Tag Archives: cancer recovery

Return to the Cancer Frog Blog

Dear Cancer Frog Blog Readers,
It has been two years since my last post. Why did I stop? There are a few reasons. One, I started to dread thinking about cancer all the time. I wanted to think about the rest of life. Instead I had drawn a really ugly scary cartoon about hope and death and thought “Who wants to look at that?”

Death Dreams

Two, I got lazy – I had framed all the cartoons and had a show of them at a local gallery. Many of my friends generously came to the opening and bought the framed pieces (which I was not expecting – I sort of forgot that the art was for sale and that the gallery wanted to make some money). After all this excitement and a return to work and recreating, I didn’t feel like staying up till 1 in the morning to work on the blog. I became a couch potato. The last reason is the most embarrassing to of all. I got scared. Here is why – this was written at the time it happened:
January 2011
I continue to write down the names of famous people who die of cancer, Jill Clayburgh, American actress, of Leukemia, Maurice Lucas, basketball star, of bladder cancer, Pete Postlethwaite, British actor, unnamed cancer. This gets tiresome, seems elitist, not to mention wearing. So many people are dying of cancer everyday.

Chronicle Books has a fundraiser for Habitat for Humanity. Make a donation and you can present your book idea to an appropriate editor. I print out some of the frog blog illustrations and three entries of text. It is a rainy day in San Francisco. I wear an ultramarine long raincoat whose fabric flows artistically. Chronicle’s small retail store serves as the waiting room and many eager writers mill around, reading titles, leafing through books. I imagine the Cancer Frog Blog imprinted and bound professionally between two hard covers with amphibian textured end pages. What an honor, what a coup, what a perfect ending to this ordeal! I look at my notes for my Pitch. I feel a hot flash coming on but don’t want to take off the attractive raincoat, as though the bright blue will help me get published.

Just before my turn to approach an editor in the Living and Style section, another candidate approaches me and we exchange book ideas.
“Oh, I had a friend who had cancer. She just died, four years after her diagnosis.”
“What kind of cancer did she have?”
“Same as you,” she says. My blood pounds in my temples and I am suddenly so hot, there is no question of leaving on the raincoat. I take it off, juggle it with my cheat sheets and blog excerpts. My name is called. I approach a small table and sit in front of a young woman with cropped dark hair, hip casual clothes. She is half my age. The raincoat slithers out of my grasp and puddles to the floor. My faces flushes. Instead of cool blue I present her with freaked out red.

Chronicle Books

I hand her the proposal with 3 pages of text and 15 printed illustrations from the blog. I stammer something about a memoir about cancer using a frog as the protagonist. She looks through the art. She does not read a single word. “I don’t see how people could relate to a frog,” she says, “and the quality of the art . . . Furthermore you have no platform.” Later a friend of mine who is a published author tells me that editors these days are all looking for an author’s “PLATFORM,” like a diving board from which the work can soar with a fancy sequence of commercial gymnastics. “Have you seen Marisa Marchetto’s book, Cancer Vixen?” My face flushes again. I hear: “You are a nobody. Your art sucks. Marisa is a famous New Yorker cartoonist. Her book is being made into a movie starring Cate Blanchette. Even Kermit wouldn’t want to star in a film about you.” To this young, ambitious and determined editor, I am just a statistic who will soon die of cancer.
“Who is reading your blog?” she asks.
“Friends, other people who come upon it or are referred to it. Everyone seems to like it.”
“Well just keep writing it for your friends. Thanks for coming by.”
I try to smile graciously but feel my eyes shrinking into dark little beads of humiliation. I grab my notebook and the raincoat, which keeps snaking off my arm. I am so hot I don’t try to wrestle it on as I hurry past the tidy shelves of smug published books into the drizzle. A car honks at me as I dodge blindly across the bustling San Francisco traffic.

End of the post. So the young editor’s opinion was enough to scare me into inactivity. Because of the disappearance of the blog, people have even wondered whether I have died. Well I have not – yet. And the Cancer Frog Blog is back!!!

