This week's weblog is past times Lauren MacDonald who was a 29 twelvemonth onetime junior physician when she was diagnosed alongside phase IV cancer. She wanted to portion her even to inspire our followers to non hand upwards hope, together with to maintain looking for option ways to back upwards their wellness together with wellbeing.
Hello friends!
Sorry I’ve been AWOL for the past times few months.
After becoming completely exhausted whilst working total fourth dimension inwards the infirmary this summer, I decided to hand myself some other career interruption for a few months (until I finally goal cancer handling at the goal of 2017). Despite the blood, sweat, tears together with shingles, I’m pleased I went dorsum to go when I did every bit it finally enabled me to consummate my F2 preparation together with at nowadays puts me inwards a seat to locum every bit together with when I have got the energy. In the meantime I’ve been enjoying a mixture of relaxing down-time along alongside embracing my novel ticket to worldwide move (my yoga instructor qualification) – summation nonetheless having handling at The Royal Marsden every 3 weeks.
My Recent Adventures
Sri Lanka
Just to acquire you lot upwards to speed on the past times few months… For those of you lot next my Instagram line of piece of occupation organisation human relationship (dr_laurencara), you’ll have got seen I shared my recent remain at Sen Wellness Sanctuary in Sri Lanka. Although the sanctuary is primarily a kundalini yoga together with ayurvedic centre, the lovely possessor Sam, who has go a honey friend over the past times few years, invited me out to experience the retreat but besides exercise educational activity vinyasa/yin styles of yoga. Below are a few photos from my trip – the starting fourth dimension i beingness of my beautiful friend together with kundalini teacher, Candace, who I learned hence much from during my fourth dimension at the sanctuary. If anyone is currently stuck inwards a labor that no longer serves them, if you lot are stressed together with exhausted together with feeling empty – just have got a await at this stock-broker turned kundalini instructor for inspiration!
After a calendar month inwards this beautiful healing setting I tin honestly study I felt healthier together with to a greater extent than energised than I have got inwards years. The nutrient was amazing, the people were inspiring together with the unloose energy inside the sanctuary itself was pretty incredible. I can’t recommend the experience enough.
Portugal
After my trip to Sri Lanka I returned to London for a busy calendar week of CT scans together with treatment. Fortunately my scan was in i lawsuit once to a greater extent than clear – pushing me beyond the i twelvemonth NED mark! (yay!). Following this wonderful tidings I together with then spent a wholesome calendar week at Vale De Moses, a secluded yoga retreat inwards the foothills of Portugal. The combination of eating fresh vegetarian food, practicing yoga daily, embracing a slower stride of living, together with having express wifi provided me alongside some other adventure to fully residuum together with recharge inwards the most beautiful setting.
Cornwall
My concluding adventure involved joining my friend, Julia, for her starting fourth dimension e'er yoga retreat downwards inwards St Ives. The 5 twenty-four hours retreat run past times Julia together with Jo (the squad behind By The Sea St Ives) was a combination of vinyasa together with yin yoga, nutritious, wholesome nutrient (plus a footling flake of wine), surfing, together with hiking. I was besides invited to verbalize to the guests about Gut Health which I absolutely loved.
What tin I say… the in conclusion few months have got been pretty epic!
Celebrating One Year Of No Evidence Of Disease
Although I didn’t throw whatever sort of i twelvemonth “cancer free” political party (or celebrate inwards whatever way come upwards to recall of it), I recall you’ll concur that I’ve been busy living life to the total together with celebrating inwards my ain way. I’ve besides finally started to brand plans for 2018, something I’d have got never have got done during the starting fourth dimension twelvemonth after my phase IV diagnosis.
Back together with then the average survival for patients alongside phase 4 metastatic melanoma was nonetheless considered to live less than a twelvemonth – due to it beingness a notoriously aggressive together with chemo-resistant shape of cancer. In fact just a few years ago, possibly just i inwards 20 patients alongside phase IV would live beyond 5 years. Therefore I institute myself living life inwards 3 calendar month blocks betwixt my scans. I institute it easier to endeavor together with live every bit mindfully every bit possible, living each twenty-four hours every bit though it was my last. As shortly every bit I started worrying most the hereafter I’d at nowadays ruin the introduce moment.
None Of This Would Have Been Possible Without Immunotherapy!
Despite the abysmal statistics for phase IV melanoma patients during the past times few decades, the statistics are finally starting to live re-written together with that’s all downwards to immunotherapy. Pembrolizumab, the drug I’ve been receiving for the past times xviii months, is i of the starting fourth dimension generation of immunotherapy drugs. It was designed to release the “brakes” that inhibit the immune organisation from attacking cancers. In the early on trials 24% of patients diagnosed phase IV had an overall response to therapy (meaning tumours partially or completely shrank). Fortunately, that’s precisely what happened to me. After my sixth infusion (around 4 months into treatment), several large visible tumours beneath the peel on my pectus began to shrink. By my 2nd ready of scans – around six months into my ii years of handling – all the tumours inwards my torso were gone.
