Just a series of notes someone made on Sara Zarr’s keynote speech at the Winter Conference of the Society of Children’s Book Writers and Illustrators. Well worth reading if you’re a writer. Here.

I have to say, this quote struck home: “The time between when you are no longer a beginner but you are not yet in the business is the hardest … and one of the biggest frustrations is: no one can tell you how long this phase will last.”

I’ve been in this phase for a long time. Quite a few published short stories, very close with one novel, but no published novel yet. And to be ‘in the business’, well that means selling novels. I’ve got something good that’s winding slowly towards completion . . . but really, given all the shit that has rained down on me in the past eighteen months, I find I don’t really give a crap anymore.

Forget writing things which other people may approve of, or which would fit in the more ‘litr’y’ short fiction venues. (Yes, Fantasy Magazine and Strange Horizons, I’m thinking of you.) I don’t read those ezines, so why would I try to write stuff that would fit in them? Fuck it. I haven’t got time to deal with bullshit anymore. I’m just trying to write the best work I can, and include as many of the things that make me go ‘wowthatissocool’ as possible. If the stories don’t sell, who gives a shit? I know they’re good, and I will have enjoyed writing them.

. . . but as usual, it’s years away. Treatments like this come into view fairly regularly, but then almost always sink during the clinical trials. Maybe this one will be different.

Breakthrough Hope for Melanoma Blocker – RA Drug Singled Out from Thousands Screened

ProHealth.com
April 1, 2011

“We are very optimistic that this research will lead to novel treatments for melanoma tumors which, working alongside other therapies, will help to stop them progressing.”

A breakthrough discovery by researchers at the University of East Anglia and Children’s Hospital Boston promises an effective new treatment for one of the deadliest forms of cancer.

As reported Mar 24 in the journal Nature(1), they found that leflunomide – a drug commonly used to treat rheumatoid arthritis – also inhibits the growth of malignant melanoma.

More.

Diana Wynne Jones has died, reports the Guardian. It’s a shame; I really enjoyed her ‘Tough Guide to Fantasyland’. If you haven’t read it, do yourself a favour and pick up a copy. It’s well worth the money. The obit notes she died of cancer–it will sound self-centered, but I get a nasty twinge each time I read that in an obit. It brings home . . . well, it brings home certain things. Let’s leave it at that.

(AP) – 2 days ago

WASHINGTON (AP) — The Food and Drug Administration has approved a breakthrough cancer medication from Bristol-Myers Squibb Co. that researchers have heralded as the first drug to prolong the lives of patients with melanoma.

The federal health agency approved the injectable drug, called Yervoy, for late-stage or metastatic melanoma. The agency has only approved two other drugs for advanced melanoma, the last of which was cleared more than 13 years ago. Neither drug has been shown to significantly extend patient lives.

Known chemically as ipilimumab, the biotech drug only worked in a small segment of patients studied, and on average they lived just four months longer than patients given older medications. But experts say the drug is an important milestone in treating the deadliest form of skin cancer, which is often unresponsive to therapy.

“Clearly this is not a home run, but it’s a solid base hit,” said Tim Turnham, director of the Melanoma Research Foundation. “And because we see other things in the pipeline, we think this the first in a series of important new therapies for melanoma.”

More.

Well, it’s good that the FDA approved it. It’s not a cure–except possibly for a minority of patients–but it is far better than the current treatments, which are frankly pretty useless. It’s still in progress with the NHS, but I don’t imagine it will take too long before it’s approved for use in the UK as well.

FDA Approval Expected this Month for Ipilimumab

By: BRUCE JANCIN, Skin & Allergy News Digital Network

More.

***

Worth a read, especially for some of the peculiar responses people have had to the drug (tumours growing and/or new sites of metastasis before stabilization). And also there are the usual dismal survival stats:

“The 12-month survival rate was 46% with ipilimumab alone, compared with 25% with vaccine only; the 24-month survival rates were 23% and 14%. Median overall survival was 10.0 months with ipilimumab plus vaccine, 10.1 months with ipilimumab alone, and 6.4 months with vaccine only”

Median survival 10 months. And that’s an improvement. Melanoma is a very nasty cancer once it’s spread. I was diagnosed with Stage IV melanoma in August, 2009. That’s 19 months ago. I am lucky to still be alive.