Radioactive Birthday – Caution, “R”-Rated Post

Replete with maitaki mushrooms and blue-green algae, I go to the pre-radiation appointment at Kaiser’s Cancer Treatment center, a building separate from the main hospital. A nurse tells me how the treatments will proceed. “You will have three treatments, each a week apart, each lasting 10-15 minutes. You will be alone  in a specially insulated room during the radiation. The process you will have is called ‘Brachytherapy.’ Here is a pamphlet that describes it. Basically they insert a tube into your vagina and deliver the radiation though there. Do you have any questions?” I am too busy contemplating the bombardment of my vagina to speak. The doctor comes in to meet me and to explain things in more detail. “Brachytherapy will reduce the likelihood of the cancer coming back in your vagina from 15% to 1.5%. Brachytherapy is the application of radiation into the body through a device, which can be a wire or seeds, so that the radiation is proximal to the tumor. In your case a wire is fed through the tube we insert in your vagina and this carries the radioactive charge to your tissue. We also embed little stainless steel or gold seeds into the crown of your vagina to help us gauge how far in we insert the wire. Computer software controls how much radiation is emitted through the wire and how far it penetrates.” “What exactly will the radiation accomplish?” “It will prevent the exposed cells from replicating. If any of them are cancerous, theoretically, the cancer won’t spread. Irradiated cells will not divide – neither will any healthy cells that happen to be in the radiation’s path.” “And for all we know all the cells are healthy?” “Yes, that could be the case.”

Instead of imagining a mushroom cloud ballooning out of my vagina, I can now imagine this:

Brachytherapy

I look up Brachytherapy on line. “Brachys” means “short distance” in Greek. The advantage of it is that it exposes less healthy tissue to radiation than other available methods. In my case no one knows whether there is cancerous tissue in my vagina – the cancer was in the endometrial wall and this was removed surgically. So my choice is part guess work, part faith, part risk: Do I expose healthy tissue to radiation and possible cause cancer to prevent a possibly remaining cancer from metastizing?

The procedure does not sound at all fail-safe. By the time I write this entry – a year after my treatments, there have been at least two articles in the San Jose Mercury News about deadly radiation overdoses. The first in January of 2010 features Scott Jerome-Parks. He was being treated for tongue cancer at a New York hospital. A software error caused a linear accelerator to blast his brain stem and neck with errant beams of radiation. This happened on three consecutive days. Scott became deaf, blind, unable to swallow and lost his teeth. He developed ulcers in his mouth and was finally unable to breath. His dying wish was that these accidents be studied and eradicated. Soon after this incident a breast cancer patient also suffered overdoses of radiation that burned a hole in her chest and were ultimately fatal. In August of 2010 there was an article about CT scans exposing patients to overly high doses of radiation, causing them to lose their hair, and to face long-term risks of cancer and brain damage. I have already had CT scans of my brain and abdomen, leg and lung x-rays, countless routine mammograms and oral x-rays. Enough is enough. I ask if  I can have a second opinion. What is the point of irradiating healthy tissue? “Of course you can have a second opinion, “ says the doctor. “Let me see what I can do.” He steps out the door. Moments later he returns with an older man. “This is Dr. _. He is my mentor.” The more senior doctor has some sort of speech impediment. Slowly, with great deliberation, he recounts the studies and convinces me that statistics prove that the treatment is worth the risk. My father was a statistician. He had a small black book on the shelf with large gold letters: How to Lie with Statistics. The older doc’s opinion is simply an affirmation of the first doc’s. He seems kind, conscientious, honest. I need to make up my mind. I feel the right brain yielding to the weightiness of Western protocols – of making decisions based on documented empirical study. Intuition combined with panic and remnants of childhood fears of anything nuclear, rail against the rational. The left brain wins. My treatments are scheduled for July 7, 14, 21, 2009. My birthday is July 12. I promise myself a mint chocolate chip ice cream cone when it is all over.

