We’ve talked some here at the End of the World weblog about tumor nutrition. Our interest has been largely diagnostic: because malignant cells have screaming rates of metabolism, they reveal themselves in their desperate thirst for radioactively tagged sugar. But there is a mechanistic aspect to this. Clumps of malignant tissue (that is, tumors) are not engineered like clumps of normal tissue (approximately, organs). Among the many groceries in the shopping cart of evolution is the three-dimensional functionality of vertebrate bodies. Every one of the billions of cells (if you google “number of cells in human body” you get a hilarious grab bag of hits, about a third of which point out that the number of microbes in the normally-functioning human gut outnumbers the number…uhh, outnumbers the number…yeah, that works…outnumbers the number of human cells in the whole body by orders-of-magnitude) in the body gets regular deliveries of the long list of stuff needed to function. And also has its waste products carted off to the wastewater treatment facilities and the landfill. But a tumor is a runaway, improvised, rapid-fire mock-up of real tissue. Ravenously dysfunctional cells glued together in a structurally impaired cartoon of a happily operating organ? How does everybody get fed? Where does the sewage go?
Normal (that is, noncancerous) cells can signal blood vessels to grow on an as-needed basis (for example, after an injury). When a clump of cancer cells reaches a certain size, the baby tumor hijacks cellular signals and gets blood vessels to proliferate in and around the tumor [3]. Now, the mutations that release cancer cells from normal constraints on cell growth have only open highway ahead. The tumor gets all the care and feeding and waste removal it needs from the circulatory system it has carjacked. Indeed, the tumor-induced blood vessels themselves contribute to the runaway nature of the enterprise [2]. At this point, the mutant DNA is riding shotgun, with a weapon pointed at the driver, a full tank of gas, and a lap full of truck stop burgers and fries.
The frantic, mutated metabolism of the tumor cells sometimes provides therapeutic leverage [1]. More frequently, it just sucks up increasing shares of the body’s nutrition, expanding its influence at the expense of the normally functioning tissues.
Nutrition continues to be my basic problem here in Cancer Land (copyright, trademark). We continued to work with the nutritionist, attempting to find ways to get sufficient calories into my system so I can function. Actually, her advice began to wander down unproductive pathways. Eventually she recommended a product called “Ensure Clear” which has zero fat, zero fiber, and 60 calories per 100 milliliters. Given that my primary problem has been inability to maintain weight, and knowing that I need somewhere approaching 3000 calories a day to do so, this didn’t seem like a productive way forward. I gave up on the consultations, and reverted to my standard U.N. emergency rations, which at least provide well north of 100 calories per 100 mls. So I’ve upped my intake of liquids and antinausea drugs and started forcing in five or six 250 ml containers per day. I may feel stuffed and have to struggle to keep everything down. But at least my weight is going back up and my energy level maintains.
Sigh. It’s not easy. But it sure as hell beats the alternative! My love and thanks to all of you. As a reward for your patience, I append below a musical coda to this week’s column. With summer coming on, it is becoming appropriate to open the doors and windows and crank up the stereo to broaden the musical horizons of the neighbors. I’ll try to include at least a brief selection of musical recommendations on a weekly basis going forward. If spring is here, the beach can’t be far behind!
Music Update
In the four years or so I’ve been struggling with cancer, a number of remarkable circles in my life have closed. People who were important to me, and lost for decades (in some cases, almost all the decades) have come back around, and we are part of each other’s lives again. So it has been for books, poetry, and art, even some of my own work.
Anyway. For more than 30 years, I’ve been waiting for Athens Georgia jangle rock band Swimming Pool Q’s phenomenal album Blue Tomorrow to make it to CD. Well, a couple of weeks ago, it did. This album has been on my “10 Best Albums of All Time Bar None” list since the first time I played my vinyl copy in the early 80s. It was the Q’s third album, and their best. Also something of a swan song, although they soldiered on through various lineups, and reunited after Anne Richmond Boston got her kids raised. But Blue Tomorrow is absolutely incredible. I commend it to you, particularly in the “expanded” edition available from Amazon as “The A&M Years” (http://www.amazon.com/1984-1986-Years-3xCD-DVD/dp/B00CMYRS9I/ref=sr_1_1?s=music&ie=UTF8&qid=1397945078&sr=1-1 ). The Amazon set contains the Q’s second album (self titled), plus Blue Tomorrow, a disk of rarities and alternate versions, and a DVD of the band. To me, it is remarkable that anybody retained and curated all this material all these years. But, as I’ve discovered through my health travails, there is much that is remarkable in the world. Like Blue Tomorrow. Do yourself—and the world—a favor. Go to Amazon and purchase this. It is more than worth the $33 for the 3 CD, 1 DVD set. It is absolutely awesome. And, unless you’ve been subjected to my compilation sets over the decades, it is fresh and surprising music that you’ve never heard before. Absolutely recommended—No Household Should Be Without.
Notes
[1] Vander Heiden, M.G. 2013. http://www.jci.org/articles/view/72391
[2] http://weill.cornell.edu/news/news/2014/03/tumor-blood-vessel-signals-turn-cancer-into-a-lethal-disease-resistant-to-chemotherapy-shahin-rafii-bi-sen-ding.html
[3] http://www.cancerresearchuk.org/cancer-help/about-cancer/what-is-cancer/grow/how-a-cancer-gets-its-blood-supply
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