How to Tour Italy with a Four-Year-Old

A little over three weeks ago our little family set off for Venice, Italy. I'd never been, and Italy was at the top of my list. You could say I pulled the cancer card when planning our family vacation. I may have said something along the lines of, "You've been three times. What if I never make it there at all?" Cue the violins, right? And so Chris indulged me, with the caveat that he gets to choose the next trip (which very well might be camping in Utah's canyon lands. Our vacation choices pretty well sum the two of us up.)

We toured between Venice, Florence/Tuscany/Sienna, and Rome over the next thirteen days. It was every bit as awe-inspiring as I'd hoped. Everyone keeps asking me what my favorite part was, and to be honest, I have to say the absolute sense of community -- the life lived in squares, enjoying the company of friends and family, lingering over dinners and a bottle of wine, the lack of smart-phones. It gave me a lot to think about with regards to how we live and interact with our neighbors and friends. The focus on togetherness -- without rush or to-go cups -- left me longing for more of that in my own life.

Also, I am deeply in love with Rome, especially its food. Next time, I might just do a culinary tour and forgo the museums entirely. Yes, I believe there will be a next time.

We'd been nervous about taking Quinn -- who turned four just three months ago -- to Europe for almost two weeks. Because how would he do on the plane? How many museums would we have to skip because he wouldn't have the patience for them? How much gelato would we have to bribe him with each day? These were the pressing questions we asked ourselves, never mind my energy levels or health concerns.

Tangent, sort of: I did get my doctor's permission to leave the country for two weeks. Since I'm on an every-three-week infusion schedule, it didn't interfere (much) with my treatment, and since my blood work has looked relatively okay for two years now (as long as I've been on Kadcyla), my oncologist wasn't concerned.  I will say that traveling for this long made me realize I probably can't ever live in another country, or even leave here for more than a couple of weeks, tied as I am to my infusion chair and the insurance that pays for it. Small gripe in the grand scheme of things, but it's just one more way cancer limits your choices.

But I can't complain, not right now. We just got back from Italy, after all. And as for our concerns about Quinn?

We clearly forgot who we were dealing with. 

Here's how to tour Italy with a four-year-old. Step one: make sure he's not on a nap schedule (ding ding ding!) We had that one down like two years ago.

Step two: Show him incredible views.

And put him up to the task of spotting all the lions in Venice. He will want to count them. In every language he can think of. "Mom, how do you say three in French? How do you say five-hundred in Italian?" "I'm not sure, honey," I had to say more than once. Or: "Let's ask Google."

Step three: Carry him in a backpack if necessary (walking six to seven miles a day is exhausting, after all, even for the energizer bunny himself).

Find more lions.

Let him go at his own pace once in awhile.

Show him extraordinary beauty (and make sure he knows he's part of it).

Look at the world through his eyes.

You might see incredible sights!

Let him slide on the bridges (so long as he promises not to fall in the water).

Take breaks.

Let him do some of the navigating.

Try not to have a heart attack as your husband picks him up higher than the railing when you're on top of the world (or on top of Il Duomo di Firenze).

Let him find some magic.

And chase some pigeons.

And more pigeons.

Take more breaks.

Carry him some more. Hey, he's a cute forty pounds!

This might be the most useful tip (and I've lost track of my steps): give him his own camera.

If all else fails, ply him with lots of gelato.

And pasta.

And hugs.

We are settling back in to life where we aren't saying, "Ciao!" at passers-by out our windows in the evening, where we don't have prosciutto and pasta and prosecco nearly every day, where we have doctors appointments again, and scans on the horizon, and temperatures in the triple digits.

But we'll always have Italy.

Around the Web: Italy Edition

Thanks for the great feedback about keeping this series here. (Although it seems as if once a month might be my posting schedule for a lil' bit.) I've been pulled in a lot of different directions lately, not all of them deserving complaint. And to all who checked in and suggested I stop to get some rest, I've taken note, I promise.

