Cancer drug Nexavar has made its point. It can help people with liver cancer survive longer.

Bayer Pharmaceuticals and Onyx Pharmaceuticals announced Monday that advanced stage clinical trials for this drug will end early. And now patients in the placebo arm of the study can begin treatment with the actual drug.

It's been a long road for researchers who have been searching for a liver cancer treatment that can target tumors with minimal side effects while extending life for months or even years.

It is estimated that 16,780 people in the United States will die from liver cancer in 2007 -- and it seems Nexavar, a drug initially predicted to fail when used for liver cancer -- may help save some of these lives.

Bayer and Onyx are planning to pursue FDA approval for this drug that has already been approved for kidney cancer.

There is a general belief that opioid use to control pain around the time of death causes the patients to die sooner. "Hospice providers, families, and patients should not be afraid of opioid drugs because of the belief that their use to control pain shortens life" says, Dr. Russell K. Portenoy, of the Beth Israel Medical Center, New York.

Dr. Portenoy and his colleagues examined the relationship between opioid use and survival using data from the National Hospice Outcomes Project (NHOP).

After analysis of all the factors, opioid use accounted for very little in differences of times of death. He believes that opioid therapy by itself contributes very little to the time before death occurs in hospice programs.

"Opioid drugs," Portenoy concludes "can be used aggressively at the end of life to relieve pain and suffering, and this use should not be constrained by inappropriate fear of serious consequences like earlier death".

I remember thinking when my grandma was a spunky 80-year-old -- still going to aerobics classes in her purple tights -- that it must be sad to be such an age when so many friends and acquaintances are falling ill and passing away. My grandma was always one to care for others, call on others, pray for others -- and often she seemed to be the only one in her circle who was thriving. Somehow, she took it all in stride and continued baking and gardening and sewing and living strong until her own death at the age of 86 -- when she left her remaining friends and acquaintances wondering if their own time on Earth was approaching a quick end. At the time, I thought this loss of friends was merely a side effect of aging. It didn't seem to concern me at my own young age of 30. I didn't really know any 30-year-olds who were dying. And I didn't predict anyone my age would be dying until I was closer to the age of 80. How wrong I was.

I am now 36 years old. And I know many women my age who have died -- most of them because of breast cancer, the same disease I have been fighting for nearly two years. So it's not only sad to me that people my age are dying, it's also quite personal and frightening -- for it could easily me in the same predicament. So I feel vulnerable -- so many years earlier than I imagined.

I think I know how my grandma must have felt when her loved ones were leaving her. And I think I will take her same approach to coping with this unfortunate fact of life. Although I couldn't possibly bake and garden and sew like she did, I can keep busy with my own hobbies and interests. And I can continue living strong until my own death -- which hopefully won't occur until after I've made my appearance in purple tights. About 50 years from now.

Numbness is wearing off, and I am beginning to feel twinges of pain surrounding the area where my port was once located. I can't see what was done to me today -- because the area is carefully bandaged -- but I know from what I feel that my skin has been cut and sewn back together. I feel the skin tightening, stretching, pulsing and while it's not terribly comfortable, it's pretty minor compared to the pain of so many other cancer procedures -- like my lumpectomy, my chemotherapy, my nausea, my neutropenia, my allergic reactions to various medications.

So I am fine, following my port removal that was predicted to last a few hours but somehow took most of the day. The actual procedure took just one hour, and the twilight drug that kept me in a peaceful funk allowed me to relax while the port that was tunneled into the tissue underneath my skin was precisely taken from my body. It was an uneventful experience -- except for a few tears that dripped from my eyes during the final moments before my surgery. I think it may have been the power of the moment -- the moment signaling the end of my active cancer journey. Or it may have been the power of support offered by my sister and my three-year-old son who accompanied me today. Or it may have been the power of the response I gave a nurse who had just seen my little guy and asked me if I planned to have more children. My response -- probably not, because of cancer -- seemed a little too final, a little too sad.

