Monday, February 29, 2016

Monday Motivation - 7 Week Countdown!

7 weeks from today we run the Boston Marathon. This morning was the third morning in a row that I awoke at 5:00am with high hopes of running 16 miles. However the only running I did today was to the pharmacy, to finally pick up a steroid prescription in hopes of calming down my angry asthmatic lungs (which have been more active this week than the rest of me).

And believe me, I never thought the day would come when I would say I am frustrated because I couldn't go out and run 16 miles. But I am. It is maddening to feel fine with the exception of your lungs rebelling with every breath. To be stuck at home knowing you are causing more work for other people. To feel weak when all you want to do is be strong.

But these cough riddled hours on the couch have given me pause to reflect on just how very precious our health is. And it is a stark reminder that I am running because each and every day, people's lives and health are forever changed in the blink of an eye when they receive a cancer diagnosis. And so who am I to complain when the frustration I am feeling is merely momentary and will (hopefully) subside in coming days? When the "inconvenience" of my ailment is but a fraction of what cancer patients and families endure for not just days or weeks, but months and years. When I know people who are sitting in treatment every day and then heading out to log miles on the weekend because they won't let their diagnosis hold them back. And when there are countless parents, friends, and loved ones who have to be strong all the time for those who simply can't be. Well, that sorts of puts things in perspective doesn't it?

So instead of whining about what I missed out on this weekend, I am going to focus on what will drive me forward the rest of the week.


When people ask me why I am running again this year, one of the top reasons is because I am simply so proud of the impact the Dana-Farber Marathon Challenge has had, and continues to have, on the future of cancer care and cures. But what do I really mean when I say that? Well for starters, it means that when you make a gift to DFMC, 100% of each and every dollar goes DIRECTLY towards funding research projects via the Claudia Adams Barr Program at Dana-Farber. Not a single cent goes towards the tremendous amount of lady/man power, support, and resources it takes to get 500+ runners to the starting line on Marathon Monday, or towards the "administrative" costs you will often encounter when supporting similar initiatives. Which means that even a $10 gift can help make a difference (and help make you a winner during my March Madness opportunity drawings)

As such, today I want to highlight the work being done by David Weinstock, MD and the Weinstock lab, 
which is particularly fitting in advance of my next guest post which will give you an insider look at the work being done in this lab!  With support from the Barr Program, Dr. Weinstock and his laboratory members collected and analyzed samples of a rare leukemia called Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN). BPDCN is a rare, aggressive form of leukemia that affects approximately 800 people in the United States each year. Patients with BPDCN face a tough prognosis, and researchers are working hard to learn more about this illness. Dr. Weinstock and his team discovered a mutation that can promote the growth of BPDCN cells. Having identified the mechanisms through which this mutated gene drives leukemia, they are now testing a strategy to target this mechanism. Dr. Weinstock's team also discovered that this gene is mutated in many other cancer types, including melanoma, ovarian cancer, some forms of lymphoma, and other types of leukemia. Dr. Weinstock's research could therefore have major implications not only for BPDCN, but could also lead to the development of new therapies for many other forms of cancer. Dr. Weinstock and his collaborators published some of these findings in December 2014 in the journal Nature Medicine. Oh and if that isn't amazing enough, Dr. Weinstock is also running his third Boston marathon this year a part of the DFMC team!

Still think $10 doesn't make a difference? Think again. 



















Tuesday, February 2, 2016

Guest Post - Paige's Story, "Five Years Later"

Since becoming a part of the DFMC family (and let's face it, this really is a family and not just a team), I have met so many amazing people who have inspired me with their stories of resilience, healing, hope, and yes - even struggle and loss. One of my goals in my second season was to share some of these stories with all of you in hopes of showing why our mission is so important, as well as the true and tremendous impact that your support has in getting us closer to a world without cancer. And what better way to hear these stories than from the special and brave people who have shared them with me.

