How do cancer cells do their thing? Why are they so dangerous? Why can there be cancer in essentially each organ of our bodies? What makes them break the rules of cell existence? I have no answers to any of those questions, and as far as I can tell, the scientists don't know a whole lot more than I do about the origins of cancer. But, since I was diagnosed with gallbladder cancer, I have been trying to acquire a real layperson's understanding of the disease. I just read an article that helped me (although, goodness knows, I didn't understand all of it). Mostly, I really, really learned a lot from a small side box to the article entitled "Hallmarks of Cancer."
The article is in the March, 2007 edition of Scientific American, and it's entitled "Mapping the Cancer Genome," about efforts to begin mapping the genes involved with cancer as a way of learning more about the disease in general, and hopefully, ways to treat it. The project is called the Cancer Genome Atlas Project, and the plan is for it to follow the pattern established by the Human Genome Project, which completed mapping of the human genes about three years ago.
But the sidebar talks about the SIX rules of cell existence that are broken by cancer cells! How do they get away with it? Why don't our natural defenses step in after step 1, or 4, or 6 is broken? In the article itself, the author comments that "Some mutations may disable genes that normally protect against abnormal cell behavior, whereas others increase the activity of disruptive genes. Most cells must acquire at least several of these alterations before they become transformed into cancer cells - a process that can take years." (p. 52)
The sidebar begins by commenting the six abnormal capabilities listed below together give tumors their lethal power to overrun their native tissue and spread through the body.
Here are the Six Cell Rules Broken by Cancer:
1. "Self-sufficiency in growth signaling. Cancer cells amplify external growth cues or generate their own."
2. "Insensitivity to antigrowth signals. Cancer cells become deaf to quiescence cues from surrounding tissue." (I'm a little fuzzy about this one, but I think it means that cells signal each other that it's time to grow or time to stop growing, but cancer cells don't listen to the "stop growing" message.
3. "Evasion of Cell Suicide. Mechanisms that should trigger or carry out a self-destruct program in damaged cells are disabled or overriden." (This is the apoptosis I've been writing about for months.)
4. "Limitless replicative potential. Cancer cells evade intrinsic limits on the number of times a normal cell can divide."
5. "Sustained blood vessel growth. Tumors emit signals promoting the development of new blood vessels to deliver oxygen and nutrients." (This is why one of the most promising new anticancer drugs, Avastin, is in trials for most/many cancers. It was included in the clinical trial originally proposed to me last summer, and I may still add it to the regimen.)
6. "Invasiveness and motility. Cancer cells defy multiple signals and forces that hold a cell in place and prevent it from traveling to - and thriving in - other tissues." (This is the metastasis that is so dangerous to those of us with cancer, where the cells wander about the body until they find a spot to settle, divide, and grow, and become a danger to this new organ.)
Anyone reading this with more knowledge of biochemistry and these statements, please feel free to chime in!
So, today is Day 10 of this cycle, and I felt really, really tired and sleepy earlier in the day, but have felt better as the day went on. I told folks at church I felt "floppy." Now I'm not peppy, but better. I was nauseous a lot yesterday, and had better appetite today. Now I'm on the downward slope of this cycle, and hoping that each day is better than the one before. Twelve days until we leave for St. John! Yeah for sunshine and swimming!
Showing posts with label change. Show all posts
Showing posts with label change. Show all posts
Sunday, February 25, 2007
Monday, February 12, 2007
Stamina-less!
This is just a quick check-in to say that those four groups of papers to return to my students are finally graded! I'm so relieved that I can return them tomorrow, as my students need the feedback.
One thing I had to figure out about grading is that my energy is all turned around over the course of the day. I've always been a night person, with lots of energy in the evening - my favorite time of day to grade papers! Since I started chemo, my energy is best in the morning, and slowly seeps away as the day progresses. By evening, I'm wiped, and only good for dinner -maybe - and an hour of TV before falling into bed. The stamina I have relied on so much all my life has just left me.
I talked with Tia tonight. She started chemo last week; Oxaliplatin and Gemzar, one drug the same as mine, one different. We compared symptoms and stories. We are both relieved to be doing really well, all things considered.
Tomorrow is my big teaching day, and Wednesday I get to see my doctors in the midst of a forecast northeaster snowstorm. We'll see if this one is more than a dusting, and how the roads are. I trust we'll make it there and back safely, and so will Alice and Lexie, going to Boston for Lexie's chemo.