It may have been the combination of everything, all adding up over the past two years, that brought tears to my eyes today. But for now, the tears are gone. And the port is gone. For now, my cancer is gone.

There have been many strides over the years when it comes to treating childhood cancer. Many are surviving but some children will still die of their disease.

Parents of dying children have certain issues that are very important to them when going through the end of life process. The quality of care that is delivered at the end of life plays a critical role in the well-being of both child and parents prior to the child's death. It can also influence how the parents cope with their grief after losing their child.

Researchers surveyed 56 parents of children who had died in pediatric intensive care units in the Boston area. One of the most important aspects was that the care included honest and complete information. One woman noted "What we cannot handle is not knowing what is going on".

The parents need ready access to staff, communication and care coordination, emotional expression and support by staff. One parent said "Parents need to feel that people really care, not that it's just a job". Faith also played an important role when the parents said that chaplains and community clergy can be an important resource for parents.

The parents that were in the study were asked if they had any advice for other parents. Parents encouraged other parents to make decisions based on their own values and beliefs and to sustain hope, trust and love.

When we memorialize someone at the time of death, we often refer to the date of birth and the date of death. These numbers tell us something -- like the age of the person -- but they don't say much about the life that fills the gap between start date and end date. They don't tell of the life that was surely full of ups and downs and victories and struggles. And happiness and joy and sadness and sorrow. And family and friends and jobs and hobbies. They don't do justice to the true stuff of life that is so much more important than numbers. But there is something important about these two sets of numbers -- something that when really examined, tells the full story. This important something -- the dash.

The dash that separates these static numbers is what tells the story of life. So consider your own dash when contemplating life, while determining how to spend your time and fill your days. Make your dash matter. Make it worthwhile. Make it something that people will talk about long after your own numbers become a matter of permanent record. And when you memorialize loved ones in the future, think about what their dashes mean. Talk about them, remember them, honor them. And pass on this link -- www.thedashmovie.com -- so others will consider the meaning that flows from each simple dash.

Health care coverage for working Americans is like a brittle tree in a hard wind -- and the larger limbs are beginning to snap. Between the years 2000 to 2005, 6.8 million more people became uninsured according to the latest report from the U.S. Census Bureau's Housing and Household Economic Statistics Division. Current data estimates 46.6 million people are without health insurance coverage. As employer-based health insurance continues to fade, government programs are taking up the slack -- up to a point. But given the lack of funding, there is only so much that can be offered.

In a statement issued by the Center for American Progress, "These problems did not just happen: they resulted from flawed economic and health policies which force Americans to work more for less. When it returns after Labor Day, this Congress should act to mitigate these problems by passing a straightforward minimum wage increase and extend health funding for programs like the State Children's Health Insurance Program. Moreover, policy makers should recognize the need for major change, such as providing affordable health care to all Americans and taking action to address growing income inequality."

Some are calling for a government-based universal health care system that guarantees health care coverage for all Americans. Others are suggesting a mix of private and public health care coverage. What ever the solution, there certainly needs to be one.

We can start with a shift in perspective and change in expectation. If you are working full-time for a company, presumably your efforts are helping that company make a profit. Health insurance coverage should not be viewed as a luxury benefit, nor should the largest burden of health insurance premiums be shouldered by the employee whose earnings just meet living expenses. Yet, this is happening every day in this country. The hard wind continues to batter the brittle tree.

Personally, I am not sold on a government-run, government-backed universal health plan simply because I have covered too many horror stories about rationed care in other industrialized countries. It seems a combination of programs might be the solution but the government and our elected officials certainly need to be held accountable for implementing programs that insure all Americans.

American Public Health Association Georges Benjamin is quoted by United Press International as saying, ""This is the worst news we've had all year. Our nation is not secure if we're not healthy."