As I write this, we are were in the midst of reconnecting with each other as a family in Italy. The month prior to our trip felt like a strange square dance in which Chris and I kept passing Quinn off to one another without stopping to a) dance with each other or b) rest our feet as a family. We've needed this time for awhile.

This was my first time to Italy, and I wanted to pinch myself at every passing gondola or square with a lion-spitting fountain in its center. There have been moments since we arrived when I've caught my breath in my throat to ward off tears because these are things that a couple of years ago I thought I might never get to experience.

I might never come back. (Spoiler alert: I came back. But I'm still considering a future move to a pied-à-terre in Rome, on the off-chance I could get my insurance to approve Kadcyla infusions abroad and convince Chris that a sabbatical there makes sense.)

We're doing a lot of walking, so I'm not sure we'll get much actual rest for our feet, but we're being fueled by pasta and wine and gelato so I think we'll be okay.  We averaged more than six miles a day, and Quinn kept up like a champ. We were more than okay. Now that I'm home, my body actually craves the movement...and the gelato. More on how to do a trip to Italy with a 4-year-old coming up in a post soonish.

Posts might be a little spotty here for a couple of weeks, but I'll try to manage an occasional photo of my bambino enjoying the sights. We had really terrible internet coverage when we had it at all, then I was too jet-lagged to even form sentences for a couple of days, and then I had chemo on Friday so I'm still having trouble forming sentences. But I do hope you saw some of the photos of Quinn over on my Instagram account.

A photo posted by Jen Campisano (@jencampisano) on Jun 1, 2015 at 1:07pm PDT

Here's what I've seen around the web the last couple of weeks month. If you have something you'd like me to include in future editions, please send me an email (jen dot campisano at gmail).

Grazie, bellas!

There Was This Depravity (Or, Pay Close Attention to Where and to Whom You Give Your Money)

"In its complaint, the F.T.C. called all four of the cancer groups “sham charities,” charging the organizations with deceiving donors and misusing millions of dollars in donations, including putting money toward personal expenses like carwashes and college tuition, from 2008 to 2012."

There Was This Loss

“Of course I wish I had more time,” she told the Jewish newspaper The Forward in 2009, after learning that her cancer had returned. “I would love to see grandchildren, to see weddings, to be a part of these amazing things for more time, but I love life and don’t want to spend any of it mourning the loss of that which I can’t have. I’d much rather embrace that which I do.”

And This One, Which Seemed to Shake Our Entire Nation

""It is with broken hearts that Hallie, Hunter, Ashley, Jill and I announce the passing of our husband, brother and son, Beau, after he battled brain cancer with the same integrity, courage and strength he demonstrated every day of his life," Joe Biden said in a statement issued by the White House."

But also some uplifting news...

New Device Brings Us Closer to Understanding Metastases

"Metastasis occurs when cancer cells break away from a tumor and travel to distant parts of the body—the most dreaded event for a cancer patient. It is a mystery why some cells are able to travel through the body while others are not. Researchers from the University of Michigan, comprising a team of oncologists and engineers, have developed a new technology to help unlock this code.

A groundbreaking new study released in “Scientific Reports” describes a device that is able to sort cells based on their ability to move. The device allows researchers to take the sorted cells and compare the ones that are highly mobile to the ones that are less mobile. Understanding the differences in gene expression between these two types of cells can help identify why some cancer cells can spread to other parts of the body."

And a Potential Solution for Overcoming Her-2+ Drug Resistance

To be clear, this is still in the earliest, pre-drug stages. Super cool stuff nonetheless.

"There are currently no approved treatments that specifically target the ability of HER2 cells to join together or with other proteins, an essential first step in tumor growth. Lupu and her colleagues are now confirming the antitumor activity of this potential HER2 “master switch” in animal models. They will then move on to clinical testing, and the investigation of drugs—such as mimetic agents, targeted antibodies, and small molecules—that could specifically block this site responsible for HER2’s oncogenic potential.