At the first appointment, the nurse leads me back to the dressing rooms. “Choose any of the free lockers to put your clothes in,” she says. “Can I use the bathroom first?” My nerves have gotten the best of my bladder. “Yes it’s right through here.” She leads me through a waiting room filled with the cheerful clucking of other patients.
“Oh what is she here for?!”
“What kind of cancer do you have?”
“How many treatments are you having?”
“We’ve never seen you here before.”
“ A frog???”
“Don’t mind these girls,” says the nurse. “They’re regulars.

The Waiting Room

I emerge from the dressing room donned in the shear cotton hospital gown (Shouldn’t I be wearing a body suit of lead?) and the nurse leads me into the radiation room. It is filled with computers, x-ray and radiation machines, a variety of monitors, all connected by a tangle of wires. Each piece of equipment looks like another potential for error. The radiation machine is locked to a steel u-bolt in the floor by long cables. The table where I am told to lie down is fitted with stirrups and these have knee to ankle leg wraps that the nurse velcros closed around my calves. “Is this in case I try to escape?” “This is for women who have to stay here for multiple days, so they don’t fall out when they fall asleep.” Humbled, I remember my friend’s experience with cervical cancer. She was strapped into a contraption like this for three days to shrink her tumor. She is alive and well today. My ordeal will only be 11 minutes long.

The doctor decides to experiment with stainless steel seeds instead of the usual gold ones. Using a speculum, and some kind of long-barreled device, he shoots these into the crown of my vaginal cuff (this is what it is called now that there is no cervix, no pathway to a uterus). Bang bang bang! Ow! Ow! Ow! Then he inserts the tube that will hold the radioactive wire. The nurse secures this tube with a harness and straps that fit over my shoulders and shove the base of the tube against my pelvic floor. Everything hurts. The nurses and doctor chime in, “Just relax, just relax.” But my vaginal walls feel raw and inflamed, like they are being strafed with a cheese shredder every time something goes in or out. Once everything is in place, the nurse X-rays me to make sure the wire and seeds have the right relationship. She and the doctor mumble to each other. “I’m sorry Ms. Ogus,” says the doctor, “the stainless seeds are not showing up.” “Where could they go?” I ask. “Right through the vaginal cuff? Are they floating around somewhere in my abdominal cavity?” “No, no,” reassures the doctor, giving me no explanation. “We’ll try the gold seeds this time.” The team regroups, each performs his or her duty: off come the straps, out comes the tube, in goes the speculum again. Bang bang bang! “Ow Ow Ow!” again. Out comes the speculum, in goes the tube. The nurse shoves the tube, pulls the harness tight, re-X-rays. The vaginal cuff is crowned with shimmering seeds.

The Queen

They are about to irradiate me. Doom, dread, Oppenheimer, Hiroshima, Three Mile Island, Chernobyl, sloughing flesh. Marie, Pierre and their daughter Irene Curie died prematurely so I could lie here on this table, trying to prolong my life.
“Okay, now we leave you alone in here. This is the computer that controls the radiation. Somebody will be out here the whole time. If you need anything you can call us. Don’t worry.” I try to settle in, look up to a ceiling of illuminated glass panels imprinted with treetops and blue sky.

Irradiated

Genies, Genes & Stress

The last blog entry ended with Dr. Marie Mulligan saying the following, “You are not really the type I associate with this kind of cancer – it tends to appear in women with a lot of stress.”

She does not know that during the several years preceding my diagnosis, my brothers and I had been taking care of my parents whose health and well being were rapidly declining.

It all started when my father called. “Your mother is leaving me.”
“Dad, what are you talking about – after all these years?”
“No, no that’s not what I mean. I dropped her at the doctor’s office the other day and she went to the wrong clinic. She doesn’t know where she is.” I hop on a plane immediately and when I get to my parents’ house, no one answers when I ring the bell. I go in and discover my father trying to pull my mother out of bed. She has projectile vomiting. The bedroom reeks of urine. I start to call an ambulance. “No, we don’t need one,” says my father and I realize the depth of his denial. At the hospital, they discover Mom has gone septic from a urinary tract infection (UTI). She recovers but begins a steady cognitive decline. After much discussion, my father agrees to sell the house and move into assisted living to be near us. I make repeated trips back and forth across the country, organize 3 estate sales and watch my mother shrug her shoulders as people leave with her treasured collections of copper pots, blown glass, African masks, and beads.

