The following post is one of a series of posts appearing Monday through Friday on The Cancer Blog. This feature -- Today, I am grateful -- allows me to share with readers my appreciation for all the treasures in my life, both big and small. In my post-cancer world, I find It healing for my soul to be mindful of the good in my life. It is my pleasure to share my gratitude with you.

The night before my lumpectomy, way back in December 2005, I was consumed with fear, worry, and panic. Since I'd found it, the lump in my left breast had been sitting untouched for nearly two weeks. I imagined the mass spreading with each day and believed I could detect its growth each time I felt for it. A doctor told me if it was growing like I thought it was, my tiny pea-sized tumor would be the size of an apple within days.

My fears were unfounded and irrational. I know that now. But during the moments of uncertainty that filled my days between diagnosis and prognosis, I had no direction. I had only my wandering mind for company. The waiting really is the hardest part. Once faced with the specifics of our diseases, we can take action.

Yesterday, I saw my oncologist for one of my every-three-month follow-up visits. As always, I went armed with my list of questions -- which is really my list of worries -- and one by one, I rattled them off. On a little sticky note, I had written:

• Lymph node
  
• Digital mammogram
  
• Next MRI
  
• Heart
  
• Colonoscopy

And this is what my doctor had to say about my concerns of the day:

Fighting cancer is physically and mentally draining. Getting better should be the main focus of cancer patients, but often, it's not, because cancer can also be draining on your bank account. Even if you have health insurance, some drugs aren't covered, and they're not cheap.

I started thinking about this when I read this article on breast cancer patients in New Zealand who have gone to court to all but beg the local drug-governing body, Pharmac, to cover their treatment, Herceptin, in their fight against their aggressive cancer. A 12-month course costs upwards of $70,000, and they just can't afford it. Really, beyond the ridiculously wealthy, who can comfortably afford $70,000 a year? Certainly not I. Apparently the women don't meet certain criteria that would make them eligible for coverage, and I hope they can sort it out before it's too late for these women.

Since when did the right to live become a matter of money, an issue to be debated in court? It's heart-breaking to see money win out over the chance at life, but that's the reality of our world, it seems. It's a complicated issue that has no clear answer.

Somehow, it's been one whole year since my very last treatment for breast cancer. This time last year, a final dose of Herceptin whirled through my veins, capping off 52 weeks of therapy with this targeted drug and completing a total of 18 months of intensive cancer care. Where has the time gone?

It's gone to a preschool job, writing jobs, a revamped exercise routine and an overhauled diet; to kindergarten pick-ups, reading and writing practice sessions, arts and crafts and play dates; to beach trips, family trips, a Canyon Ranch trip; to trick-or-treating, Christmas cheer, backyard Easter egg hunts; to birthday celebrations, anniversary celebrations, the arrival of my new baby niece; to growing out my hair, ditching an anti-depressant, and clean mammograms. The list goes on. And on. The more I list, the more I realize a year seems like so much less. I could have never predicted it -- that the endless, dismal, painful days wrapped in cancer could disappear and fade so quickly into the background. Yet happily, they did.

And what do I have to say on the occasion of this special anniversary? Just one thing: Ahhh!

I have known my friend Claire for years (she asked that her last name not be used). So, I remember the shock I felt three years ago when I found out that she had breast cancer. Malignant breast cancer, we whispered to ourselves. Claire had been teaching English for Dole Fruit in Honduras. She came home that summer, and she never went back, even though she had another year left in her contract. Even though we have talked about her experiences over the years, we had never done so formally before she agreed to talk to me for this Survivor Spotlight. She came over and I poured her coffee (black) and we went out back to my studio/office to chat.

How did you find out you had breast cancer?

I went in for a routine mammogram. I had been having mammograms for about the past ten years or so. But I missed the previous year! So, after I found out that I had cancer, I was mortified that I had forgotten the previous year. But actually, I had a benign cyst years earlier, when I was younger and hadn't gone through as much. That was actually much scarier.

How did you find out it was malignant?