“This drug does not yet exist; it is a promising area of future research,” said Lupu. “We believe that there is definitely hope because this is the first time that anybody has identified any region that blocks homodimerization and heterodimerization, which will simplify the treatment of the cancer. Rather than combining two, three or four drugs together, this will be a one-stop-shop.”"

How Breast Cancer Spreads to Bones -- And a Simple Way to Stop It

In my mind, this is HUGE news.

"Breast cancers can manipulate the structure of bone to make it easier to spread there, a study has found.

Researchers at the University of Sheffield said the tumours were effectively "fertilising" the bone to help themselves grow.

The study, in the journal Nature, said it may be possible to protect bone from a tumour's nefarious influence and consequently stop the cancer's spread. . . .

The animal tests also showed that a set of osteoporosis drugs called bisphosphonates could prevent the spread of cancer.

Bisphosphonates also interfere with the way bone is recycled in order to strengthen it.

They are already given to some cancer patients, but the Sheffield team believe they could have a much larger role."

Promising Early-Phase Clinical Trial Results Against Stage IV Her-2+ Breast Cancer 

"Promising clinical trial results presented at the American Society for Clinical Oncology (ASCO) Annual Meeting 2015 show activity of the investigational anti-cancer agent ONT-380 against HER2+ breast cancer, in one case specifically against brain metastases and in another case in overall survival of heavily pretreated HER2+ breast cancer patients.

"I am thrilled to have been able to offer this therapy to a patient in her early 40s. She didn't have any other great treatment options that we would have expected to have any meaningful impact, especially on her brain. Now she's been on the study over a year. The mets in her body are gone and the brain lesion has shrunk down to a little nubbin. She's living a normal life, fretting about the family business and how the kids are doing -- normal stuff," says Virginia Borges, MD, MMSc, director of the Breast Cancer Research Program and Young Women's Breast Cancer Translational Program at the University of Colorado Cancer Center and one of the study's authors."

Study Shows Complete Response for Some Patients with Metastatic TNBC 

"Immunomedics, Inc., (IMMU) today announced that among 49 patients with metastatic triple-negative breast cancer (TNBC) evaluated for response to treatments with sacituzumab govitecan in a mid-stage clinical study, 31%, or 15 patients, showed a reduction in tumor size of 30% or more. They include 2 patients with complete response. Response assessments were based on the rules set by the Response Evaluation Criteria In Solid Tumors (RECIST 1.1). Adding the 22 patients with responses between less than 30% tumor shrinkage and less than 20% tumor increase, the disease control rate was 76%. . . .

The U.S. Food and Drug Administration has designated sacituzumab govitecan a Fast Track development program for the treatment of patients with TNBC who have failed prior therapies for metastatic disease and patients with small-cell or non-small cell lung cancers."

And Promising News on the Cancer Front in General (out of the ASCO 2015 Annual Meeting)

"A new drug that unleashes the body’s immune system to attack tumors can prolong the lives of people with the most common form of lung cancer, doctors reported on Friday, the latest example of the significant results being achieved by this new class of medicines.

In a separate study, researchers said they had found that a particular genetic signature in the tumor can help predict which patients could benefit from the immune-boosting drugs.

The finding could potentially extend use of these drugs to some patients with colorectal cancer, prostate cancer and other tumors that have seemed almost impervious to the new drugs. Most of the substantial results so far with these expensive drugs have been in treating melanoma and lung cancer."

A Way to Eliminate Many Types of Cancer Cells -- At Least in Mice

"A type of immune cell can be primed to attack and eliminate various kinds of malignant cancers in mice, according to a study by Stanford University School of Medicine researchers.

The researchers studied mouse models of melanoma, pancreatic, breast and lung cancer and found that their technique could eliminate not only primary tumors, but also distant metastases throughout the body.

“The potency is impressive,” said Edgar Engleman, MD, PhD, a professor of pathology and of medicine at Stanford and the senior author of the study. “You actually see tumor eradication.”"