One day, back at home, I notice that I have a rash covering my entire body. The doctor says “I don’t know what it is, we can take a biopsy.” The biopsy comes back negative. “It’s some kind of auto-immune problem. “Could it be caused by stress? I ask. “No,” he says, “definitely not.” My friend Dr. Beverley Kane, says “The skin is the first line of defense.” She suggests that I contact another forward thinking scientist who recommends reading, The Genie in Your Genes.

It is about epigenetics – the idea that there are environmental forces acting upon genes that cause them to mutate, to manifest or not manifest. “Environment” can mean the emotional state of the person, which in turn causes chemical changes in the body, which in turn effect genetic behavior and disease. The book sites studies with couples upon whom small wounds are inflicted – scratches. One set of couples is exposed to stress, another not. The wounds of the stressed couple heal more slowly than the wounds of the unstressed couple. So can one extrapolate from this that if a cell’s genes have a mutant cancer sequence, this can be suppressed until some change in the cell’s chemical contents enable the cancer to manifest? My rash remains for over a year. It disappears after we get my parents settled into assisted living.

My brothers and I still have plenty of stress, trying to manage my parents’ care. My mother calls her living space “this lousy apartment.” One day she asks, “Why don’t you have a baby for me to play with?” She forgets that I am well past menopause. There are so many ways in which I have failed her expectations.

Her health is fragile. She gets one UTI after another. We ask the doctor how we can prevent these infections from recurring. He stands at the foot of her bed and says, “She has to die of something.” The first neurologist she sees suggests looking into new medications for Alzheimer’s. “What are some?” I ask. “Look it up on the internet,” he says.

At the assisted living facility, a compassionate but disorganized health care manager engages in ongoing conflicts with the owners. We look for an alternatives, but my father has dug in. He doesn’t want to move, doesn’t think anywhere else will be an improvement. Two years into my parents’ stay, he has a stroke. As a result, he cannot swallow properly, his speech is slurred, but he remains mentally acute. Within a short time he can walk and speak more clearly. His swallowing never improves and there is a danger that he will inhale food into his lungs and die of pneumonia. He has a stomach tube inserted for nourishment. He hates the stomach tube, hates having an aid administer the feeding. The more he loses control over personal tasks, the grumpier he gets. He practices his own private form of Judaism. I give him Jeanne and William Steig’s book, “The Old Testament Made Easy,” thinking it will make him laugh. Instead he complains, “There’s a mistake. Steig drew Adam with a belly button.”

We visit another neurologist to get to the bottom of my mother’s cognitive wasting. “She is losing tissue,” he says, and points to dark smudges on her brain scan. She slips further and further away, stops talking, withdraws from my father. One day I bring her Chinese food for lunch. She eats it, falls asleep, awakens for dinner. She sits with other barely cognitive patients. Suddenly her head drops to the side.

We rush her to the hospital. A nurse slaps her hand and calls her, “Shirley, Shirley!” She opens her round blue eyes and smiles, lifts her hand to the nurses cheek and strokes it. I want it to be my cheek, I want to be touched by her, seen by her one last time. I am on the wrong side of the bed; I wouldn’t have the nerve to disturb her sleep. The nurse smiles back. Mom’s hand drops down. She closes her eyes.

