Jan West

i guess I should write the "in the beginning"  part, so everyone has  the same information and no one needs to try to read between the lines.
So I went in for my wellness check earlier in November .  Did lab work and all that good stuff.  Since my back/sciatica is not improving with physical therapy and a great exercise regime, I asked Chantelle (my Nurse Practitioner) if we could take another look at my back, and, oh by the away, I've got this lump next to my cervical spine, so can we look at that as well?  Sure thing, no worries, and I had an MRI done in the traveling trailer - this was done Saturday,  November 19th.   On the 21st,   Chantelle called and asked if I would come in and we could go over the MRI results.   The lump in my neck is benign and I have arthritis in my back, so can talk about a referral to a neurologist.  There were, however, some incidental findings from the peek at my neck.  They identified 8 areas in my brain that were suspicious of metastatic cancer and they could see spots on my lungs.  Next steps are a CT scan of my lungs and a full MRI of my head.  CT scan morning of the 22nd and got the MRI  of my head scheduled for Saturday.  Tuesday afternoon, Chantell calls and has CT scan results she wants to go over with me.  I call Keri Donica (my EMS Director) and ask her to go with me the be another set of ears and memory aid.   Chantell tells us that I am in great health, my labs are all good, but that I have Stage 4 cancer, probably started in my lungs, but has moved into my brain and lymph system.  I am totally asymptomatic.


Chantell made a referral to Mountain States Tumor Institute (MSTI) at St. Luke's in Boise.   The next morning - the day before Thanksgiving,- I got a call from MSTI, setting up an appointment for Friday - the day after Thankgsgiving.  My daughter Sarah has been at every appointment, asks wise questions and is a great advocate when needed.


That Friday, we met the Jennifer, (Nurse Practioner at MSTI).  Sarah asked her for a prognostic time frame.  Jennifer explained that 1) this will take my life and 2) some people who come in at this stage live 4-6 months, others last longer, everyone is different.  She also clarified that most people at this stage are usually pretty sick,  and since I'm not, it makes it even more difficult to make any kind of guess.   She made a referral for a lung biopsy, sent me over to medical imaging to get my radiology mask made and made a referral to start radiation on Monday.  


Saturday I had the MRI of my head done in McCall.  They super-imposed these images on my mask and mark the mask instead of tattooing my head.  This means the radiation is very focused on unhealthy stuff.  The drugs used to treat this cancer don't cross the blood-brain barrier, so radiation is the treatment of choice for the brain mets.  


I've also had a CT scan of my abdomen and pelvis - no cancer found there.  Radiation is 1 x daily  Monday-Friday for two weeks.  I am at the 1/2 complete  point in that arena.


The lung biopsy was done on Thursday.  From that tissue  harvested, they will be able  to determine what kind of cancer I have -  2 major categories. Small cell and non-small cell.  The non-small cell are slower growing.  There are other kinds within each of the broader categories.  Preliminary results look like I have non-small cell lung cancer and probably adenocarcinom.  


They will also do some genomic testing on the harvested tissue from my lungs.  In about 10% of the people diagnosed with what I have,  there is a specific gene combination for which they have developed a "designer drug" - targeted treatment that kills  only  those cancer cells.  Treatment is taking pills at home!   Recently approved for treatment for this type of lung cancer, is also immunotherapy - one infusion about every  three weeks which is designed to ramp up my own immune system to kill the cancer cells.  And then, down the road, there is chemotherapy - which is indescriminate about what cells in the body it kills, hence hair loss,vomited and nausea, etc..


I am grateful to those who have gone down this path before me and the research and treatments that have been done to move treatment forward.  I hope to also be part of this exploration process.


Bottom line - I am in great health, but I have Stage 4 lung cancer which has metastasized to my brain and lymph system.   There is no cure, but there are very effective treatments used to treat/ kill the cancerous cells.  If we can keep the tumors from growing and maybe shrink them, treatment is working.   This will be, most likely, what takes my life - but I could get hit by a bus tomorrow!   I feel fine  - a few side effects from radiation.  I see manageable treatment options to help me maintain and continue living a quality of life.   I am approaching this as just another bump in the road - I'm going to continue to laugh and have fun, helping others and building strong supportive communities.  Life is good and I'm choosing to live mine with a hop in my step and a grin on my face!