Bah! to cancer

Breast cancer had a pop at Stephanie. It really wishes it hadn't.

Bah! BBB 1st August preview

For this round of the Bah! BBB, I’m going to try running 5 separate giveaways, one each week.

I thought you might like a sneak preview of the fabulous books that will be on offer on 1 August…..

I’ve given some more detail, and links to reviews, below. Also, clicking the name of the book will take you to Amazon where you can read customer reviews. Happy browsing!

The Swan Thieves by Elizabeth Kostova

I haven’t read this yet, but I did read The Historian by the same author, and was gripped from start to finish. There are lots of reviews around, but I thought the ones here and  here were useful.

The Disengagement Ring by Clodagh Murphy (signed copy)

Before I was diagnosed with cancer I was far too much of a literary snob to even consider reading chicklit. Several authors have proved me wrong. Clodagh is one of them. There’s a review here and you can follow Clodagh on Twitter here.

Hold My Hand And Run by Margaret McAllister (signed copy)

This is a tale of brave children escaping a cruel home in 17th century England. It’s brilliant – even though it’s a book for children (9+, I’d say) I couldn’t put it down. You can read more about it on Margaret’s website here.

Without Alice by DJ Kirkby (signed copy)

DJ Kirkby’s memoir From Zaftig to Aspie went down a storm at the last Bah! BBB. This is her first novel, published on 31 July, so really hot off the presses. Visit the author’s website here.

Beatrice and Virgil by Yann Martell

The long awaited follow-up to Life of Pi. I think this review says some really interesting things about it.

Murder in Bloom by Lesley Cookman (signed copy)

There’s nothing like a good murder mystery to make an afternoon fly by! Find out more about the books and the author here – and you can follow Lesley on Twitter here.

Delia Says: OMG! by Keris Stainton (signed copy)

A novel for teenagers, this brilliant book is honest, a bit rude and very, very funny. Keris is on Twitter here and her website is here.

24 Hours – Paris by Marsha Moore (signed copy)

I love the idea of this book – it’s an hour-by-hour city guide. You’ll never be stuck for something to do at 3am in Paris again! There’s a review here, you can visit Marsha’s website here and follow her on Twitter here.

All My Friends Are Superheroes by Andrew Kaufman

This book was donated to the Bah! BBB by the lovely Marie Phillips, who also gave me a copy for my birthday. I read it in an hour – it’s very short – but I don’t think I’ll ever forget it. It may even be a perfect book. But don’t just take my word for it. Look here.

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These books will be ready for ‘Pick me!’ comments when the next Bah! BBB starts on Sunday….. I hope to see you then!

The Answer

I am nervous about this post, which is probably why I’ve waited until I’m on holiday to publish it.

I’ve written a poem. I don’t know why publishing poetry feels more exposing than writing about every aspect of my dance with breast cancer, but it does.

Anyway, here goes. I hope you like it.

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The Answer

‘So, why are you moving?’ has replaced, ‘So, how are you?’

(head on one side, meaningful eye contact)

as the question I am asked more than any other.

The answer is not simple:

Because cancer made me ache every mile from here to my mother.

Because dancing with cancer shines an unforgiving light everywhere and London, like my scarred and puckering breast, does not look good in an unforgiving light.

Because what matters now is near me wherever I am.

Because there the beaches are empty and the sky is unlimited and I newly crave salt air.

The answer is to be standing naked from the waist up and asking to be understood.

So I have found another answer, also true:

‘Because it’s time.’

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‘Why do you think you have breast cancer?’

‘Because it’s time.’

The words were there before they had told me what they were going to be.

They frolicked between us, surprising.

The room was bare and bright. A dull print of a possible rose on the wall; clean curtains; real chairs.

Only the box of tissues, shadow of the freshly diagnosed, said that this was counselling.

We watched the words a while.

I still don’t understand them. I still think they are true.

All about Persephone

As I mentioned last week, the team running the Persephone trial have been good enough to answer some questions about Herceptin and the trial. Here they are. Even though I’m done with Herceptin, i found this really interesting. I hope you do too.

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-Why is Herceptin such a wonder drug?

Herceptin has proved to be a major advance as it helps to cure a certain type of aggressive breast cancer described as HER2 positive. This cancer is made of cells which contain HER2, a molecule involved in the rapid multiplication of cancer cells.

- In layman’s terms, what is the Persephone trial and how did it come about?

The PERSEPHONE trial is about finding the right dose of Herceptin for the patient. At the moment, Herceptin is given for a whole year based on evidence from an international trial comparing 12 months to nothing. A more recent trial has suggested that Herceptin might be just as effective if given for 6 months rather than 12.

- Why is the Persephone trial important?