The doctor says “We’ll keep her on fluids for three days. Sometimes people come back. If not, you can withdraw fluids and she will die within two weeks.” She never comes back. We decide to let our mother die of thirst and hunger. We call hospice and sit vigil. We give her oxygen to ease her breathing; we change her fentanol patches. If she seems restless, we put morphine under her tongue. We swab her gums with a soft lollipop-like green sponge on a stick, to moisten her mouth. How do you know whether you are adequately controlling the pain of someone who has fallen through the black holes in her brain? The hospice nurse tells us the signs to watch for. “Her feet will turn blue, her breathing will become sparse and rough, she will exhale and die.” On the ninth day we surround her: my father, my two brothers, the hospice nurse, and I. I count her breaths per minute. Her toes are blue, her breath a harsh cackle. We tell her how much we love her and reassure her that it is okay to let go. She inhales and dies.

My father falls into despair. He decides to have his stomach tube, the one good source of nourishment removed. He becomes emaciated and weak. One day I come into his room and he is folded chest to knees in his wheel chair, clutching tax papers in his left hand. He looks dead. I put my hand on his back, “Dad, Dad?” He sits up. “Dad, are you okay? I wish you would let someone else do your taxes.” He is a numbers man, a statistician. He is stubborn about doing his own taxes. “No, I’m not okay. The taxes aren’t the problem,” he says. “It’s my body. I’m dying.” The next day my brother takes him to the doctor, who encourages him to eat more. He dies in his bathroom that afternoon, alone, after my brother leaves. By the time I get there, my brothers have laid him out on his narrow bed.

He lies, arms and legs akimbo, his position evocative.

No Holy Mother holds him aloft. A fierce believer in the unity of G-d, my father would have been horrified that the Pieta even crossed my mind. He was also fiercely pragmatic, “Once you are dead, you are dead, kaput, finished, nothing.”

Jews do not believe in preserving corpses with embalming fluids or elaborate coffins. They return to earth in a plain wooden box. My parents went even further.  They donated their bodies to science. Each was wheeled into a non-descript van, driven to a morgue, then transported to a medical school. I have no idea what happened to them there, what happened to them when the students were finished with them.  “There isn’t a grave, an urn of ashes,” says my brother, “just nothing .”

A month later we discover that someone walked by my dead father, into his room, stole his credit card and used it to buy gas and dog food.

I have to wonder whether my stress caused the skin rash, whether it allowed my body’s chemicals to get so out of balance that it triggered the cancer. Who can know to what degree we influence our own health. My surgeon believes I can have no influence on whether or not the cancer returns. He says this as though it should be a relief to me. I settle on something in between – try not to worry about the cancer returning and buy all the vegetables, cook books and algae that Dr. Mulligan recommends – and especially the Maitaki mushrooms to prepare for the radiation.

A Diversion to the Present: 1. Cancer in Popular Media 2. Amphibian Morphogenesis


I am at the airport on my way to the Las Vegas Gift Show for work. Though pre loaded with things to read, I survey the new stand for something better, Science Magazine. I flip though the pages. A smear of green sugar icing topped with little purple grapes pops off a two page spread.  It has a strange sci-fi beauty. The caption reads “Invasion of the Bleb.”

Lung Cancer Cell by Anne Weston

It is an electron microscopy image taken by master photographer, Anne Weston, EM Unit, Cancer Research UK. This little landscape is a lung cancer cell. Anne has dyed the cell to better differentiate the little balls or as they are officially called, “blebs” from the cell surface.  The blebs are bubbles that form when a cell divides or undergoes stress. I guess one could classify uncontrolled cell division as stress. Scientists use images like this one to examine cancer’s disruption of normal cell function. pg 8 Science, March/April 2010.

I try to contact Anne Weston when I get home to see if I can use the image here in the blog. The first Anne Weston I see on Facebook has the American Cancer Society listed as a favorite organization. I think that I have found the photographer and send her an email. Instead, I have coincidentally come across the art director for the American Cancer Society publication, Triumph! By researching more electron microscopy sites, I find the photographer, Anne Weston and she kindly agrees to let me publish her image. If you would like to see more fantastic images of hers and other scientists cum artists, please visit Visuals Unlimited at http://www.visualsunlimited.com/c/visualsunlimited and the Wellcome Image Library at http://medphoto.wellcome.ac.uk/

Once in Vegas, I meet up with Prima Entrepreneur Margaret Majua, for whom I do design work. We are looking for ideas and products for her stores.  The gift show sprawls in typical Vegas extravagance across three conventions centers. Glittery bling, hippo netsuke, walky talky dinosaurs, military fashion wear, Prada purses, kitsch of all kinds adorn the aisles. We buy the remote controlled dinosaurs because anything that moves, sells. We also look for sayings magnets and I see this one:

Stupidity Causes Cancer

I keep staring at it, trying to figure out the point of view of its creator, and finally decide that it is one of those numbing conundrums, like “This sentence is false.”