With that in mind, today I introduce my first guest post written by super Mama extraordinaire Heather. Four years ago, Heather was one of the first people to welcome me to Boston as I interviewed for my company. I learned two things in those first days in Boston which would stick with me. First, that our office was located on the 26 mile mark of the Boston Marathon course (after asking "oh, does it go by here" as my coworkers excitedly talked about its approach that Spring and then looked at me like I had three heads - yeah, it goes by here). Second, that there was a pretty awesome place in Boston called Dana-Farber. The latter I learned via hearing Heather discuss the cutting edge and life saving treatment her young daughter Paige had received at Dana-Farber and the Jimmy Fund Clinic. I will never forget the day that Heather sat in our office suite and reached for tissues after learning that Paige's routine scans came back questionable. "I thought Paige was cured?" I naively thought to myself. The look on Heather's face was one that no parent should ever have and it will remain forever seared in my memory. It was in that moment that I realized just how devastating this disease is, not only at diagnosis and through treatment but in the ensuing years afterwards. It is not merely a detour from the road you are on, but a complete departure to an entire new road all together. There is no going back. And that's not to say that road is necessarily bad, it's just forever different. So here now, in Heather's own words, is what life is like on that new road. My love and gratitude to Heather for offering to share Paige's story with all of you, and Paige will be among those who I run in honor of on April 18th and always. 

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"Five Years Later"

May 3, 2015 marked five-years since we heard those unfathomable words, “your daughter has cancer”. I still remember like it was yesterday as well as the weekend before that fateful MRI and ultrasound on Monday, May 3, 2010 revealing her disease. That weekend, we were going big-girl bed shopping for Paige because Miss Maya would be arriving in just two short months and needed the crib to rest her little head. Paige wore a smocked sunflower dress that day. The Friday before, we had met with an orthopedist who reviewed her knee x-ray from the previous Thursday which had indicated a lesion on her left knee. He laid out all the possible scenarios but never focused too much on cancer. Instead, he scheduled an MRI for that following Monday. We dragged through that weekend thinking, “there is no way this could be cancer. Cancer doesn’t happen to little kids… especially our little girl. But what if it is cancer? What do we do then?” We cried a lot that weekend out of fear and not knowing. That was our last normal weekend before cancer changed our lives.

Monday came. The MRI was done under sedation which was terrifying. We had no idea then that our little 22 month old baby girl would be sedated at least four more times that week and dozens and dozens of times in the years after that. The hematologist/oncologist met us after Paige recovered from sedation in the playroom at Tufts. I remember not grasping immediately who this doctor was and why she was talking to us. I was just looking for MRI results and not paying attention to the messenger. The messenger wanted to have an ultrasound done of Paige’s belly so off to radiology we went again. That beautiful baby girl laid patiently on the ultrasound table with jelly smeared over her abdomen and a weird “stick” pushing on her tummy while I held her hand and sang about a million versions of Wheels on the Bus. The tech left the room to get the head of radiology. He returned, poked her belly with the stick-thingy while the tech looked at us with sympathetic eyes.  He then told us about the mass in her belly the size of a lemon. No one had said cancer at this point. 

We met with the hem/onc doc again after that where she said she needed to do more tests and we would be admitted. They took blood and did a biopsy of her knee where the lesion was first discovered. Taking her little body into that operating room the first time was unbearable. The days started to fold into each other after that because neither Garrett nor I slept and there was a boil-water requirement in Boston that week (that isn’t really relevant but I remember showering at the hospital 7 months pregnant trying not to get water in my mouth!). I believe it was the next morning when the biopsy and labs came back that confirmed neuroblastoma. The doc had asked to speak to us out of Paige’s room near the nurses’ station to give us the news. She used this strange word “neuroblastoma” and I wrote it down. I still hadn’t heard the word cancer so I asked the question, “Is this a type of cancer?” Her response: “Yes, your daughter has cancer.” I asked the question that I didn’t want to know the answer to after that, “What is her prognosis? What are her chances for survival?”. After the doc tried to avoid answering, she finally said, “50/50”. 

That week at Tufts was horrific. The procedures Paige endured, the information we had to learn, the choices we had to start making were overwhelming. The first difficult decision we made was to transition her care to Dana Farber where she could receive all phases of the COG protocol she was to follow and where she would have a solid tumor specialist managing her care. Our families, local adoptive families (those who ‘adopted’ us since we moved to Boston), and friends were more than incredible from the very beginning and right through the end of Paige’s treatment.  I reflect often on those people who came out of nowhere offering all different kinds of support; people who were always close to us as well as those I hadn’t spoken to in years. It still amazes me.

