It Might Get Messy

The thing about cancer…well, one of the many things about cancer…is that it is not an attack on your physiology by outside forces. With few and rare exceptions, cancers are YOU, and the medical battles amount to a civil war with your own cellular and organismal functions. 

This is problematic physically and psychologically. The physical problem, of course, is that cancer-fighting therapies have to be effective against your own body and your own bodily functions. You’re not defending against outside interloping microbes, you are battling a runaway version of YOU. 

This is an intricate technical challenge, demanding recognition and destruction of “bad you” in a body that is otherwise “good you”. And that bad you doesn’t differ greatly from the good you. The delta between bad and good, in this case, is too small to provide an easy way out. In many cancers, the disease manifests via alterations of very few genes, or the biochemical consequences of very few altered molecular pathways. Basically, to stop cancer, you have to stop appropriate parts of YOU. The most brutal analogy is probably limb amputation as a life-saving medical response during the civil war. Experience quickly demonstrated that a minie ball or even a spherical musket projectile penetrating a thigh and dragging filthy clothing fibers and matted gunk from the skin surface deep into the muscles yielded inevitable, fatal gangrene. So surgeons routinely treated such wounds by amputation. On the assumption that the victim would rather be alive and missing a leg than spending several weeks of increasingly painful bodily wreckage leading directly, if too slowly, to the grave. 

We really haven’t progressed very far from mid 1800s therapy here in the 2000 and teens. Thus first we destroyed part of my tongue and my entire right parotid gland. Then we hacked out the rest of my tongue and butchered my palate. Then we flayed my torso and dissected out my entire lymphatic system north of my tummy. 

And all that surgery? Still not enough. Now we are working on destroying the squamous cells lining my lungs, hoping to slow my forced march to death.

Sigh. It’s a rough road to ride. And yet. The drastic chemotherapy is actually working. I can take full, clear breaths, deep into my lungs, where a few months ago I cold only wheeze in and out a small portion of my lung capacity. I’m building enough energy to walk…well, shuffle…a few hundred meters every day. Which I have to do, because otherwise the string of 24 hour days not leaving the hospital-style bed in front of the TV is making my leg muscles so weak they cramp on the way to the toilet. 

This week just passed continues the holding pattern my treatment has been in for a while. First, we met with oncologist Dr. T’s assistant Doc, who helped re-sort my pharmaceuticals and pass on the thought that if the chemotherapy really is working palpably (appropriate usage?), we might consider continuing beyond the originally prescribed 5 infusions. Then, of course, yesterday (Friday) was chemo day. But the preparatory blood screens showed that both my platelets and red blood cells (RBCs) both remain impaired by the last round of chemo. So on Monday I go in to the infusion center for 6 hours of whole blood transfusion. And schedule the round of chemo for next Friday, assuming the platelets will come around on their own. Now we also have high-powered meds in the refrigerator intended to prevent my white blood cell count from crashing and burning, impairing my immune system and leading to the nasty infection that the docs think was the issue driving my last trip to the emergency room after the prior round of chemotherapy.

But you know, at least for the moment, the ridiculous (not to say savage) ongoing treatment is more than worth the tradeoffs. I’m feeling good. I’ve gotten some of my guitar chops back, and can play all of the instrumentals I’ve managed to write since my voice went into the bio waste buckets with my tongue a couple years ago. I can read, and write, and watch movies. If I move sufficiently slowly, I can cook (wait until you taste my cinnamon scone roses. They are awesome!). And, having practiced last weekend with other members of the household, I can direct the kitchen staff from my perch on the bed in the corner of the room. So I’m expecting Thanksgiving to be spectacularly delicious this year. Given that it is, unfortunately but inevitably, the Last Thanksgiving for me (make a good novel title, now that I think about it), I intend to have a walloping good time. 

So I hope everybody had a fun Halloween. I leave you with a few photos, I know some of you have seen these, but I like ‘em, so I’m repeating them here. Thanks, everybody. You make this war worth fighting. And remember to use ‘em while you got ‘em, ‘cause they are NOT forever!