I ran on my treadmill today while listening to a song by the band Green Day. I have always liked the song -- Good Riddance (Time Of Your Life) -- but I like it more at this moment in my life than ever before because it speaks about looking back on the past in light of unexpected journeys -- and because my unexpected journey with breast cancer makes me look at everything differently. And when I look back at my life one day, I want to say that I had the time of my life. And that's why I like this song. And that's why I share it here today. Because I hope that in the end, we all can look back with the crystal clear knowledge that we had the time of our lives.

Another turning point, a fork stuck in the road
Time grabs you by the wrist, directs you where to go
So make the best of this test, and don't ask why
It's not a question, but a lesson learned in time

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

So take the photographs, and still frames in your mind
Hang it on a shelf in good health and good time
Tattoos of memories and dead skin on trial
For what it's worth it was worth all the while

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

Pink Strokes is dedicated to making a difference today for the daughters of tomorrow.

I met Allison Roberts at one of the Young Survival Coalition conferences. I learned of her website called Pink Strokes. Pink Strokes is a non-profit organization that seeks to raise awareness and assist in providing information and support to young women diagnosed with breast cancer.

Allison was diagnosed with breast cancer in December 2002 at 32 years old. She was delayed diagnoses and was told that she had lumpy breast tissue, that she was too young and that cancer didn't hurt. Allison had been having pain in her breast and eventually noticed a lump under her armpit. She did as I did and trusted her doctors when they said it was nothing to worry about.

Allison was diagnosed with a 3cm tumor in the breast and positive lymph nodes. She needed chemotherapy and radiation for her aggressive cancer.

Allison says "It really became obvious to me that I wanted to do more when my husband signed up to walk in The Weekend to End Breast Cancer, a 60 km. walk through Toronto streets". That next year Allison walked herself with a team called Ali's Alliance of Angels and raised over twelve thousand dollars.

Together they organized their first golf tournament to raise money for the walk called Pink Strokes.

Allison's son Tyler asked his mom, "Mommy is breast cancer over yet"? Allison told him "Someday breast cancer will be over"!

I was present for death only one time in my 36 years of life. I consider this both a bad and a good thing. It's bad because I did not want my grandmother to die -- and watching it happen made it so real, so vivid, so painful. I don't think I would have ever chosen to watch my grandma die -- to watch her slip from consciousness to coma, to observe her altered body once death arrived, to witness the movement of her body on a stretcher as it was wheeled out of the house from the bedroom I still see every time I visit my mom's house. But I think I am lucky really -- and this is the good part -- because I got to be with her during her final moments. I got to watch her body as it lay still, peaceful and calm and still breathing. I got to talk to her and although she could not respond, I believe she could hear my words. And it makes me happy to know my grandma may have known I was with just prior to her flight to heaven. And after her flight, I got to touch her cool hands. I got to feel the power of the passing of one life -- a long life -- and I got to feel the comfort of a death that was not ugly or painful or difficult. It was sad -- it's still sad -- that my grandma died three years ago. But what a privilege it was to be part of the day she left this world.

Susan DeWilde left this world in much the same way -- with loved ones by her side. She was a fighter and had conquered several rounds of breast cancer, a tumor in her spinal cord, uterine cancer, lymphatic cancer, and then leukemia, which took her life at the age of 53. I don't know this from Susan herself but from her friend, Christy Mack -- who helped her accept her death and guided her into her own final moments so that she could escape her pain and die peacefully. Christy writes about her beautiful friend and her empowering death in an article that appears in the August 2006 Oprah Magazine. Titled Friends to the End, Christy's story details how she soothed her friend, cradled her hand, and talked her through her last breaths. She helped her on her way during a time her friend feared most. Christy writes, "What she and I shared the night she died was a precious gift of friendship, emotionally profound and sacred in its perfection. It broke my heart. It strengthened my soul."

This I understand.