Life without stamina. One foot in front of the other, and does bed ever feel good at the end of the day!
One thing I had to figure out about grading is that my energy is all turned around over the course of the day. I've always been a night person, with lots of energy in the evening - my favorite time of day to grade papers! Since I started chemo, my energy is best in the morning, and slowly seeps away as the day progresses. By evening, I'm wiped, and only good for dinner -maybe - and an hour of TV before falling into bed. The stamina I have relied on so much all my life has just left me.
I talked with Tia tonight. She started chemo last week; Oxaliplatin and Gemzar, one drug the same as mine, one different. We compared symptoms and stories. We are both relieved to be doing really well, all things considered.
Tomorrow is my big teaching day, and Wednesday I get to see my doctors in the midst of a forecast northeaster snowstorm. We'll see if this one is more than a dusting, and how the roads are. I trust we'll make it there and back safely, and so will Alice and Lexie, going to Boston for Lexie's chemo.
Life without stamina. One foot in front of the other, and does bed ever feel good at the end of the day!
Friday, January 05, 2007
Gratitude and Impatience
Since gratitude and patience are thought to be two virtues/positive attributes, it may seem strange to have gratitude and impatience together in a post title. Still, in this continuation of "what's changed in the last 7 months," these are two qualities I have cultivated in these months. I can't say that these additional thoughts came to me while washing dishes, but here they are.
Impatience first. While patience is the recognized virtue, impatience in the face of injustice or wrongdoing is a also an important virtue. Since my diagnosis, I just don't feel all that patient with nonsense, with cruelty, wrongheaded thinking, people treating each other badly.
So, this is where I get political. A year ago, I would have held my tongue in a "public" forum unless asked to speak, but now I don't have time or patience to suffer injustice. Tuesday, the Massachusetts legislature, sitting in Constitutional Convention, voted to put marriage equality on the ballot in 2008. I wept when I read of their actions, because Patty and I have been "married in Massachusetts" since June, 2004. I am deeply angered that anyone would want to take away from us (or would have denied it in the first place) the right to legal recognition of our relationship, and the benefits that society and the government have chosen to bestow on those in a legally recognized relationship. Their action doesn't finally put this proposed constitutional amendment on the ballot, as it must be passed by another session of the legislature. So, in the last day, I have contemplated personally visiting each of the 62 legislators who voted to move this proposed constitutional amendment on, and ask them to vote differently next time. And, if you aren't already familiar with this issue, and think that people should always have a right to vote on proposed constitutional amendments, ask yourself whether or not you think constitutional amendments should be used to take away the rights of any minority group. In addition, there's a reason why the legislature votes first. I'm going to ask those representatives to represent me and my family in their vote. I'm not naive, and I do realize that this is a hotly contested issue across the country, but right now, I want to say that this affects me, my life, my spouse, my children, and it hurts us.
As you can see, I feel impatient. I don't have 20-30 years, it seems, for society to get this right...
A postscript to this is that I am still working on my patience as a parent. That's a tough attribute to develop and maintain in parenting, I think.
Gratitude is a quality I've worked to develop all of my life. I try to remember to thank and appreciate those who have reached out to me, who have gifted me in some way. And, I keep working to do a still-better job of expressing my gratitude, to people in my life, and to God. I have felt immense gratitude for the gift of life in these past 7 months. I am grateful to God for my existence, and grateful to my parents for the gift of life made manifest. And I am grateful to all those souls I have met during my life, my fellow journeyers and teachers
I remember that when Patty and I first got together, 16 1/2 years ago, we developed a habit of sitting in silent grace before sharing a meal. After weeks of doing this, I realized that I felt immense gratitude for my job, my work, my profession. This may seem like an "of course" sort of moment, but I hadn't realized the depth of my gratitude until then. I certainly hadn't found the words to give thanks for a job I love.
As I was working on this post, I found an email from my friend Sandy, who shared this thought from her November calendar: Gratitude. More aware of what you have than what you don't. Recognizing the treasure in the simple - a child's hug, fertile soil, a golden sunset. Relishing in the comfort of the common - a warm bed, a hot meal, a clean shirt - Max Lucado
Those concrete, body comfort moments are an important piece of feeling gratitude, I think. Max Lucado has it right; the warm, familiar bed, comforting surroundings, loving presence, creature comforts attended to. More aware of what you have than what you don't. That's where I aim to be.