Needle biopsy. But I had warning -- the radiologist was pretty sure it was bad, so he gave me warning. The biopsy was just to make sure.

Women treated with Herceptin (trastuzumab) in combination with chemotherapy for early stage breast cancer showed that after five years the risk of congestive heart failure did not increase with time.

The findings of the National Surgical Adjuvant Breast and Bowel Project (NSABP) were presented at the 43rd annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago last week.

Heart damage occurs in around 5 percent of patients treated with Herceptin. It is the most significant side effect; women with existing heart conditions cannot take the drug. The study showed that women were either susceptible to heart problems or they weren't. The risk of long-term problems is the same as the risk that is there from the beginning.

Drugs currently in trials for obesity and diabetes may soon be fast-tracked for use in the fight against breast cancer. Typically, it takes many years to research and develop new drugs. But these already-developed drugs, if successful, could reach the market much quicker.

The drugs, believed to work by blocking the enzyme PTP1B, could help breast cancer patients because the enzyme is found in high levels in about 40 percent of these patients.

Studies on mice show blocking production of the enzyme significantly slowed tumor development. In some cases, it stopped the spread of the cancer and it might even stop some tumors from forming.

It's been one year since I began writing for The Cancer Blog. According to statistics generated by this site, I've written 27,381 words and 793 posts. If you've been reading for this entire time, you surely know a lot about me. Not only do my posts reflect current news and issues, but they feature all sorts of personal stuff too. When considered together, my work here reflects just about every piece of my cancer journey, my inner most thoughts, my morals and values, my take on the world. But for those of you who haven't been reading for long, for those who have forgotten how I fit into the cancer puzzle, for those who want a recap, here's a rundown on me: Jacki Donaldson.

I was born and raised in Ohio but have also lived in Nevada, Virginia, and Florida -- my current home. My life always went pretty much according to plan -- I lived happily with my parents and one sister, faithfully attended school, went to college, got married, had two baby boys and a series of good jobs, and had just begun commenting to my family members about how lucky our family was not to have been affected by cancer. It seems just as I spoke this aloud, cancer arrived.

On Tuesday, researchers announced that a three-drug cocktail may help women with HER2-positive breast cancer better than any other drug used on its own. About one quarter of women with breast cancer make up this HER2 category.

Tests on mice revealed using the three drugs along with breast cancer drug tamoxifen helped wipe out tumors altogether. And the tumors did not come back. This is the first time mice were cured of a very aggressive human breast tumor. Incidentally, when a single drug was used, tumors returned within several weeks.

The three wonder drugs used in this study -- all are monoclonal antibodies that precisely target certain aspects of tumors -- are the experimental drug pertuzumab; trastuzumab, also known as Herceptin; and gefitinib, or Iressa.

Published in the Journal of the National Cancer Institute, this study supports the notion that HER2-positive tumors eventually become resistant to one drug and attacking them on several fronts seems to work better.

Chemotherapy given before surgery to remove cancer is called neoadjuvant treatment. An oncologist might recommend this based of the size of the tumor -- it being very large. The idea is to shrink the tumor and then have surgery to remove the cancer.

Having chemotherapy administered while the tumor is still there can show what drugs are working and what drugs have no effect on the tumor. Chemotherapy when started immediately, not after surgery with healing time needed, gives the patient systematic treatment right away. This could be beneficial and is why physicians might recommend this form of treatment. The truth is they don't know if it is better or not.

Of course, every case of breast cancer is different. We all need to make tough decisions regarding our treatment plan. The facts are that currently there is no evidence that survival is improved with neoadjuvant verses adjuvant (after surgery) chemotherapy in women with locally advanced breast cancer.

The clinical trials that are done help physicians understand what treatments are more effective. Results from a Phase II clinical trial was published in the Journal of Clinical Oncology. It stated that neoadjuvant treatment with Taxotere, Navelbine, and Herceptin resulted in a complete disappearance of detectable cancer in 39 percent of women with locally advanced HER2 positive breast cancer.

The study showed that after two years followup, on the thirty one women with locally advanced breast cancer involved in the study, the overall survival was 97 percent and cancer free survival was 84 percent.

