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Karine, or when the inexplicable happens

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But it only lasted long enough to start hoping. In the space of a few days, in October, everything changed: the fever returned, an already excruciating back pain became unbearable, and Karine had to be hospitalized again.

Even though she continued to show indestructible optimism on her Facebook blog The summit of Victory, the young woman of 39, who had been fighting for a year against cholangiocarcinoma, a merciless cancer of the bile ducts, was at the end of her strength.

On November 25, she was transferred to the Maison Aube-Lumière, a palliative care center, to rest and spend quality time with loved ones, can we read on his blog.

On December 8, too powerful and too surly, the Beast, as she nicknamed her illness, finally triumphed, denying her even the privilege of a last Christmas with those she loved.

When asked if Karine left believing that they would all see each other again one day, her partner, François St-Louis, shares a moving anecdote.

A few days after the diagnosis was announced a year ago, the couple brought out their slightly dry Christmas tree so that they could continue to light it safely outside. Karine notices that a cardinal comes to perch there almost every day.

This had never happened before, said Mr. St-Louis. He was really in front of the window. She sincerely believed that it was someone who came to speak to her.

Everything can be

Exactly two months before her death, on October 8, Karine wrote on her blog: I know that I live on borrowed time but I dare to believe in the miracle … anything is possible.

Even though her condition had started to gradually deteriorate by then, the optimism she had shown from day one was still there. She was, after all, coming out of a relatively pleasant summer during which she had been able to enjoy the good weather with her family. She and her lover had even stayed in the Kamouraska region for a few days.

We hiked but was not in shape like she was in August, said Mr. St-Louis.

Hospitalized shortly before, the young woman convinces the hospital to give her a short leave so that she can go and celebrate Halloween with her children. She then admits to her partner that she understands people who end up giving up.

The end is coming. Doctors begin, at the beginning of November, to prepare the small family for what is to come.

Doctors would come once a week to sow seeds, said St-Louis. The first one came to tell us that it was very likely that she would not be attending Christmas. There, it hit like a sledgehammer. From there she felt there was nothing more (to do).

The metastases had started to invade his body again. A doctor offers her one last chemotherapy, while pointing out that it would only buy her a few more days at best, and that she wouldn’t necessarily be in great shape.

Karine eventually refuses this offer and takes the road to the Aube-Lumière house.

We thought we had some quality time, but the doctor called me on Sunday morning (…) because she really ‘crashed’ in the night from Saturday to Sunday, confided Mr. St-Louis.

A few days later, it was all over.

Growing incidence

Cholangiocarcinoma remains a very rare cancer, although it has possibly become a little more common in the West in recent years. The treatment options available to doctors to combat it are limited and the survival rate is extremely low.

The majority of patients have no identifiable risk factors, said Doctor Frédéric Lemay, a gastroenterologist at the Center hospitalier universitaire de Sherbrooke who specializes in digestive oncology.

Doctor Lemay was Karine’s attending physician. While he was unable to discuss his case specifically, for obvious reasons of confidentiality, he still agreed to discuss the illness and its treatment in general terms.

Karine had chatted at length with The Canadian Press in the spring. Tobacco or second-hand smoke? Never. The alcohol? From time to time, in moderation.

I have always eaten well, she said during a long telephone interview. My mother always fed me good products, not processed products. She has always made everything herself, her muffins, her lasagna. She cooked a lot and I cook a lot. I do everything myself. We eat well, not too much meat, we are balanced.

This did not stop the disease from hitting her hard.

Even if we look, even if we do genetic analyzes, to try to find out if it is something family, often we do not find anything, admitted Dr. Lemay. For some reason that cannot be explained, there is going to be a defect in the normal proliferation of cells. (…) In the case (of cholangiocarcinoma) as in other cancers that I treat, to have patients without risk factors, unfortunately, yes, it is surprising, then unfortunately, we see them.

However, we know that Karine was able to benefit from a sophisticated and fairly expensive treatment, which is not given to everyone. Personalized medicine, or precision medicine, is at the cutting edge of what is currently being done: it essentially involves analyzing the patient’s genetic code and the genetic code of his cancer in order to identify the treatment that will have the effects. better chance of success, instead of taking a more generic approach.

If the therapy was very effective at the beginning, which allowed Karine to enjoy a last summer with her relatives, the doctors had warned them that the lull might not last.

Apparently that treatment does happen, said Mr. St-Louis. Everything works and then poof, at some point, it stops. The doctor told us that we can take a break and then start it again. But when (the treatment) started not working, it was a disaster.

Dr. Lemay has confirmed that cancer can be very skillful when it comes to dodging attacks against it.

It’s as if there is a ‘switch’ that was ‘On’ in cancer. We are going to put it to ‘Off’, he illustrated. Often it works well, but it does work for a while. Then the cancer will become resistant, it will find another signaling pathway (…) then this one, we will not necessarily be able to find it, let alone put it to ‘Off’. So this is unfortunately the too frequent story of a treatment that works well, but which will be limited in time.

Not a defeat

Karine’s family do not consider that she has failed to reach the Victory summit.

In a touching post on the blog, his uncle Michel wrote: Did Karine fail to reach the Victory Summit? My answer is this: not only has it achieved it, but it has greatly exceeded it. (…) The lesson of life that Karine gives us does not end with her departure: her refusal to give up in the face of illness invites us all to follow her example in our own lives. The courage she has shown teaches us not to feel sorry for ourselves, but to strive to achieve our goals, despite obstacles, often against thick and thin. If success is not always there, the obligation to provide the necessary efforts and to push our capacities to their limits must always guide our actions.

At one point, on the morning of December 18, the line of people waiting to greet Karine and her loved ones one last time stretched to the main doors of a funeral complex in Sherbrooke.

Inside the room, two garlands of hearts made by her children, Leo and Juliet, hung on the wall.

Sometimes I feel like I’m in a movie, said Mr. St-Louis. It is an immeasurable dose of love.

At seven and five, Leo and Juliet are too young to really understand what death is (Leo told his daddy that he might understand when he is older). However, they understand that they will never see their mother again and they talk about her very often.

The illness, which stretched for a year, and Karine’s multiple absences, had somehow prepared them for the shock of her departure. Already well established, their routine of being alone with Mr. St-Louis continues, and their resilience is a source of inspiration for him.

Basically, it is we who should live a bit like them, in the sense that they are from day to day, he said. If I am hungry, I have something to eat; if I want to move, I can move; if I need affection, I have affection. The basic things. If it’s full, they’re happy.

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