We walk up and down the aisles until my eyes and feet ache equally. Suddenly I am stunned:

My African Cousins

The Booth is called Wild Creations. 4” x 4” x 6” aquariums line the shelves. In each are two of my cousins, African Dwarf Frogs, about 1.5” long, hind legs kicking furiously, front feet scraping the sides of their plexiglass prison. A young man hands out fliers touting these so called “EcoAquariums™ as having been nominated “Toy of the Year” by the Toy Industry Association, Inc..  The brochure quotes Julie J. Charlotte, NC, “The best product I’ve ever used in my classroom to teach kids about ecosystems.” Ecosystem??? The choices for the aquarium are either 4” x 4” x 4” or 4” x 4” x 6” with decorative gravel or rock, living bamboo, and Living Gravel™.  The brochure goes on, “There is nothing like our EcoAquarium™. Change the water twice a year . . . feed the frogs twice a week. All of the living elements inside the EcoAquarium contribute to the needs of each other.  The frogs and snail in the aquarium consume oxygen and produce carbon dioxide.  Naturally occurring bacteria in the Living Gravel convert ammonia from animal waste and left over food into nitrates.  These by-products provide food and nutrients for the living plants and algae, which in turn produce oxygen through photosynthesis.  Through this cycle a balanced ecosystem is created.”

Here is what I found out about African Dwarf Frogs:

“These semi-scavengers should be fed every alternate day . . . The African dwarf frogs need to be kept in a large tank of 10-gallon or more .  .  .  the African dwarf frog is a rather timid and shy amphibian . . . it is  essential to provide these amphibian lots of hiding places.” http://www.aquaticcommunity.com/frogs-turtles/africandwarffrog.php

These frogs are together in about 3 cups of water. they have no place to hide and they look miserable.

Close up of African Dwarf Frogs

“These are inhumane and I do not approve of them,” I say to the salesman, as though I am Oprah and my opinion will determine his success or failure. “Okay’” he says, and smiles knowing he has “one of the highest grossing products per sq. ft. in stores today” (also in their brochure).

We have an extra day in Las Vegas and tour the Valley of Fire, a flaming sandstone expanse that bursts up out of the Nevada desert.

Valley of Fire

Thanks to the movement of tectonic plates, the grey limestone mountains surrounding the valley will eventually bury it. There are Anasazi petroglyphs scratched onto some of the wall faces. This one shows my species:

Petroglyhs

In addition to petroglyphs, the guide points out creosote bush.

Creosote Bush

“Cup your hands over some leaves, smell them, then exhale and smell again.” We do this. At first the leaves have no odor, but after we exhale, they open their cells to suck in the moisture from our breath, and emit a subtly pungent odor. A little miracle. “The creosote bush has nothing to do with creosote, except for its odor but does have medicinal uses and is being studied for uses in cancer treatment.” This sounds like something I should verify and discover that researchers have performed experiments with an acid extracted from the creosote bush “that corroborate(s) its chemopreventive potential against skin cancer.”
1Department of Medical Elementology and Toxicology, Hamdard University, New Delhi 110062, India, 2Department of Pharmaceutical Sciences, Medical University of South Carolina, Charleston, SC 29425, USA and 3Department of Neurophysiology, Leibniz Institute for Neurobiology, Brenneckestrasse 6, Magdeburg D-39118, Germany

I also read this: “The creosote plant was a virtual pharmacy for Native Americans and the steam from the leaves was inhaled to relieve congestion. It was also used in the form of a medicinal tea to cure such ailments as flu, stomach cramps, cancer, coughs, colds, and others.” Phil Persson, a resident of Phoenix http://phoenix.about.com/cs/desert/a/creosote.htm

There are surprises for me when I return to California. It has rained every day while I have been gone. When I go out, I notice some long black dotted strands of slime in the rain puddles. At first I think they are some awful horse worm.