Celebrating NED (Rather Than Being “Cured”)
The reality is that piece the cancer is no longer detectable, it’s for certain possible that traces of the cancer remain together with could potentially render i twenty-four hours inwards the future. I recall I’ll forever live slightly concerned most the fact cancer cells may have got crossed into my brain, largely because of a swollen lymph node at the dorsum of my caput which appeared just earlier I started handling (and together with then afterward disappeared). But I approximate for at nowadays nosotros tin tell I’ve been inwards “complete remission” for over a twelvemonth – which is pretty bloody amazing specially given the province of affairs xviii months ago.
Just to clarrify:
- Cure way that at that spot are no traces of cancer after handling together with the cancer won’t come upwards back.
- Remission way that the signs together with symptoms of cancer are reduced. Remission tin live partial or complete. In a consummate remission, all signs together with symptoms of cancer have got disappeared.
Obviously the hope alongside immunotherapy is that when your torso has learned to seat your shape of cancer, it remains vigilant against it. This seems to live the illustration for the growing issue of patients who have got had progression-free survival next immunotherapy. This summertime results were published showing 42% of subjects alongside metastatic melanoma who received pembrolizumab were nonetheless live iv years into the study (and the study is ongoing). Some 13% of the subjects who received my drug had a “complete response” (like me).
Remaining Side Effects
I experience similar I’ve had a pretty piece of cake ride alongside my handling compared to many cancer patients. My alone existent symptoms have got been that I acquire real tired sometimes together with I’ve developed vitiligo on my cervix together with jaw. And that’s it. However, immunotherapy is far from a guaranteed “get out of side effects free” card. My class of handling has gone relatively smoothly, but the side effects for some – from fever to colitis to pancreatitis – tin live hence severe that they’re unable to proceed treatment. Additionally non everyone repsonds together with inwards some rare cases people give-up the ghost from the side effects of the immune organisation beingness ramped upwards together with going out of control. Just this summer trials were halted inwards which pembrolizumab was beingness tested inwards conjunction alongside some other immune-boosting drugs to process multiple myeloma – citing an increased peril of death.
Boosting Immunotherapy
The other side of this money is that some patients don’t reply to immunotherapy together with scientists are at nowadays trying to go out what is it most the subsets of patients who reply that makes them different. Obviously it likely depends largely on the extent together with spread of illness at the fourth dimension of starting treatment, but it besides appears to involve other factors. One of these factors mightiness live my favourite dependent area on this weblog – gut health.
Gut Health And Immunotherapy
Earlier this twelvemonth the results of the starting fourth dimension study looking at the human relationship betwixt the gut microbiome together with immunotherapy response inwards patients was published. Gopalakrishnan et al. found that those who responded to a PD1 checkpoint inhibitor (my drug) had a greater diverseness of gut bacteria together with larger volumes of a specific type of bacteria than those who did non respond. I know I write most this dependent area all the fourth dimension across my blog, but please, please, if you lot are a newly diagnosed cancer patient have got the fourth dimension to do everything you lot tin to back upwards your gut wellness (from certain dietary changes to adding inwards a daily probiotic, or fifty-fifty considering a 12 calendar week programme). You never know – it mightiness brand the divergence betwixt responding to handling or not.
The Future Of Cancer Treatment
Recent clinical trials together with interrogation proceed to demonstrate that immunotherapy holds hope for other forms cancer, including breast, lung, ovarian, pancreatic together with myeloma. However, non all cancers or patients reply to this treatment. Fortunately some other emerging expanse of interrogation is CAR-T cells. This is when scientists genetically engineer a patients T-cells (the fighters of the immune system) to abode inwards on the patient’s cancer together with and then grow millions of the modified cells inwards the lab. When the cells (now called chimeric antigen receptor cells, or CAR-T cells for short) are returned to the patient, they are much improve equipped to hunt downwards together with kill the cancer cells. Basically, nosotros are seeing a novel generation of cancer treatments that harness the body’s ain innate cancer-killing mechanism – how cool is that?!
My Future
Right at nowadays I have got some real loose plans for the latter purpose of 2017 together with 2018 – but zilch is firmly ready inwards stone. I recall a huge lesson I’ve taken away from this experience is learning to live each twenty-four hours every bit it comes together with non have got anything for granted. I doubtfulness I’ll e'er go dorsum to making a “5-year plan”, just because none of us e'er know what is circular the side past times side corner.
Wishing you lot all lots of health, healing together with happiness.
Lauren x