Impatience first. While patience is the recognized virtue, impatience in the face of injustice or wrongdoing is a also an important virtue. Since my diagnosis, I just don't feel all that patient with nonsense, with cruelty, wrongheaded thinking, people treating each other badly.
So, this is where I get political. A year ago, I would have held my tongue in a "public" forum unless asked to speak, but now I don't have time or patience to suffer injustice. Tuesday, the Massachusetts legislature, sitting in Constitutional Convention, voted to put marriage equality on the ballot in 2008. I wept when I read of their actions, because Patty and I have been "married in Massachusetts" since June, 2004. I am deeply angered that anyone would want to take away from us (or would have denied it in the first place) the right to legal recognition of our relationship, and the benefits that society and the government have chosen to bestow on those in a legally recognized relationship. Their action doesn't finally put this proposed constitutional amendment on the ballot, as it must be passed by another session of the legislature. So, in the last day, I have contemplated personally visiting each of the 62 legislators who voted to move this proposed constitutional amendment on, and ask them to vote differently next time. And, if you aren't already familiar with this issue, and think that people should always have a right to vote on proposed constitutional amendments, ask yourself whether or not you think constitutional amendments should be used to take away the rights of any minority group. In addition, there's a reason why the legislature votes first. I'm going to ask those representatives to represent me and my family in their vote. I'm not naive, and I do realize that this is a hotly contested issue across the country, but right now, I want to say that this affects me, my life, my spouse, my children, and it hurts us.
As you can see, I feel impatient. I don't have 20-30 years, it seems, for society to get this right...
A postscript to this is that I am still working on my patience as a parent. That's a tough attribute to develop and maintain in parenting, I think.
Gratitude is a quality I've worked to develop all of my life. I try to remember to thank and appreciate those who have reached out to me, who have gifted me in some way. And, I keep working to do a still-better job of expressing my gratitude, to people in my life, and to God. I have felt immense gratitude for the gift of life in these past 7 months. I am grateful to God for my existence, and grateful to my parents for the gift of life made manifest. And I am grateful to all those souls I have met during my life, my fellow journeyers and teachers
I remember that when Patty and I first got together, 16 1/2 years ago, we developed a habit of sitting in silent grace before sharing a meal. After weeks of doing this, I realized that I felt immense gratitude for my job, my work, my profession. This may seem like an "of course" sort of moment, but I hadn't realized the depth of my gratitude until then. I certainly hadn't found the words to give thanks for a job I love.
As I was working on this post, I found an email from my friend Sandy, who shared this thought from her November calendar: Gratitude. More aware of what you have than what you don't. Recognizing the treasure in the simple - a child's hug, fertile soil, a golden sunset. Relishing in the comfort of the common - a warm bed, a hot meal, a clean shirt - Max Lucado
Those concrete, body comfort moments are an important piece of feeling gratitude, I think. Max Lucado has it right; the warm, familiar bed, comforting surroundings, loving presence, creature comforts attended to. More aware of what you have than what you don't. That's where I aim to be.
Tuesday, January 02, 2007
What's changed in me in the last 7 Months?
Mulling over the arrival of a new year on the calendar, and that I'm still alive as 2007 has begun, I've been mentally listing some of the things that have changed in the 7 months, 9 days and some hours since my diagnosis of gallbladder cancer. Working on writing this post, I also remembered that I called this blog "Life Changing Cancer" for a reason. Even in August, I didn't feel that I was the same person I had been. So how have I changed?
In no particular order . . .
1. I think we have too much stuff, too many material possessions. I think I do, my kids do, my family does, Americans do, and I wonder what we are thinking. And I continue to struggle with where to put everything. For whatever reason, I didn't particularly think this before my diagnosis.
2. In keeping with #1, I find it easier to let go of things. I've been a collector all my life, saving all my favorite books, stones and seashells, and the elements of my varied craft projects, thinking I'd get back to them when I retired. I have carried my quilting fabric, books and patterns for years, through many moves, thinking I'd make quilts again. And I have quilted occasionally since I first learned how in the 70s, but I've never quilted like I did then. Last August, Patty, my friend Bev and I went through my finished quilt tops, and Bev took one home to have it finished. (I had made her a quilt in the 1970s, but it burned in a house fire a number of years ago.) In the fall, my younger sister, Carla, and I went through my containers of fabric, and cut pieces for quilts, and she took home a big box of fabric and pieces to work with. (Thinking about this, I realize I didn't really have to wait for a cancer diagnosis to move on some of these things!)