Worms?

Remember my distant cousin, the Western Toad?

 Western Toad

It turns out these are her eggs (or her sister’s):

Toad Eggs

There are more in a second puddle, and in a third, hatched tadpoles. I start tracking the progression.

Hatchlings on their egg tube:

Hatchlings on the Egg Tube

Close up of hatchlings looking embryonic:

Embryonic Hatchlings

Within 2-3 days, they are swimmers with fins. BTW, that other little green thing in the human hand is also a creature!

2-3 days old with fins!

Small guys compared to the older tadpoles I find in the second puddle. Note that the fins are gone:

2 day old hatchlings & tadpole, compare

Tadpole Pin-up

Arty Tadpole

I read on a creature info site (http://www.fishpondinfo.com, developed by Robyn Rhudy) that zero to ten out of all the hundreds of eggs a toad lays will mature to adult hood – Zero because the toad may have chosen an inopportune place to lay – very likely in California where rain is sparse and puddles have an unpredictable duration. There are three puddles on my property. All start to dry up before a single tadpole matures. The shallowest dries up a few days after the rain. I rescue some of its hatchlings, scoop them into a plastic container with mud, algae and rocks, but leave most to die. I rescue every single one of the larger tadpoles in the second puddle – put them in a kiddie swimming pool. Out of the third puddle, I place the unhatched egg strands in a separate container so I can track them from tadpole to toadom. The third puddle is the largest. I rescue many of the swimmers, even buy a second kiddie pool; but most die in the drying mud.

I notice that the tadpoles from a single puddle and presumably the same egg strand develop at different rates – possibly as much as this:

Different Growth Rates

These are not from my control group so I cannot be sure they came from the same strand. I will survey my control group and compare them as they grow.

I am not good at survival of the fittest. The fact that I have made it into my late 50’s is by the grace of niche markets, compassionate friends and family, and some lucky stumbling. The TV Show “The Weakest Link” seemed mean-spirited to me. I hate Donald Trump’s “The Apprentice.” It is as Darwinian as the baboon downing the baby Gazelle, the upstart cabochin monkey killing its pack leader. The fact that my cancer was not papillary serous, that I came out of the surgery and returned to relative robustness, that I earn a living and can draw using computer tools – all of this seems to be the result of luck, not willfulness. When I tell a friend, a doctor whom I haven’t seen for 20 years, that I survived cancer, he says, “Nu, so you’ll die of something else!”

My need to save all the tadpoles is a fool’s errand – by averting one calamity I am postponing or causing another. I scoop up one bunch of tadpoles and not another. Death is delayed longer for the scooped up bunch. Eventually they will succumb to cannibalism, predatory attack, lack of food or water, will get run over by a truck, or die of old age (unlikely). My surgeon, the oncology team at Kaiser, scooped me up.

I find an ant who has met some accident. It is curled into a ball and cannot unfurl its body, though it waves its legs with great intention. The humane thing to do is smash it, put it out of its misery. But I wait in cowardice long enough for a puff of wind to carry it away, leave it to its painful fate.

Cancer  quotidienne is my new nomenclature for serendipitous mentions of cancer in the media.  In a March 2010 issue of the New Yorker: Joseph Papp (Joseph Papirofsky), died of prostate cancer October 31, 1991. What he did during his lifetime – turned the old Astor Library into one of the most prestigious theater venues in New York – The Public Theater, “responsible for among others, the original productions of “Hair,” “A Chorus Line,” “The Normal Heart,” and “That Championship Season.”

