Let's go all the way with research.

So, I have been involved in research for nearly 15 years now. I have read and written a lot of papers. I have been to a lot of conferences, and I have attended countless seminars. Today, I want to challenge each of you to take your research beyond the easy paper and go all the way. What do I mean by this? Well, our group has been doing cancer research (mostly brain) for the last 3-4 years. We have focused primarily on the "easy" papers. I throw some materials/drugs at some cells, look at how they respond, and write a nice paper summarizing my results. The cells are probably transformed cells, not real patient cells, so who knows how well this research would translate into the clinic, and honestly probably don't care just want that next paper to put on my CV.

I met with my lab a few days ago and told them that this is bulls**t. I don't want to do easy research anymore. I want to go all the way. I want to do the hard research, the stuff that takes years, that no one wants to touch because they don't even know where to begin, the stuff that matters. Let's take an example. OK. So let's say we publish a paper that says material X causes tumor cells to migrate faster. I can publish that paper. I can build a whole career on papers exactly like that, but what I have I actually done to make cancer better? Jack squat! Now, what if after observing that material X has this property, I publish a follow-up paper identifying factor Z as the main reason that the cells move faster. Then examine what parts of the cell specifically interact with factor Z, identify which genes/proteins are involved in those interactions, and try to find drug targets to block them? The latter is a lot harder, but that is the work that truly matters.

We are going to start doing the hard work that really matters. I challenge you to do the same.

Post Apocalypse (Oh and BTW I got tenure)

Well, yesterday I chopped all my hair, and I have to say not as bad as I thought. I look okay bald, actually quite butch. If I got a nose ring and some leather, I could totally pull that look off. Also, doesn't look too bad with a hat; the wig however is an absolute disaster. It looks like a cross between Lindsay Lohan and Jessica Simpson all while having the appearance of being totally fake. What's up with these ladies that have such awesome wigs!!! Mine looks awful! I am going to send it to my stylist to try to get it rehabilitated tomorrow, but in the meantime, I guess its just hats.

On another note, which I should be a lot more excited about, my tenure is officially through. My husband asked what I want to do to celebrate and I said I just want a wig that doesn't make me look like a street walker. I guess I can use that raise to get a new one?

Chopping My Hair

So, met with the oncologist last week and chemo will be starting in about a week. I will go to the hair dressers this week and chop my hair off. It is long enough that I can have a wig made from it, but that takes two months so I will also get another 1or 2 ready made wigs for the short term. I will be getting chemo for 5 months. Out of all the things that have happened to me so far or will happen in the future, I think the thing that bothers me the most is the hair. I mean if a guy is bald, it's a look. If a girl is bald she is either mentally ill or has cancer. And although the wigs are really good, you can't wear it all the time. At some point I will have to look in the mirror and see myself bald. Argh!

On the positive side, with chemo (and not including radiation which I will also get), my odds are 90% for survival (so it will ultimately be higher). On the academic positive side, I have no service or teaching requirements right now. So other than resting and Dr's appts, I am sitting around working on proposals and papers. I think my research productivity is about the same as before. So I guess that means time spent on cancer = teaching + service. I think I may be doing too much teaching and service (or at least was before).

Where I've been

So a couple of you have asked if I stopped blogging. The answer to that is no...but hold on to your hats.

The initial part of my hiatus was because I decided to write 4 grants in 2 months. we have several grants expiring next year and I wanted to ensure continuity. Well, G-d blew a hole in that plan. The day that I turned in the first grant I was diagnosed with breast cancer. I am 35 years old with no family history. I had my children young, I nursed them, I was on birth control for nearly 20 years. I am practically a vegetarian. I work out 5 days a week. Sometimes there just are no answers.

It all started a few months ago when I noticed the shape of my breast had changed. My nipple became inverted. I really didn't think anything of it because that breast has always been a little odd, especially after I finished nursing my son about 5 years ago. I started doing more frequent self-exams, but didn't notice the lump until January. It was very subtle, but large. Since I do a lot of research on cancer cell mechanics I knew that it was a really bad sign.

