I (heart) Starbucks

So, I go to CVS this morning to grab a Vitamin Water on my way to work, and right there on the front doors, there's a big, handwritten sign saying: THE PHARMACY IS OUT OF PLAN B. PLEASE COME BACK TOMORROW. Must have been a busy night in Manhattan last night. It's a good thing Plan B can be taken up to 72 hours after the fact. 

I got the new issue of CURE magazine (Cancer Updates, Research, & Education) last week, and I just got around to reading it on the subway home today. There's an article about women living with metastatic breast cancer, because these women are often not talked about so much. Metastatic breast cancer is largely ignored during pink ribbon events - there's hardly any booths about Stage IV cancer, if any - and support groups are not really geared toward these women, and even other breast cancer patients avoid women with metastatic breast cancer at times, because it reminds them of what could happen. It's true - Stage IV breast cancer, aka metastatic breast cancer, cannot be cured. It can be treated. Managed. Somewhat controlled. The median survival time of these women has usually been between 18 - 30 months after diagnosis, but now patients are living with mets (metastases) longer. The goal then is to keep it controlled as well as possible while still maintaining quality of life. 

No one likes thinking about cancer, let alone metastatic cancer. Not even those of us who work in the field. Standing on the subway, reading this article, I read these words and even I began to feel lightheaded: "...25 percent of women diagnosed with invasive breast cancer [who] later learn that so-called seed cells from the first tumor traveled to another part of the body and set up shop....Indeed, when a woman dies from breast cancer, as some 40,000 will this year, it is almost always a result of the breast cancer taking over one or more vital organs - most often the liver, lungs, or brain...." So nearly a quarter of women initially diagnosed with invasive breast cancer will be diagnosed with mets. My brain is trying to wrap around this and failing miserably. I read this and don't want to believe it. I read this and it is hard not to be discouraged. I read this and wonder who, in my life, will be part of this sobering statistic. A family member? Mentor? Friend? Myself? And then that familiar, desperate feeling of we have to do something now takes over, and I am reminded why I got into oncology again in the first place. So I could do something about this feeling. Some days, though, it's a struggle. 

Also discouraging in this issue is the discussion about pediatric cancer drugs. See, the problem is that almost no new pediatric cancer drugs have been developed in years and years. It is not profitable, so it's not really done. In 2004, the drug Clolar (a leukemia drug) debuted on the market - the first cancer drug in 20 years to reach the pediatric market ahead of adults. Drug companies need big sales, and since by and large, most children are healthy, pediatric cancers are too scarce to be profitable. In dollar terms, it's not worth it. TWO-THIRDS of all meds used in kids - for ANY medical condition - have not been tested and labeled for pediatric use. Last year, the Archives of Internal Medicine reported that 93% of children with cancer receive at least one drug that has not been approved for pediatric use. 

"Psycho-oncology is the only subspecialty in cancer that is involved in the care of EVERY patient at EVERY visit, with EVERY cancer and with EVERY treatment." - James Holland, MD (he wrote like, THE book on Cancer Medicine and yes, he is the husband of the founder of psycho-oncology who is @ MSKCC, Jimmie Holland). 

High Point: my "free iced coffee at Starbucks on Wednesdays" card, finding my Chaco flips

Low Point: the seemingly endless line at Jamba Juice, the rude man who butted in front of me in line at aforementioned Starbucks - and we were THE ONLY TWO in line