The tunnel was long. And dark. And winding. And foggy. And ominous. It seemed to last forever -- at the time -- and at moments, time seemed to stand still. I was not sure if I'd ever pass through it and be okay -- if I'd ever see the light at the end. But I did. I tunneled through it all -- somehow -- and I came out feeling more alive than ever before. Now, some time after my escape from the fog, I am already taking for granted the fact that I am breathing, that I am healthy, that I am living. And when my fitness trainer noticed yesterday that I do not get dizzy and lightheaded anymore during my workouts -- when I once had to sit down, breathe, collect my whereabouts -- I realized that some of my progress since exiting my breast cancer tunnel is already lost on me. And I don't want to lose sight of where I was and how far I've come. I want to remember it and measure it and never forget how alive I am at this very moment. So I have started to really think about how things have changed since I felt stuck in time, in a dark place. I am thinking about my times in a hospital bed when I was barely able to stand up, barely able to walk a few steps without feeling like I would collapse. Now I can hop out of bed at a moment's notice, half asleep in response to a demanding child screaming from his bed. I am thinking about my once challenging pre-cancer exercise routine and how a time came when my legs felt so heavy I could not even contemplate walking down my street. Yesterday, I completed an hour of weight training. Today I ran for 20 minutes. Tomorrow, I go back for more weight training. And I remember feeling incoherent, unable to conjure of meaningful thoughts or sentences. And now, despite some potential chemo brain forgetfulness, I am back on track.

I have only just touched the surface. There is so much more to reflect on. So I plan to think more about my travels so I can better appreciate how I arrived at the exact place where I am right now -- where it's light and clear, where time passes at normal speed, where I feel lucky to be alive.

I've been wearing a breast cancer bracelet that jingles with charms in the shapes of hearts, with inspiring little messages like Go with your heart. One of the heart charms is a watch. My friend sent me this shortly after my breast cancer diagnosis. I love this bracelet. So I was sad the other day when the glass piece covering the watch somehow cracked and shattered. I only realized this when I tried to check the time and learned that my watch was not actually telling time anymore. So I went for my back-up -- another watch, exactly the same and also given to me as a gift. I replaced my old watch with the new watch and then days later, my new watch was not working. I think water got inside the glass and damaged the battery or the mechanisms -- or something. I'm sure I could repair the watches -- and I considered this -- but then it entered my mind that maybe this is a message that I am okay now without all my breast cancer gear.

At the same Atlanta meeting of the American Society of Clinical Oncology where the breast cancer drug Tykerb was touted as perhaps the next wonder drug, findings were also released concerning chemotherapy and end-stage cancer. It seems that many patients in the last weeks and days of their lives are receiving chemotherapy -- when it is clear that there is no hope for survival. Perhaps patients don't want to give up and so they choose to fight to the very end. I think I would be hard-pressed to throw in the towel if a doctor thought I might benefit from continued treatment. Miracles do happen.

Doctors may be part of the problem, though, according to researchers. Patients don't want to give up -- and neither do doctors. But cancer specialists report that overly aggressive treatment gives false hope and puts people though unnecessary suffering and costly ordeals when hospice would be a more effective route. The purpose of hospice -- to help people die with dignity and in comfort -- is ineffective, however, when it's not used to its full potential. A large review of Medicare records showed in 1999 that nearly 12 percent of cancer patients died after receiving chemotherapy in the last two weeks of life. This was up from 1993 -- 10 percent -- and is probably higher today. These individuals could have been peacefully preparing for death and instead were suffering through the trials of harsh treatment.

The solution -- that must be implemented by doctors -- is a willingness to accept that there is a time to stop followed by an honest conversation with the patient whose cancer has spread widely and is incurable.

Another study presented at this Atlanta meeting revealed that some patients are not being offered newer treatments that might truly save their lives. New lung cancer treatments have extended survival from 20 percent at one year to 50 percent, for example. Yet only 11 percent of doctors in one Wisconsin study would refer such patients for treatment.

It would be nice to know for sure that one life is about to end, regardless of treatment, and to know that another might be saved because of treatment. And maybe one day -- when treating cancer is an exact science -- this will be a reality.