Every day of Paige’s treatment is vivid in my mind but it seems like a dream. You know those dreams when you wake up and although images might be kind of fuzzy but you remember details like smells, feelings and emotions? That’s what those 15 months are like for me. I thank God every day that Paige has very little, if any, memory of that experience.  

Five years after her diagnosis, Paige is still with us. Are we blessed? Did we win the gene pool lottery (that’s ironic, isn’t it?)? Was it something we did to get to this point? I don’t know. I think it’s just luck. I read a blog recently of a mother who has a child who appears to be “out of the woods”. She made such a great point in describing how children with serious medical conditions are never out of the woods; they live in the woods and make the best of the leafy canopy that covers them from basking fully in the freedom of the sun. I know there are people who think we are slightly nuts when it comes to the food we eat and the products in our house. But here’s the thing: Paige has had more toxins pumped into her little body at age 7 than 10 people will have in a lifetime. It is our job to limit the other toxins she is exposed to in her environment because the woods are a freaking scary place and we never know when one of those long term effects from her aggressive treatment will manifest into something else. We know all of the potential long-term side effects that Paige will be managing for the rest of her life and its’ flipping terrifying. The woods suck but, here we are. It’s our job to do everything we can to try to prolong the occurrence of those late effects and make her body strong now to fight later.

Part of living in the woods is living with and managing the care of a child who needs “a little more”. Paige still has a million doctor appointments with specialists both on-cycles and off cycles. I often refer to the number of “-gists” that Paige has in her life and that list continues to grow: oncologists, cardiologists, radiologists, allergists, nephrologists, pulmonologists and more that I’m “gist” forgetting.  We spend a lot of time with her different audiologists: one for her actual hearing loss and one for the hearing aids. Additionally, I spend a lot of time with specialists in her school as well as her teacher in figuring out the technology to help her hear better during class and working with the deaf and hard of hearing specialist to ensure the technology is accurate. Beyond the technology in school, it’s staying on top of the specifics of her needs in the learning environment and watching closely for signs of cognitive impairments brought on by the treatment she endured, not the cancer itself. Her hearing impairment and learning development alone are consuming enough not to mention all of the organs we must monitor so closely which is why I don’t have much left to give for all the normal kid stuff (I’m still taking applications for a wife, if anyone is interested) and I have given myself a 50% efficacy rate as a “normal” mom. 

I received a call from the Cord Blood Registry (CBR) last month saying that our five years of free cord blood storage (free because of Paige’s diagnosis) for Maya’s cord blood was ending in July. That also took my breath away. If it weren’t for Paige’s diagnosis, we never would have considered banking Maya’s cord blood because we didn’t bank Paige’s. I’m so happy we did and we will continue to do it because every day, brilliant minds are finding ways to use that powerful cord blood to help people. The CBR web site indicates stem cells are used 73% of the time for the person from whom they were taken and 27% of the time for siblings. I feel like it is an investment in both of my girls’ futures and pray we will never have to use them but I’m happy knowing they are there.  I recently read a clinical trial where cord blood is being used to help children who have suffered hearing loss like Paige’s. If we would have reserved Paige’s cord blood, she could have potentially participated in this trial to see if her hearing could be regained. I cannot and do not dwell on that past because if you would have asked me what I thought the chances of one of my children getting cancer back when I was pregnant with Paige, I never would have imagined that it was a possibility. The call also reminded of driving around five years ago with a cord blood kit in my car in case I went into labor when I was at Children’s or at Dana Farber. Ahhh… memories…

In five years, none of us are the same. My family outwardly resembles the people we were five years ago (with the addition of wrinkles and gray hair… lots of gray hair) going into this experience but we are forever changed. I know that about myself and those who knew me best before dx would probably say the same. Something was taken from us and although I have tried hard to get it back, I just can’t fill that space. For Paige, I believe that my free-spirited, willful, happy child is probably who she would be regardless of her diagnosis because she doesn’t remember it and her approach to life is hers alone. I admire that about her not to mention about a billion other things.