PERSEPHONE is an important academic trial because it addresses the question of how long you need to take Herceptin for.

- Is it really a big issue if Herceptin is over-prescribed?

Yes, because Herceptin can cause damage to the heart. Some chemotherapy treatments can also do this. Patients who receive both treatments are therefore at a greater risk of experiencing some damage to their heart. Also, it means that patients may be experiencing the side-effects of treatment for longer than necessary instead of returning to normal life quicker without the inconvenience of prolonged treatment.

- When will the trial report?

The trial should report 2 years after it has recruited its 4000th patient. Obviously this depends on the speed of recruitment but we are currently on target to have reliable results reported in 2016.

- If it turns out that 12 months of Herceptin is better than 6 months of Herceptin, what will happen to everyone who only had 6 months of treatment?

This is very unlikely based on the results of previous trials. Duration trials throughout Europe have safety committees and trial steering committees who regularly monitor safety and efficacy.

There is only a very small risk that 12 months of Herceptin is better than 6 months. However, if it was the case, patients who received only 6 months will be follow-up more closely than the others.

If it is reported that 6 months is safer than 12 months then the patients randomised to the 12 month arm will be closely monitored in terms of cardiac toxicity.

- Where is the Persephone trial taking place?

PERSEPHONE is offered in 117 hospitals throughout the UK. Another 20 hospitals will be open soon.

- What’s involved with taking part in the trial, apart from the 6 or 12 months of Herceptin?

We’d also like you to complete a quality of life questionnaire at various stages of treatment. This will help to give us a clearer picture of the impact of Herceptin treatment on everyday life. Also, the research team will ask you if they can send a sample of your blood and some of your tissue taken at surgery to the Cambridge Research Institute where analysis will be conducted to get a better understanding of HER2 positive breast cancer and how Herceptin works.

- Can anyone join, or ask to join?

To join, you have to be HER2 positive and have received less than 6 months of Herceptin treatment.

- Are other, similar trials being conducted?

Similar trials are conducted all over Europe and in New Zealand. In total more than 13,000 patients are going to participate in Herceptin duration trials comparing 12 months with a lesser duration.

- Where can those affected by breast cancer find out about this and other trials?

If you are interested, please ask your oncologist or contact the clinical trials team at your hospital.

Also, a list of trials that operate in the UK is accessible here. and here.

The Persephone trial website provides more information and it’s here.

Team Bah! is at it again

I told you a little while ago that I will be doing the London Night Hike in aid of Maggie’s Centres again this year. I’m proud and honoured to be joined by my Dad and my son on this 20 mile night time adventure. Here are the three of us in Northumberland last summer.

(It’s not often I get to be the shortest one on the team.)

We’re hoping to raise £1000 for Maggie’s Centres, a haven for anyone touched by cancer in any way. I know I’m always asking you for money; but please, help if you can. I’ve set up a fundraising page here.

Thank you.

Thank you.

Thank you.

(That was one from each of us.)

Guest blogger: Serena Alam

I asked Twitter for guest blogs on how to choose what to read next. (I am all too often seduced by 3 for 2 tables in bookshops and end up reading things I didn’t really want to read at all, and don’t especially enjoy.) Here’s one perspective, from @ProofersR_us. I like it very much.

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Forget quantum physics or Einstein’s theory of relativity, ‘what do I read next?’ is one question that even the most intelligent of minds will struggle to answer! Of course you can ask your friends for suggestions, or use websites such as www.whatshouldireadnext.com that will give you an automated answer. However have you ever tried thinking about what it is that makes it difficult for you to decide what book you should read next? Do you know that while most people have a favourite author or have a favourite genre of book, many people will still be besotted with books written by totally different authors or from a different genre, depending on the situation?

People read books for a vast number of different reasons. So, before you embark on the tedious process of deciding what to read next, one of the best things to do is to ask yourself what purpose YOUR next read will be serving (and bear in mind that the answer to this question won’t always be the same). If you can answer this question, I firmly believe it will fast-track you throughout the process of choosing your next book. For example, if you want your next book to take you away from the real world, a fantasy novel of some kind might be just what you’re looking for. If you want to read a book because you’re in need of a good laugh, there are plenty of good humour novels out there.

Now on the other hand if you need to have some reading material at hand to help you through a tough patch in your life, fiction novels such as Playtime by Stephanie Fox which is about a boy who’s been abused, or We need to talk about Kevin by Lionel Shriver which describes a mother’s need to come to terms that her son is completely out of control, are probably just the kind of thing you want to be reading. You’ll be amazed at how easily you can bond with some of the characters in these types of books, and how some of the characters can almost become like a best friend, that you want to treat as a confidante!

