mr. Nurse Ratched had predicted.

When I returned for my next chemo treatment, a week later, I reported for the usual lab work to check my red and white blood cells.  About 30 minutes later, the charge nurse in Infusion 1 called my name in the waiting room.  I assumed she was escorting me to a recliner for my treatment.  Wrong!  She informed me that my white blood count was very low (neutrophils at 2.1); therefore, Dr. Makhoul cancelled my chemo.  In fact, she said Dr. Makhoul was very concerned that if I were exposed to a cold or other type of infection my immune system wouldn't be able to fight it. She explained that if I ran any fever over the weekend I was to call Dr. Makhoul immediately.  Well, it was now understandable why I was experiencing extreme fatigue; it was the low white blood count.

The plan was to stimulate my bone marrow to make more white blood cells, so Dr. Makhoul prescribed three consecutive days of Neupogen, a drug that would do just that.  The first injection was scheduled to be given that day – Friday – while I was still in Infusion 1.  The RN, who was preparing to inject the Neupogen into my belly forewarned me that the main side effect was bone pain.  Well, that’s just dandy – fatigue AND bone pain.  The next injection was to be given on Saturday morning at UAMS Cancer Institute on the 4th floor, where multiple myeloma patients receive treatment, followed by another injection on Sunday morning in the same location.

Over that weekend, I was not only exhausted, but I was experiencing a lot of bone discomfort that moved from my upper spine to my lower spine and all places in between. All I could hope is that the pain was due to my bone marrow making lots of new white cells.  The good news is that by mid-week I felt like my old self – full of energy and a renewed fighting spirit.

I was scheduled for another chemo treatment the following Friday.  When I reported for the routine lab work, I was anxious to know the results.  About 30 minutes later, I was called back to the infusion room… for chemo.  My white blood cells had increased enough to get back on track with treatments.  I was relieved because every week without chemo could give the cancer cells a head start.  Bring on the chemo; I’m more than ready.

The following week, the extreme fatigue returned, indicating that my blood count had dropped again.  When I reported that Friday for the next chemo treatment, I flunked my lab test and, again, had to take the Neupogen shots to build up my white count.  The next five days were filled with exhaustion and bone pain but my energy level improved by mid-week. 

I had an appointment with Dr. Makhoul a few days later.  We agreed that I would return to a regular chemo schedule and the Neupogen shots would automatically follow for three consecutive days after each treatment.  This plan would keep us on track and prevent any future cancellations of treatments, which suited me just fine.

During our visit, Dr. Makhoul informed me that his research team had found two new drug trials for triple negative breast cancer for which I might qualify.  Both trials are being conducted at Washington University in St. Louis.  Dr. Makhoul was very excited about one of the trials in particular, which involves a chemo drug that is currently being used as a treatment by some oncologists for other kinds of cancer – one that I have yet to experience.  After administering the existing cancer drug, the trial drug would be injected, which should flush the cancer cells into the bloodstream, making them much more susceptible to being “zapped” by the existing chemotherapy drug. We learned that this particular drug trial is taking a three to four-week hiatus to collect and organize the data collected at this point.  When the trial comes back on line, Dr. Makhoul has submitted my name and case for admission to the program.  

The second trial is brand new and involves testing the cancer-laden tumor that was extracted during last year’s mastectomy.  If the tissue contains a particular mutation, then I would qualify for the trial and be given a new immunotherapy drug that would enhance my immune system and improve its capability of fighting cancer cells. The medical necessity for me to qualify for either of these drug trials is monumental. As Dr. Makhoul told me several months ago, the plan is to keep me alive long enough to find a cure for my particular type of breast cancer.  While those words are sobering, they are also my reality. My fingers are crossed and many prayers are being said daily in hopes of qualifying for one of these programs.

Several weeks ago, someone asked me how I cope on a daily basis with the knowledge that I have Stage IV breast cancer.  My answer surprised the inquisitor.  Even though I have a life-threatening disease, my life is good.  I work at a job that I love and with people that are like family.  My responsibilities at the Arkansas Department of Parks and Tourism help occupy my mind so that cancer seldom enters my thoughts during the day.  I’m a happy working girl.

In addition, I’m lucky and fortunate to have a loving relationship with Don, who has been with me during every step of this battle. He interprets the tests and translates the doctor­-jargon that might confuse any other patient.  He talks frankly with me and doesn't soften the reality that I’m sick.  He makes me happy.

I have a caring family that has committed themselves to accompany me to each chemo treatment and doctor’s visit, even though they live more than 180 miles away. They provide me with encouragement and embrace me with their love and support on a daily basis and that makes me happy.

My support network is hundreds strong and includes friends, both old and new, colleagues and acquaintances that cheer me on and offer their prayers when I need them most.  They make me happy. 

I’m fortunate to have a remarkable, experienced medical team that cares for me as an individual patient and not just a number.  They are just as concerned about my health status as I am.  They talk me through the difficult treatments, answer my questions and treat me with respect-and that makes me happy.

Cancer has taught me much, like loving unconditionally and not taking myself too seriously.  It has taught me how to be grateful for the smallest of accomplishments and to appreciate the wealth of support and encouragement received from family, friends and my medical team.

Make no mistake; cancer is not my friend, yet it is a part of my life.  One of the ways I have learned to fight this disease is to not give into it.  How do I accomplish that?  By being happy!

And that, I am.


  1. Hi Marla,
    My name is Kathleen Engel and I am an editor at Health Monitor Network in Montvale, NJ. I would love to talk to you about doing a short profile on you for one of our guides, which are distribute free to patients through doctors' offices. Your words are inspirational!

    If you'll send me your email address, I'm happy to send you a PDF of our last guide so you can see what these look like. And then if you have any questions, just let me know.

    Thanks so much!

    Kathleen Engel
    Editor, Health Monitor Network

  2. Sorry, I forgot to include my email at work:

  3. you are truly inspirational. such things in life not only alter you physically but mental is gets also critical i am so inspired that you didnt give up and kept going. i will definitely learn a thing or two from you


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