On the Side of Chemo

01 July 2020

People who feel poorly in the prime of a pandemic will develop three classes of side effects. There are the ones we are warned against in the chemo manuals. These could be fatigue, or constipation, or diarrhea, loss of hair, or any of a host of other things. None of them are a matter of choice and there’s nothing anyone can do to avoid them.

The best we can do is take another drug to relieve the effects of the one we just took. If a dose of carboplatin gives you the runs, a doctor might tell you to take 2mg of Loperamide every couple of hours until your pipes dry out. If it doesn’t do that, it might bung you up and send you out shopping for Metamucil. What one medication gives, another one takes away.

Don’t lose sleep over them. What will be, will be. You’ll either get one or you won’t. A second set of side effects can’t be treated with pharmaceuticals. Or at least not the type I’m inclined toward. This is the rapid onset of acute hypochondria.

As I’ve mentioned before, I have a net inside me. A net, as I’ve also mentioned, is a neuroendocrine tumour. Mine is on my pancreas. In all my 73 years, or the first seventy-two and a half of them, I never gave a second thought to my pancreas. Not even a first one. If you had asked me where it is, I would have reacted like the average American when asked to locate China on a map. Put me in front of a mannequin and ask me to point to the pancreas, and I might point to the middle of the back. You know the spot that’s always just out of reach when it starts to itch.

About four months ago I learned that a pancreas is somewhere in the waste disposal system, tucked away among the drainage pipes. Knowing this was enough to convince me the tumour was growing. And not just that. It was also moving and being as malignant as a born-again Christian who refuses to wear a covid mask.

I developed a sharp pain in my abdomen. It was most pronounced when I pushed in on the left edge. It was obvious, to me at least, that the net was closing in. The more I Googled abdominal pain, the clearer it became. Until I was saved by a movement stronger than any I joined in the 1970s. I made the major medical discovery that a spoonful of Metamucil makes the tumour go down.

Chemo also has a way of dehydrating you. The chemo manual suggests drinking as much as eight glasses of clear fluid per day. Fruit juices, not craft ales or single malts. As I was falling asleep one night, my brain told me I should take another glass of water because my mouth felt like it was full of sand. A small blister was developing on my lower lip. My mind told me it was too late. Water wasn’t going to help. I’d missed the boat.

The net had spread to my mouth and would soon metastasize onto my upper lip and tongue. I fell asleep in mid-thought. When I woke up, I was still alive, so I rubbed in some Burt’s Bees lip balm. By afternoon, the blister was on the way out. You can take it from me: Burt’s Bees is a sure cure for lip cancer.

The third set of side effects is more pleasant and rewarding. When a pandemic and a net come together to double down on your health, you suddenly have more time on your side. You can read more. When you do, you often find things you weren’t looking for.

Last week, while leafing through The Emperor of All Maladies, I looked at the origins of chemotherapy. Two of the scientists at the centre of this development were Charlotte Auerbach and Gertrude Elion. They have fascinating backstories that would make great movies all by themselves.

Auerbach was born into a family of scientists in Germany. When she studied for her PhD, she had a research advisor who joined the Nazis. He told her to focus her work on his social interests rather than her scientific goals. She said no, dropped him and went back to work as a high school science teacher. Soon after that, Hitler decreed that only pure Aryans could be schoolteachers and she lost that job. She moved to Edinburgh, completed her PhD and worked on groundbreaking research on gene mutation. Her work made the connection between mustard gas and cancer cells. She was also active in the Campaign for Nuclear Disarmament, the anti-apartheid movement, and other good causes.

In 1988, Elion became the fifth woman to ever receive the Nobel prize in medicine and one of the very few to win it without having a PhD on her resume. During the 1930s, she overcame several institutional obstacles to women in science, most intended to keep them out of university. She went on to help develop AZT as a treatment for AIDS, and other drugs to treat leukemia, hepatitis, malaria and many other diseases. Outside the laboratory, her interests were photography, travel, and opera.

  • Thanks to David Josephy, recently retired professor of Molecular and Cellular Biology, for pointing me in the direction of these incredibly talented scientists.
  • The book The Emperor of All Maladies is a good read, but fairly long. It clocks in at about 575 pages. Documentary film maker Ken Burns produced a six-hour version for PBS. It is available for free streaming on Kanopy. Check your local library to see if it has a subscription. Guelph does.
  • I find that if we learn as much as we can about a disease, we still won’t be able to control it on our own. We will be able to control the fear it induces. Join me in this search for understanding and share what you learn in the comments section.
  • Happy Canada Day. The celebration will be a lot different this year with social distancing and virtual events. It is further complicated by a more vigorous re-examination of our history – what we remember and how we remember it. Don’t set the analysis aside until the week before next July. Get it done now.

4 Comments

  1. Really good one… once you ring that bell I expect you will at the very least consider taking your tumour humour on the road… perhaps at least one performance at that comedy spot on Cork Street.

  2. “ malignant as a born-again Christian who refuses to wear a covid mask.”
    Ha! Great line. Made me snicker over my morning coffee.

    “We will be able to control the fear it induces”

    Music to my ears….logic and knowledge is always my go-to blanket, wrapping me in my most beloved; answers.
    Stay upright and fighting guy. With words, with actions, with feelings.
    I’m cheering you on!

  3. A hungry mind and a great sense of humour — the two best antidotes to cancer that you can have and you have an abundance of both. I’m with Ed. This stuff is worthy of your own traveling comedy show — The Pancreas Monologues.

  4. Alan you started my morning off on the right foot. I am blessed that I do not have NET but I do admit that hypochondria runs in my family and I have a good dose of it my self .When you were relating the episodes of the abdominal pain and the lip blister , I was laughing so hard that tears were rolling down my face. Ed is right ,you really have a “calling” to continue in comedy.I always look forward to hearing from you and can’t wait to cheer with you when you ring that bell.
    Carolyn

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