3. As you can see from #2, I no longer expect to be alive and doing projects in 30 years. I might be alive, but I no longer have that expectation, and it makes it easier to let go of things, and to make other choices. And if I am alive, maybe I'll be choosing some new craft projects!
4. I've done my best to identify the stressors in my life, and to reduce them whenever possible. I resigned from some of my work responsibilities in the summer, and I think more carefully before saying "yes" when asked to take on something new. As a result, I find it easier to say "no" when that's the right thing to do. I'm meditating regularly, and working consciously on stress relief.
5. I've been working on strengthening my spiritual self these past months. I felt connnected with my spirituality when this happened, but the diagnosis broke open something in me, something that wants more, wants to be more, and certainly wants my life to mean more.
6. I have a new empathy for people with chronic, life-threatening or terminal illness. I have been healthy all of my life, had my first surgery (and it was elective) at 52, and my first broken bone at 58. It's not that I blamed people with physical problems, it's that I just didn't understand their journey in some deep way because that had not been my life's path. Now, my new experience with the medical profession, and my readings of the stories of so many people's journey with cancer, have shifted my lack of understanding, my lack of empathy, for those, like me, in this situation.
7. I'm less likely to postpone joy. Last summer when our family traveled to the southwest for a long-planned "trip of a lifetime" to many national parks, Patty and I began to say "If not now, when?" We were more extravagant on that trip than we'd ever been (and we were still saying at campgrounds), and we didn't spend our life savings, but we have different priorities. When we talked about vacationing in the Caribbean in March 2007, we said "Let's go!" (and we're still staying at a campground). We will go back to St. John in the U.S. Virgin Islands in March, all of us, and if it's my last trip there, I will have gone to a place full of memories, and our family can make new memories. The last time there, Lucy was almost 5, and did some snorkeling while holding onto Patty, but now both kids can swim, and we suspect they will love snorkeling!
8. I frequently feel mortal. We all are, of course, but I didn't particularly feel mortal before this diagnosis. Some days I feel more mortal than others, but it's definitely a place I visit frequently.
Somehow, I think my list of changes was longer while I was washing dishes this afternoon, but this is what comes to me now. It's not an exhaustive list, but it's an honest one for the moment.
In no particular order . . .
1. I think we have too much stuff, too many material possessions. I think I do, my kids do, my family does, Americans do, and I wonder what we are thinking. And I continue to struggle with where to put everything. For whatever reason, I didn't particularly think this before my diagnosis.
2. In keeping with #1, I find it easier to let go of things. I've been a collector all my life, saving all my favorite books, stones and seashells, and the elements of my varied craft projects, thinking I'd get back to them when I retired. I have carried my quilting fabric, books and patterns for years, through many moves, thinking I'd make quilts again. And I have quilted occasionally since I first learned how in the 70s, but I've never quilted like I did then. Last August, Patty, my friend Bev and I went through my finished quilt tops, and Bev took one home to have it finished. (I had made her a quilt in the 1970s, but it burned in a house fire a number of years ago.) In the fall, my younger sister, Carla, and I went through my containers of fabric, and cut pieces for quilts, and she took home a big box of fabric and pieces to work with. (Thinking about this, I realize I didn't really have to wait for a cancer diagnosis to move on some of these things!)
3. As you can see from #2, I no longer expect to be alive and doing projects in 30 years. I might be alive, but I no longer have that expectation, and it makes it easier to let go of things, and to make other choices. And if I am alive, maybe I'll be choosing some new craft projects!
4. I've done my best to identify the stressors in my life, and to reduce them whenever possible. I resigned from some of my work responsibilities in the summer, and I think more carefully before saying "yes" when asked to take on something new. As a result, I find it easier to say "no" when that's the right thing to do. I'm meditating regularly, and working consciously on stress relief.
5. I've been working on strengthening my spiritual self these past months. I felt connnected with my spirituality when this happened, but the diagnosis broke open something in me, something that wants more, wants to be more, and certainly wants my life to mean more.
6. I have a new empathy for people with chronic, life-threatening or terminal illness. I have been healthy all of my life, had my first surgery (and it was elective) at 52, and my first broken bone at 58. It's not that I blamed people with physical problems, it's that I just didn't understand their journey in some deep way because that had not been my life's path. Now, my new experience with the medical profession, and my readings of the stories of so many people's journey with cancer, have shifted my lack of understanding, my lack of empathy, for those, like me, in this situation.