Perhaps you feel like exploring the world, or are in the mood for going back in time, in which case a book by an international author such as Khaled Hosseini or Vikram Seth would be ideal; or Dissolution by C.J. Sansom which will take you back to the Tudor times. Have you on the other hand, just gone through a major life event such as moving house or changing jobs? In this case a bit of familiarity is just what you need. So try reading a book by an author whose books you have previously read, or even a book you’ve read before – you’d be amazed at how quickly you suddenly start to ‘feel at home’ in your new environment!

I hope that my suggestions will give you some ideas of how to decide what book you should read next.

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Serena Alam is a biomedical science graduate, specialising mainly in neuroscience, and has been working as an editor in the UK publishing industry since 2005. She has co-authored an article about post-herpetic neuralgia which has been published in The Cochrane Library (http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004846/frame.html). In her spare time she also writes articles about books or publishing. You can email her here, She can be contacted at: copyeditor08@gmail.com. follow her on Twitter, and keep an eye out for her new blog: http://alamse.blogspot.com.

I can wholeheartedly endorse Serena’s recommendations of Vikram Seth, Lionel Shriver and C.J. Sansom. Khaled Hosseini is sitting on my shelf waiting for his moment, and I’d never heard of Stephanie Fox, so I might well give her a go!

If you’d like to share your thoughts on how to choose a book, please email me 300-500 words on the subject, and I’ll publish it here on the blog. Reading a book is a big investment of time and I think it will be interesting to find out what different people’s processes of choice are.

On holiday

Today, Alan, Ned, Joy and me are heading to Tallinn on holiday for a week. In answer to your two most likely questions:

1. It’s the capital of Estonia.

2. Because it’s historical enough for Ned, interesting enough for Joy, different, not too hot, and not too far away. And it looks kinda pretty.

While I’m away, there will be guest blogs, an interview with the lovely Persephone people, a preview of the Bah! BBB books for next Sunday, news of Team Bah!, and a poem. (I’m nervous about the poem.) So, please keep coming by. I’ll see you on 2 August.

(Alan was a little concerned about publishing the fact that we are away, until Ned and I reminded him that Hard Pete and Dave the Knuckle will be house-sitting, and bringing their dogs Ripper and Doom. Burglars, don’t even think about it.)

Trials and macaroons

I do always try to be fair on this blog: to report my experience on the cancer conveyer belt accurately , while trying to see the points of view of others. There are people I have praised to the skies, and people – St. George’s Oncology Department, I’m mostly looking at you – who I definitely haven’t. Overall, I think if I had to sum up my experience of the professional cancer people I’ve met, I would say: mostly good, apart from pockets of soul-destroying awfulness. (Remember this? And this? And this?)

What I forget, of course, is that the patient perspective is a pretty straightforward one. I have a disease: you will tell me what you think will cure me: I will go along with it, unless the cure becomes unbearable, or turns out not be working, in which case we try something else. Thinking about survival makes everything black and white.

But for those at the other end of cancer treatment, it’s more complex. I found out a lot more about this in a rather sublime setting on Monday – eating macaroons (the vanilla was best) in La Duree in Harrods department store in London. I was meeting with Emma and Anne-Laure, who are involved in the Persephone drug trial, which is looking at the efficacy of 6 months versus twelve months of Herceptin treatment.

I was approached by Emma shortly after I wrote about stopping Herceptin. She asked me if I would contribute to a leaflet; I asked if she would answer some questions. We’ve been in touch ever since, and we met to talk about how I can support the Persphone trial.

During the course of our meeting, I got an insight into just what clinicians and scientists trying to further cancer treatment are up against. We talked about recruitment, about ethics, about data protection. We discussed making literature both patient-friendly and scientifically accurate. I found a bit about the hoops that researchers have to leap through to get a trial (a)designed (b)approved (c)underway (d)completed. Let me tell you, many of those hoops are on fire. Which is right and good, of course. Without this kind of rigour, results are meaningless, and it’s good to see respect for patients so high on the agenda.

Not that Emma and Anne-Laure were complaining. They were just explaining. And as they did, I thought about how it’s a miracle, really, that any trial anywhere happens. The Persephone trial is looking for 4000 women in the UK with a HER2+ve breast cancer diagnosis who are also being treated with chemotherapy. Sadly, the statistics show that shouldn’t be difficult. But those 4000 women need to be told about the trial, have the trial explained to them, and be in a hospital that is part of the trial, where research nurses are able to reassure and answer questions. They need to read information and sign consent forms. They need to be sure about the purpose of the research and happy to take the (very small) risks involved. They must understand the concepts of anonymisation and randomisation. They must trust the NHS and the oncologist who is recommending the trial to them.