Post from the NZ Herald:

Drugs give hope to melanoma patients

 A cancer researcher has predicted that advanced melanoma patients could survive the disease within five years, thanks to dramatically improved drugs.

Malignant melanoma is the most deadly form of skin cancer and New Zealand’s fourth most-common cancer. The country has one of the world’s highest incidence and death rates from malignant melanoma.

Each year, more than 2000 new cases are diagnosed and more than 250 people die from the disease.

If a melanoma is detected early it is readily treated by surgery. Of patients diagnosed with a tumour just 1mm thick and whose cells haven’t spread, more than 90 per cent will be alive five years later. But in cases where it has spread to organs before detection, fewer than 10 per cent are alive after five years.

However, a melanoma conference in Wellington yesterday heard hopeful news about the progress of drugs in clinical trials for patients with disease that has spread – metastatic melanoma.

“These advances offer the realistic promise of our being able to convert metastatic melanoma from a death sentence to a chronic disease within five years,” said Professor Richard Kefford, the director of the Westmead Institute for Cancer Research at Sydney University.

Read more.

I think the article is a bit too hopeful regarding the time frame, but this is certainly the way cancer treatment is heading. At the moment, though, melanoma treatment is not very effective. I really have no idea when/if these drugs are going to come into widespread use, but it will probably be too late to have any effect on me (either I’ll survive without them, or I’ll die before they are around).

I have an appointment with the Royal Marsden today–progress check on my cancer. Although I’m not having any symptoms at the moment, just thinking about going in to the hospital is making me antsy. The people are great, the standard of care is amazing, but it’s just not somewhere I can feel comfortable, and the thought of going in is casting a shadow over my morning.

On the other hand, I ran eight miles this morning and felt great, so there you go.

One of the operations I’ve had was to remove the lymph nodes from under my right arm (happened in April 2010). They warned me before the operation that there might be permanent side effects, one of which was nerve damage. After the op, I had patches of numbness down the back of my arm. Sometimes they prickled when touched, like pins and needles. At other times, they were just completely numb. Nine months later, it’s now settled down to lessened sensation down the back of my arm . . . and a patch of complete numbness in my armpit. It’s odd. it doesn’t feel like numbness from an anaesthetic, like when you go to the dentist and get a numb face (it’s numb, but you can feel it feeling numb, if that makes sense). It’s more like a hole in my body awareness.

So now when I put on deodorant, I spray my left armpit and get a cold feeling where the spray hits. You know that, right? It’s how you know you’re spraying in the right place. But when it comes to my right armpit, I feel nothing. If I’m feeling sleepy, I only stop when I start smelling the deodorant–and given my crappy sense of smell, that’s about the time my wife wakes up and starts yelling at me for stinking out the bedroom.

Not upsetting, like many things about cancer. Just . . . odd.

Serious stomach pain all night, despite taking three codeine. Either it’s the mother of all ulcers, or the cancer has spread to my stomach. I’m calling the hospital to try and get an appointment ASAP.

I said I’d post yesterday, but I was too tired. The run was torture, but the press-ups afterwards were easier. Took two more Zopiclone, but couldn’t sleep very well (Sleep 8.45, waking: 12.30, 1.30, 3.00 (glass of milk), 4.45, 5.20). I got up eventually at 5.20 and had a couple of glasses of water. I felt tired, but about normal. But when I went back to try dozing again, I ended up rushing for the bathroom with saliva filling the back of my mouth, then spent about five minutes getting rid of the water and the milk.

So, that’s headaches (mild at the moment), nausea, fatigue, some dizziness. Is this due to a combination of insomnia and the side effects of Zopiclone? Or has the tumour woken up? (Two months after being zapped, which kind of sucks.)

Scan on Thursday next week. Counting down the days.