7. I'm less likely to postpone joy. Last summer when our family traveled to the southwest for a long-planned "trip of a lifetime" to many national parks, Patty and I began to say "If not now, when?" We were more extravagant on that trip than we'd ever been (and we were still saying at campgrounds), and we didn't spend our life savings, but we have different priorities. When we talked about vacationing in the Caribbean in March 2007, we said "Let's go!" (and we're still staying at a campground). We will go back to St. John in the U.S. Virgin Islands in March, all of us, and if it's my last trip there, I will have gone to a place full of memories, and our family can make new memories. The last time there, Lucy was almost 5, and did some snorkeling while holding onto Patty, but now both kids can swim, and we suspect they will love snorkeling!
8. I frequently feel mortal. We all are, of course, but I didn't particularly feel mortal before this diagnosis. Some days I feel more mortal than others, but it's definitely a place I visit frequently.
Somehow, I think my list of changes was longer while I was washing dishes this afternoon, but this is what comes to me now. It's not an exhaustive list, but it's an honest one for the moment.
Friday, September 08, 2006
Bittersweet
Last month, I was sitting on a Cape Cod beach with my family and friends when my friend Maria asked me if it was hard, being there, having fun in the moment, but knowing about my diagnosis and the future. I thought about the question for a moment, teared up, and responded that it was bittersweet. My life is filled with bittersweet moments these days.
This past week I attended convocation, where the University formally welcomes new freshmen to campus and to their role in the University community. "Welcome to the Class of 2010," the University president said. And I thought, as I never had before, "Will I be here in 2010 to see these incoming students graduate?" Added to that thought was an even more personal question about 2010: Would I be here to see my daughter enter high school? Would I be here in 2014 when she would graduate from high school? Painful, bittersweet thoughts.
Yesterday I stood before a new class of students, discussing the course, welcoming them to a new field of study, and suddenly it hit me. The wall of sadness that came to me was powerful, and I had to shift from it in order to stay present to the class. The last time I stood before a class, I didn't know that cancer was growing inside me. I envisioned myself teaching well into the next decade of my life, my 60s, and teaching into the next decade of this century. Perhaps I will indeed defy the odds and medical predictions and be here then, but I no longer assume that will be the case. And, the sweetness of all of this is that I am teaching, I am standing before new groups of students, sharing what I know, supporting them in their learning, and in being active participants in the changes, academic and personal, that ideally are part of their college years.
As I have pondered these thoughts and feelings, I have noted that the sweetness is in the present moment, and the bitterness is in looking toward the future and noting its uncertainty. And, the truth is that while we humans like to look to the future and make plans, and anticipate with delight good things we want to have come our way, the future is not within our control. So, once again I return to now, to the present, to the moments over which I have some control, over how I feel, and how I greet each moment.
This past week I attended convocation, where the University formally welcomes new freshmen to campus and to their role in the University community. "Welcome to the Class of 2010," the University president said. And I thought, as I never had before, "Will I be here in 2010 to see these incoming students graduate?" Added to that thought was an even more personal question about 2010: Would I be here to see my daughter enter high school? Would I be here in 2014 when she would graduate from high school? Painful, bittersweet thoughts.
Yesterday I stood before a new class of students, discussing the course, welcoming them to a new field of study, and suddenly it hit me. The wall of sadness that came to me was powerful, and I had to shift from it in order to stay present to the class. The last time I stood before a class, I didn't know that cancer was growing inside me. I envisioned myself teaching well into the next decade of my life, my 60s, and teaching into the next decade of this century. Perhaps I will indeed defy the odds and medical predictions and be here then, but I no longer assume that will be the case. And, the sweetness of all of this is that I am teaching, I am standing before new groups of students, sharing what I know, supporting them in their learning, and in being active participants in the changes, academic and personal, that ideally are part of their college years.
As I have pondered these thoughts and feelings, I have noted that the sweetness is in the present moment, and the bitterness is in looking toward the future and noting its uncertainty. And, the truth is that while we humans like to look to the future and make plans, and anticipate with delight good things we want to have come our way, the future is not within our control. So, once again I return to now, to the present, to the moments over which I have some control, over how I feel, and how I greet each moment.
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