It goes without saying that cancer can be an insidious and devastating disease. We lost Pat to lung cancer (NSCLC) on February the 8th, 2020. She was diagnosed on August 31st, 2019. On that day my daughter and I were arriving back from a holiday in the UK. My father had picked us up at the Ottawa airport in the early evening and after a long day of travelling I asked my father how Pat was doing. Asking Pat how she was feeling became a daily occurrence over the last few months as increasingly she had not been feeling well since the spring of last year. At the time we attributed her feeling of malaise to the recent death of her mum. Pat and her sister Lynn were very busy attending to their mothers declining health and medical issues. Pat visited her family doctor complaining of a vague respiratory issue that had started in her throat but then seemed to have moved down into her chest. An x-ray was done and her lungs were clear. The doctor diagnosed Pat with chest wall pain (Costochondritis), a condition of relatively harmless musculoskeletal chest pain that resolves without treatment. Feeling satisfied Pat took Tylenol to manage her pain. Weeks went by with no improvement. The doctor told Pat shed have to be patient as chest wall pain could take up to a year to resolve. More Tylenol and Pat began losing weight and her appetite. Another doctors visit, another x-ray and her lung showed pneumonia. Pat was relieved and began antibiotics to treat her symptoms and she felt some improvement in her condition but it didnt last long. The pain continued and about this time a little cough started showing up, almost like a little tickle in her throat that would not go away. Perhaps it was allergies and Pat was sent to a respiratory doctor to check her lung function. Yet another x-ray was done and Pats lungs were back to being clear. The respiratory doctor noted that there was something not right with Pats breathing and she was given an appointment to continue on with the next stage of investigation. Meanwhile, more pain, more Tylenol, more weight loss and Pat started staying close to home, not venturing out for more than an hour or two if at all. On the car ride home from the airport my father told me Pat had gone to the emergency department that day because she had reached her limit with having to deal with all her chest pain. Her friend Sherrill went with her. A lung x-ray showed clear lungs yet again so it was thought Pat had an underlying heart issue and subsequently sent for an ECG and a CT scan. It was only then with the CT scan results that Pat was given the news that it was lung cancer and it had metastasized to her spine and sternum. She was blown away. The next month was horrible as we tried to navigate through getting the diagnosis, scheduling an appointment with an oncology doctor, do further testing including more CT scans, MRIs, blood tests, a bone scan and a lung biopsy. It was an excruciating time as we waited for all of this to be completed so Pat could begin treatment. It was a time of furious Google searches on lung cancer and its outcome, at least for me, but I think Pat and I both knew her prognosis was bleak. Somewhat reluctantly Pat agreed to start taking Hydromorphone prescribed by her new family doctor to deal with the ever-present chest pain as she had been exceeding the daily dose amount of Tylenol for several weeks. We finally got the appointment with the oncology doctor on September 30, a month after diagnosis and we prepared to hear the worst. Sympathetic as the doctor was, in no uncertain terms he told Pat that she would die of lung cancer and his best advice to her was to get her affairs in order. We left with hardly any words passing between us as we absorbed the stark reality of Pats situation. Shortly after the visit with the oncology doctor Pat was scheduled to receive five daily sessions of palliative radiation. This was to address the immediate concern of Pats chest pain. She was also convinced to give up Tylenol and allow the Hydromorphone to do its work. It took a couple of weeks for Pat to feel some concrete relief. With our spirits raised Pats first chemotherapy treatment was set for Oct 16th. In preparation for this we moved Pat to the Oakpark Retirement Residence so she could receive respite care during her treatment. We were all hopefully optimistic. Pat fared relatively well with the first treatment and the second treatment was scheduled for 3 weeks later. Nausea started to set in and Pats condition took a turn for the worse. A visit to the Cancer Clinic determined that Pat appeared dehydrated and pale. The next chemotherapy treatment was suspended while the clinic worked to improve Pats hydration. At this time another CT scan was done and it revealed no reduction in the cancerous lesions and if anything, they had grown. We were cautioned that it didnt necessarily mean that treatment was not working since treatment had not started until many weeks after the prior CT scan. The tumours had likely grown during that time. By the end of November Pats condition continued to deteriorate. She could hardly walk and was breathless upon any type of mild exertion. We visited her house and she lamented that it was all too much for her, that perhaps she should consider just going into a wheelchair. While sitting in her living room she got a call from the cancer clinic saying her hemoglobin levels were critically low and she needed to get herself to the hospital for a blood transfusion right away. Emboldened by this new development we left Pats house with a renewed hope for the future. Not surprisingly, the blood transfusion worked its wonder on Pats energy level and demeanour but with that came the realization that the chemotherapy was too toxic for Pats body and chemotherapy treatment was discontinued. Immunotherapy became the next course of attack. December 6th saw Pats first treatment with Nivolumab, a monoclonal antibody that helps to turn on your own immune system to attack the cancerous cells. Our fingers were crossed harder than ever before. Christmas came and we celebrated as best we could. One of the best gifts we all received was watching Pats young cat react to her name and jump into her lap for some familiar cuddles. We took so many photos knowing this was a special moment. This celebratory mood was short lived as breathing became an effort again in the days after Christmas. Up to this point and right to the end of her cancer journey Pat was brave and didnt complain. On the morning of New Years Eve, she called to tell me she was in distress with not being able to breathe. We went straight to the Emergency Department at the Ottawa Hospital. An x-ray showed her right lung was filling up with fluid. Pat was stabilized over the next week and a half. While she was on the cancer ward her oncology doctor visited her at her bedside. The visit concluded with a decision to stop any further treatment as it seemed hopelessly apparent that the immunotherapy was having no beneficial effect. The following days saw us preparing to get Pat discharged from the hospital and back to the Oakpark Residence where she would be taken under the wing of palliative care administered by Dr. Ruth Farey. The first few days were a struggle as Pat grappled with her failing situation and forthcoming demise. Dr. Farey was instrumental in putting all of Pats worries to rest and armed with her new found comfort Pat settled in to wait for the end. Pat took great pleasure from her many visitors whether by telephone or in person. We watched a lot of junk TV and saw the days getting longer knowing that spring was on its way. On the morning of February 8th, I had texted Pat to ask how she was doing and whether she wanted to put an order in for a Tim Hortons Ice Capp. Not today was the reply but she would see us later that afternoon at our scheduled time. Lynn and Sherrill had similarly texted receiving the same confirmation that all was well. My daughter and I arrived at the Residence at 2pm. First in the room, Bridget turned back to me in the hallway and said nana was sleeping. This was not unusual as Pat often nodded off watching TV but as I entered her room, I could see that Pats colour was not right. In that millisecond of time I knew Pat had passed but I couldnt believe what I was seeing. What happened? Why was she ok in the morning but dead now? My mind raced to come up with an explanation. Bridget was distraught and my father was equally shocked when he arrived half an hour later. It was incredulous that Pat was gone. Later, Dr. Farey arrived and explained that likely a blood clot dislodged from the tumour and gave Pat a pulmonary embolism. Her death would have been quick and painless. I take a lot of comfort in that and believe it to be true. Pat literally just looked as if she was sleeping. I also take comfort in thinking that she died in the way she most wanted to.quick, painless, on her own so as not to distress any beside vigil holders but not left too long on her own after she left this world. For that I am grateful.