Resilience and a Good Report

This week I began my fourth cycle of lorlatinib, the targeted therapy that has chased off cancer metastases in my brain and resolved all the tumors in my lungs. As I get myself around Boston on the T like a pro now, it hardly seems like three months have passed since I showed up at Yawkey Cancer Center Suite 7B to enter Dr. Alice Shaw's clinical trial. But as I made my way from the Red Line stop across the now-familiar intersection and into Mass General for my clinic visit, I realized how oddly normal, even routine it has become to be doing that very thing. Despite this routine familiarity, I remain mindful of the fact that what I am getting to do here in Boston is remarkable. This research study in which I am fortunate enough to participate is moving cancer treatment forward in important ways and is fueling a paradigm shift that will, I am certain, lead to better treatments, and eventually more cures for more kinds of cancers, and very soon.

This last visit made me aware, too, of how resilient the body can be. When I began taking this drug, my liver enzyme count sky-rocketed, so much so that I had to get blood drawn every two weeks to monitor the response to the new drug. I am happy to report that my liver has recovered from its initial lorlatinib shock and is performing nicely again. And so, wine and bourbon (in small amounts) are back on the menu, yay! The brain fog has lifted as well; I still have some memory issues and word finding issues, and multitasking is super hard, but my thinking doesn't feel as...gooey. The annoying neuropathy in my hands continues, though it is not as severe. Less happily, flying to Boston exacerbated the edema in my legs, so now I have an unfortunate case of cankles.

The nicest part of this last trip (I mean besides getting my hands on more of that life-saving medicine) was the company! I got to spend a few days with my brilliant and beautiful pal Rebel, who lives up to her name in more delightful

Rebel being fabulous in the elevator.

ways than I can even say. She is an expert on many things (the career of actress Betty Buckley, for example) and is especially gifted at pointing out which movie stars people on the train resemble. Rebel is also the best director of cell phone selfies I know. Plus she keeps my emotional shit together, insists I floss, and makes sure I stay hydrated. I'm grateful to travel under her supervision.

This coming week I'll return to work, preparing to teach a full load of classes and doing some advising, then beginning classes on the 27th. Back in May, when I learned Xalkori had failed and I had mets in my brain, I just stopped thinking about school. I'd already decided to forgo summer teaching, for the first time in my entire career, in order to spend my summer visiting family and friends, so with the new diagnosis, that time became paramount. And when I started lorlatinib and felt like my brain was churning through cold molasses, I started seriously looking at retirement; I was pretty certain I couldn't go back to school if I couldn't remember a conversation from five minutes ago or find the words I was looking for to express a simple idea. And though I'm not feeling like my brain function is 100 percent, it's a good bit better, and I have been persuaded to make a new attempt at "normalcy" and return to work. So, that's the plan. I only need to get my neuropathic hands working a little better in the morning, or just give up buttoned shirts in favor of pullovers.

I've got scans coming up in early September, so I'm hoping the lorlatinib is still holding the cancer in check and that the plan will still roll. It's been an amazing summer, full of blessings. I stand full of gratitude and optimism on the cusp of a new season to come.