My ob-gyn saw me the next day and said it was probably nothing, but that I should get a mammogram and ultrasound. He wasn't in a hurry so it took nearly three weeks to get in. That was the second worst day of my life. I showed up thinking that I would be there for an hour and was there for 6. The mammo showed a suspicious area so they had to do follow-ups. Then I sat there for two hours while the radiologist looked at my scans. Then I went for ultrasound and even I could see the lump on the scan. At this point, I was still hoping that it was a cyst. They told me that I needed a biopsy and 30 minutes later, I was getting not one but two (apparently there were two "suspicious areas").

Five days later they called to tell me that I have infiltrating ductal carcinoma (IDC). My pathology was a slow growing grade 1 (good news) and hormone positive (er+ pr+ ner2/neu-) which is the best possible combination. They said the tumor was about 2 cm and the second biopsy was negative. I started preparing myself for a lupectomy with maybe chemo and radiation. They said I would be fine. That I would need treatment, but would be fine.

After pulling numerous strings, I was able to get in to the chief of surgical oncology a week after my diagnosis. He dropped the first bomb on me which is that he thought the second spot was cancer too and wanted to do another biopsy on that spot. I said there are two possible outcomes: it comes back + or -. If it is positive, he said we would have to do a mastectomy. If it was -, I told him that after what he said neither he nor I would believe it. I opted to skip the second biopsy and scheduled a mastectomy.

Two weeks later, I had a mastectomy of my right breast with temporary reconstruction using tissue expanders. These hold the skin out so that I can later have a more natural tissue reconstruction, but this will have to wait until after all my other treatments, possibly a year or more. I was shocked at how good I felt after surgery and how good the reconstruction looked. Apart from the fact that I have a scar extending horizontally from my breast bone to under my armpit and no nipple, it looks almost the same size as the breast I started with. The scar will heal and a nipple can be added later.

The pathology report, which I got a week later, was the second bomb dropped on me so far. My tumor was not just two spots but three! for a ginormous total of 7 cm!!!!. A lumpectomy would not have been possible. In addition, my sentinal node biopsy was positive so they removed all the lymph nodes under my arm. A total of 2 of 35 lymph nodes are positive, which isn't many considering my large tumor size. I will definitely need radiation and chemo is very, very likely, but I am waiting to meet with medical oncology next week to confirm. Everyone is convinced that I will be totally fine, including me, but this wasn't exactly the year that I was planning to be having.

I am so grateful that I had the lump checked out, that people paid attention to my concerns, and that I have so many friends and family that support me. The day after my diagnosis four faculty in my department offered to take over my classes. I am off teaching until all my treatments are over. I am trying to work on research and have so far managed to get out 1 paper and 1 proposal. I can't just sit at home and do nothing. A lot of my personal relationships have become much deeper very quickly, and I am constantly surprised by how much I am loved.

What's in my future?

Well, I will probably have chemo for 6 months or so. I will probably lose my hair. I have found a place that can make a wig from my own hair, which is comforting, but I also plan to get a pink Lady Gaga wig, because hey, why not? And this is my chance to try all those hairstyles that I would be too nervous to try for "real". I will then have to wait a month or so and then will have radiation for 6 weeks. I will then wait another 2-4 months and have reconstructive surgery. This consists of a tummy tuck coupled with a boob job and is MAJOR surgery, requiring a 4-5 day hospital stay with a 2-4 month recovery. The tissue from the tummy is used to construct the new breast. My breasts are large so I may need tissue + implant to get to where I was before. I will then have a second surgery to add a nipple, probably using skin from my thigh. Then a final third surgery (fourth if you count the mastectomy) to even up the other side to match the new breast. This will probably take a year and a half.

What else?

Well, thank G-d I went up for tenure early. My case is nearly complete receiving unanimous votes at every step so pretty much a done deal. My lab is being run by my research scientist, which I fortuitously promoted from postdoc just before my diagnosis. I am working slowly on grants and papers. I plant to go back to work in about a week, but will be in and out depending on the treatments that I am receiving etc.

The most important thing is that I will be okay. I decided that I would be, and as far as I'm concerned that's good enough for me.