I always appreciated the treatments and drugs available to me – even the really nasty ones that had me begging for mercy, and peace, and sleep – because I’d a million times rather have the chance of treatment than hear the words, “I’m sorry, but there’s nothing else I can do”. But after Monday, I appreciate them all the more: I gained an insight into how we get these treatments, and the people, like Emma and Anne-Laure, who work so hard to make trials happen.

The upshot of our meeting was that I am going to advise on, and contribute to, consent forms, leaflets, newsletters, etc, which I’m really happy to do. (Don’t worry, I won’t be advising on any science.) Also, I may now be addicted to vanilla macaroons.

(I feel I ought to say that Emma and Anne-Laure do not mostly swan about taking tea with bloggers in exclusive cafes. They were in London for a meeting just round the corner.)

I’ll be publishing my interview with the Persephone team next week. In the meantime, there is more information here.

Rebbbborn

The Bah! Brilliant Book Bonanza is starting to gain momentum. Writers are offering to donate books; people are asking about rolling out the idea; increasingly, it feels as though it’s a real, proper thing.

I’m glad. it was one of those ‘don’t know until you try’ projects, and I tried it, and now I know. Mostly what I know is that there are a lot of kind, compassionate and supportive people out there who get what I am trying to do, and are helping me to do it. Thank you.

I’ve also figured out some things that could be improved.

1. The BBBB gets a bit lost up there at the top of the page. So it’s going to have its own domain, www.bahbbb.com. (Please don’t go and look, because there’s nothing there yet – I have to get myself into the right frame of mind to wrestle with getting a new site up  - but there will be, soon.)

2. There are lots of things, it seems, called BBBB. Mostly boring stocks and shares type things, so our BBBB is definitely the best – but, in view of the duplication and the new site name, I’ve decided to rename the Bah! Brilliant Book Bonanza. Henceforth, it will be known as the Bah! BBB.

3. There is such a thing as too much choice. Psychologists have found that, although this is counterintuitive, we are more likely to choose something from a list of 7 things than a menu of, say, 30. So instead of having one Bah! BBB in August, I am going to have 5 little ones, one on every Sunday in the month. There will be 7 or 8 books to choose from and make a donation for, and I will allocate books at the end of each week. So you have a better chance of getting a book you like, and psychologists insist it will be easier to make a choice. Let’s see how it goes.

Are there any more improvements you can suggest?

Eye eye

I woke up yesterday morning to find that I had conjunctivitis. Have you ever had conjunctivitis? My advice to you is: don’t. It’s horrible. It’s a highly contagious infection that makes the eye swollen, red, itchy, hot and sore.

So, I woke up and found I could barely open my left eye. Once I prised my lids apart, I took my contact lens out in the vain hope that the problem was a lodged eyelash or similar. It wasn’t. Taking contact lenses out of a sore eye with long fingernails resulted in only a limited amount of gouging, which was good.   I washed my eye and waited for the pharmacy to open.

When I got to the pharmacy, the conversation went like this.

Me: I think I have conjunctivitis. Is there anything I can buy over the counter for it?

He: Yes, of course. Try these drops. Keep them in the fridge. Your eye should be better withing 24-48 hours.

Me: Thank you.

He: If it’s not better in two days, see your GP.

Me: Will do.

I paid. I left. I started using the drops straight away, and they seem to be working.

Are you waiting for the punchline?

There isn’t one.

And that’s the point: I had a whole medical conversation and there was no cancer based complication. At all. For the first time since diagnosis.

Tooth problems were exacerbated by chemotherapy side effects; IBS needs to be seen in context of a stripped out gut; almost-endless toe infection a consequence of low immune system, and had to be treated in the context of chemotherapy damage to toenails. Even manicures, pedicures and haircuts require a chat about collateral damage. But eye infections? With eye infections, I get to go to the pharmacy and act like a normal person.

I like this gradual falling away of cancer-related stuff. Every time there’s a little, unexpected happening like being able to buy medicine without the c-word coming into it, my step gets a little lighter. I remember that, although treatment’s not over, it’s more over than it used to be.

Number 5

According to Wikio, Bah! is the fifth most influential health blog in the UK and Ireland. (And the 2,223rd most influential blog overall. Less catchy, that one.)

Look here!

I’d never heard of Wikio before but having meandered around the site a bit, I like the way it distils and sorts web content and makes it easy to find good writing. It’s worth a look.

I’ve added badges to the sidebar so we can keep an eye on how I’m doing.

Of course what makes this blog influential (if it is, and however that’s defined) is not really me, but you, coming back here day after day to find out what’s what at Bah!. In the beginning, I never really thought anyone outside my immediate circle would read my cancerous ramblings, so finding myself here now is strange. Looking up the blog stats recently I was shocked (and delighted) to see that there have been over 100,000 hits here over the last year. Thank you for keeping coming by. It means a lot to me.