It Might Get Messy

We used to think (that’s a royal “we” as in “we scientists”…) that invertebrates didn’t get cancer. As the authors of a 1950 review paper [1] put it: “… until fairly recently, invertebrate tissues were often considered incapable of developing tumorous growths”. That was then. Nowadays we know better. 

Sponges, corals, and nematodes are all theoretically subject to tumor development based on cellular biochemistry, and actual tumor-like growths have been observed or induced in corals and nematodes [2]. An enormous lobster developed a correspondingly enormous tumor that filled its carapace, pushed into its head, and killed it. Ants are known to develop brain tumors (I know, it’s hard to fathom how a tumor could form in the itty bitty blob of nerve cells serving as a “brain” in ants). A bumblebee was found to have a tumor on a pharyngeal gland. This gland is generally similar in function to human salivary glands. The cancer in my parotid gland thus has an antecedent in a little “throat” gland of a bee!

And why the hell would we be interested in invertebrate malignancy? Well, consider the effect of X rays on fruit flies. Outcome of X ray exposure has a threshold below which tumors are propagated. At higher doses, X rays apparently heal fruit fly tumors [2]. Such an effect has potential for understanding and administering radiation therapy in human beings. 

There are a number of studies demonstrating that virus and bacteria infections cause tumors in invertebrates. This knowledge was gained in the 1940s, eerily forecasting our present understanding of microbial infections as direct causes of  specific kinds of cancer in people. 

Weirdly, tumors are induced in some insects after certain nerves are severed. This raises concerns regarding the potential for nerves damaged by injury or surgery to cause cancer in humans. 

On the plus side, “A large body of data indicates that invertebrate marine organisms produce a multitude of active substances that, in humans, exhibit potent anti-tumor activity” [2]. 

So, it’s clear that studying tumors in invertebrates can provide important insights regarding the genesis and development of cancer. Even better, there are potential cancer treatments kicking around invertebrate physiology. Maybe someday chemicals extracted from fiddler crabs or oysters will provide breakthrough therapies for cancer.

But, given the infancy and rarity of scientific investigation of invertebrate malignancy, I’m not going to survive long enough to benefit. Sigh. 

However. It seems, preliminarily, that I may be around for a lot longer than any of my doctors thought. I saw radiation oncologist Dr. N this week. He continues to be surprised and amazed that he doesn’t see tumor recurrence when he examines my throat with the endoscope. I also saw Dr. S, my new “palliative care” specialist. I think palliative care means treating symptoms vs. the actual disease. Basically, all my other doctors enlisted this guy to take charge of my medications. 

Of which I continue to need a boatload. We’re working on cutting out some of the drugs treating depression, inflammation, and pain. I’m having a lot less of this trio of contretemps, so the diversity of pharmaceuticals now has some redundancy—I can suppress the triad triptych with precision guided weapons vs. intense carpet bombing. I still have periodic bad days when my throat gets sore, mucous production rises, the mucous itself turns thick, ropey, and brown, and I develop inflammation in my oral cavity. But those incidents are declining in frequency and intensity. I’m getting better. 

So it seems that, assuming the cancer doesn’t recur, I may emerge from this long-running soap opera with a reasonable quality of life. Although the bar defining “reasonable” has certainly been lowered. In one of the early posts of this “how to have cancer” diary I was fairly certain that if my voice was destroyed I would halt the treatment and let myself pass more-or-less peacefully (depending primarily on how willing the docs are to issue pain killers, tranquilizers, anti-depressants, and mood enhancers) onto the ferry across the dark river to oblivion. Now I find it’s more of an inconvenience than a life or death threshold. 

So if the December PET/CT scan is negative for lung and throat cancer, I’ll be back in business. I’ve already turned my attention back to cranking hard on the urban ecology book. Learned to write and play (primitive, but listenable) instrumentals on the guitar. Improved my photography skills. And upgraded my cut paper artworks. It’s autumn. My favorite time of year. The time of year when I am at my intellectual and artistic best. I didn’t think I’d be here to revel in this autumn. Turns out I’m not only having a great autumn this year, I might (pending that PET scan) have many more autumns to enjoy. 

Hell frickin’ yeah! As always, I thank you all for being here. My strength through this odd and long-running challenge derives in large measure from your support. You have my love and gratitude. Hang in there, everybody. Talk to you next week!

[1] Tumors in the Invertebrates: A Review Berta Scharrer and Margaret Szabó Lochhead
Cancer Res 1950;10:403-419.

[2] Robert, J. 2010. Comparative study of tumorigenesis and tumor immunity in invertebrates and nonmammalian vertebrates. Developmental and Comparative Immunology 34:915-925.