So, the message here is that, even though the study group was small, the results showed a good response to this treatment plan.

Breast cancer drug Herceptin has been approved in Europe for use with hormonal therapy for postmenopausal patients with HER2 and hormone receptor positive metastatic disease.

Herceptin, made by Swiss drugmaker Roche Holding AG, is already approved in Europe for early and metastatic HER2-positive breast cancer.

This new approval is based on data from an international late stage clinical trial showing the combination of Herceptin with hormonal therapy doubled the median progression-free survival time.

Twenty to thirty percent of breast cancers over express a protein referred to as the human epidermal growth factor receptor, better known as HER2 over expression.

Herceptin is an agent that is targeted against the HER2 receptor and helps to slow or stop the spread of cancer cells that over express this protein. Unfortunately, some women that do have the over expression of HER2 on their breast cancer cells do not respond to treatment with Herceptin.

The Journal of the National Cancer Institute has published a report that says among breast cancer patients with HER2 over expressing cancer cells, those whose cells also express a receptor called p95HER2 have a poor anti-cancer response rate with Herceptin.

The study included forty seven women with metastatic breast cancer. All were treated with Herceptin. Nine of these patients also expressed the receptor p95HER2.

The results showed that only 11 percent of the women with the p95HER2 expression showed an anti-cancer response to Herceptin. Of the patients who did not express p95HER2 demonstrated a response of 51 percent. The report also showed that laboratory testing of cancer cells that do express p95HER2 demonstrated anti-cancer activity with a drug called Tykerb.

The researchers concluded that patients with HER2-over expressing breast cancer who also express p95HER2 appear to be more resistant to treatment with Herceptin and "may require alternative or additional anti-HER2–targeting strategies." Patients with HER2-over expressing breast cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating biologic markers that may help predict responses to certain therapies.

Advocacy runs far and wide. Thank goodness for that.

Think about this:

A new breast cancer non-profit organization has been launched especially for South Africans affected by the disease.

Founded by Samantha Galliet, the 31-year-old breast cancer survivor who made headlines with her "David and Goliath" battle to get life-saving Herceptin treatment, created PinkLink to give patients affected by breast cancer a voice.

PinkLink, focusing on the need for self-examination and awareness to encourage prevention and early detection of this silent epidemic, is intended to be a one-stop-shop with valuable South African based information on doctors, treatments, financial considerations, and health issues.

Tykerb has been approved by the FDA for use in conjunction with the chemotherapy drug Xeloda. Tykerb is a cancer medication that more precisely targets tumors without killing lots of healthy cells in the process.

Herceptin and Tykerb target a protein called HER-2/neu but work in different ways. Herceptin targets the outside of the HER2 protein and Tykerb works from the inside of the cell. This difference can give advanced breast cancer patients another drug to switch to if Herceptin stops working for them.

Glaxo said that Tykerb will be available in two weeks. The results of a study showed that Tykerb worked so well that the international study was stopped early and all the participants were offered the drug.

The FDA said it was too early to know if women taking Tykerb and Xeloda would live longer than those taking the latter drug alone.

Dr. Steven Galson, FDA drugs chief, said "Today's approval is a step forward in making new treatments available for patients who have progression of their breast cancer after treatment with some of the most effective breast cancer therapies available."

If the experimental breast cancer drug Tykerb continues to prove successful in study participants, it could be headed for FDA approval.

Tykerb, now in international study, showed in early studies to be even more effective and to have fewer side effects than similar breast cancer drug Herceptin. Both drugs are part of a cluster of targeted therapies that attack cancer cells while sparing healthy cells. Designed for use on women whose breast cancer is HER2 positive -- meaning it contains too much of an aggressive protein -- Tykerb may be a wonder drug, with the capability of effectively keeping breast cancer at bay.

Dr. Paul Goss of MA General Hospital says, "We're seeing Tykerb, which is a pill, which is easier to take, has a broader attack and gets inside cells. It's like an electrical circuit that's turned on, and Tykerb can pull the lever, the circuit breaker, and switch it off."