We had Paige’s tests in August… note I didn’t say scans. Everything came back clear! This is the first time in five years that Paige was not lit up from the inside, squeezed between MIBG plates, sedated for MRI or had her breathing controlled by another human in order to see what’s going on in her little body. This time, she had labs, urine, pulmonary, cardio and will have renal later. This was the first time in many years that she actually had to have a “poke” to draw labs which was a little stressful for her. She is the bravest person I know, not only from what she endured through treatment but also just in her drive to experience all life has to offer and always with that smile that lights up a room. We’ve also just added another –gist to her list of doctors too: an endocrinologist to monitor her body as it matures and approaches puberty at the right pace. So, I don’t know what to call this feeling that I have referred to as scanxiety for the last five years… is it just anxiety? Well, that sounds like a normal emotion… I’ll take it... at least until February.  

Paige started second grade this fall and Maya started kindergarten. I still can’t believe it. Paige’s teacher has described her as “a bundle of joy”. She is certainly a bundle of something! Five years ago, I had prayed for second grade not because I wanted to blink through the bad stuff but because in my warped mind, if she got to second grade it meant she would be five years passed diagnosis and on the other side of the scary odds. She is there. Although we continue to wander the woods on high alert, there are breaks in the canopy where the sun filters through shining more and more light on the time we have to enjoy a seven year-old who is on a normal-kid path. 

I decided to retell Paige's diagnosis story this past September because it was Childhood Cancer Awareness Month and while it is now February, awareness of childhood cancer is a year-round struggle. If you are reading this, you are aware already. My request is that you help spread the word of childhood cancer and that with the right funding and attention, more kids can have a response like Paige has had. Share her story. Encourage friends to donate blood, platelets or time at their local children's hospital because all of those things can save lives as much as funding can. Wear a gold ribbon and when asked why, tell them that you know a Super Bug who has Super Friends who all deserve more.

Monday, February 1, 2016

Monday Motivation - 11 Weeks To Go!

Fact: Saying in January that you are running a marathon in April is a lot less scarier than saying it in February.

The 2016 Boston Marathon is 11 weeks from today and things are really starting to heat up - no, literally. It is currently 62 degrees in Boston, birds were chirping as I left for work this morning, and most of the snow in our yard has melted away. This is a far cry from last year's frigid temps and the mountains of snow that towered over me for months. And I am not complaining! However, if that groundhog sees his shadow tomorrow I respectfully request the right to ask for clarification as to whether that would be six more weeks of this winter's weather or last year's.  

If the weather isn't motivation enough today's impact statement reminds us why will run our hearts out on April 18th (and in the 77 days leading up to it). While every type of cancer diagnosis is life changing, none are perhaps as scary as a pediatric cancer diagnosis. So today I wanted to highlight the work of Barr investigator Dr. Rani George, whose research into neuroblastoma in children is leading to new and innovative treatments to fight this aggressive cancer.

Neuroblastoma has historically been a very difficult cancer to treat in children, and, although
chemotherapy and stem cell transplants have improved survival, relapse is common and nearly
almost always fatal. Dr. George and her team used Barr Program funding to discover that about 10% of pediatric neuroblastoma tumors contain a mutation in the gene ALK. Several successful drugs
already exist to treat other types of cancer that demonstrate these same ALK mutations, so Dr.
George and her team were able to initiate clinical trials that could result in new treatments and have the potential to improve survival for children with neuroblastoma. This research also paved way to continued research by Dr. George and her team to investigate the mechanisms of ALK activation and regulation, as well as strategies that can be employed therapeutically. You can learn more about Dr. George and the tremendous research being done by her labratory HERE.

Today you are learning about the clinical side of neuroblastoma and how your generous support helps to have an impact on this and other cancers. Tomorrow I will share a very special post that shows the other side of a Neuroblastoma diagnosis and you will not want to miss it. Until then, I leave you with one of my favorite pieces of motivation which I believe both runners and researchers can appreciate.