The next FrogBlog entry will be back on track with the cancer story continued. Sometimes I cannot help myself by yielding to distraction – and my fascination with worlds under the radar.

Tadpole close-up; nostrils, eyes, pupils and sparkly irises:

Eyes, Nostril, Pupils

Introduction to Henrietta Lax and Hela Cells

February 2010: On the radio show, Fresh Air, Terri Gross interviews science journalist, Rebecca Skloot, author of The Immortal Life of Henrietta Lacks. In April, 1951, Henrietta Lacks discovered she had a particularly virulent kind of cervical cancer. The doctor who biopsied her tumor cultured the cells, which were dubbed “Hela,” He for henrietta, La for Lacks. Henrietta’s were the first human cells robust enough to survive outside the human body, to be fruitful and multiply in test tubes and petrie dishes long after her death. Her family had no idea Henrietta’s cells were being used in this fashion and did not find out until the 1970’s that medical companies were merchandising Hela cells for profit. There are currently over 50 metric tons of Henrietta’s cancer cells still thriving and dividing. Skloot describes a Hela cell undergoing mitosis, which in normal cells means dividing into two:

“. . . one cancer cell, its edges round and smooth . . . began to quiver and shake violently, exploding into five cancer cells.” The Immortal Life of Henrietta Lacks (pg 57)

*These cells are not to scale. 5000 human cells can fit on the head of a pin.

These are some of the things that Henrietta’s cells have achieved and been subjected to:

  • Sent by Russians on the second satellite ever put into orbit, 1960
  • Accompanied the first humans sent into outer space; scientists thus discovered that living in zero gravity accelerated Hela cell division, rendering the cells even more virulent
  • packed in ice in various stages of mitosis and sent all over the world for research

  • Used to develop the Salk polio vaccine
  • Exposed to massive doses of radiation to see how the atomic bomb would affect humans
  • Spun in centrifuges till the G-force was 100,000
  • Used to test new products and drugs including steroids, chemotherapy, hormones, vitamins
  • Used to study TB, salmonella, the bacterium that causes vaginitis, hemorrhagic fever, and of course, cancer

By the 1990’s one scientist believed that Hela cells had mutated enough to be considered another species. The Immortal Life of Henrietta Lacks is a wonderful read and fascinating book about medical ethics.

Bad Chinese Food • Good Fortune

Cancer as Metaphor 2009:

David Sedaris suggests some children’s reenactment of the Christmas story should come to an immediate halt, “if there’s a cancer, you must treat it at the earliest possible opportunity.”

President Calderon, responding to the killings of a police officer’s family by Mexican drug kingpins, “These contemptible events are proof of how unscrupulously organized crime operates, attacking innocent lives. And they can only strengthen us in our determination to banish this singular cancer.”

An Afghani spokesman says of his own country: “Corruption is the cancer that is spreading across our country.”

Home
The day after I get home from the hospital, my partner leaves on a business trip. Two of my best friends come to take care of me. We all like good food and I remember the surgeon’s parting words, “Eat whatever you want to.” On my second evening home we share Mexican food, by the second weekend, Chinese. The next day, when the friends are about to leave, my ornery intestines rebel once again. My partner gets home and I reveal my distress but declare that I will soldier on. By one in the morning the intestines are battering relentlessly. I call the advice nurse at Kaiser. She recommends a trip to emergency in case an infection has set in. I wake up my travel weary partner and apologize, “I have to go back to the hospital.” On the way there I lose my cookies and moan. The emergency doctor orders a bunch of tests: a full torso CT scan, vaginal ultrasound, blood work, and IV morphine. By six in the morning it is time for another Lovenox shot. The attending nurse bustles about and says, “I can give it to you. Do you want me to give it to you. I can give it to you or do you want to do it?” In a morphine stupor I mumble agreeably, “You can do it.” She holds the syringe two feet above my abdomen, aims and POW!, like a hawk plummeting for prey, she plunges the needle into my belly.

All the tests are negative. The blood work shows mild dehydration and anemia. The severe pain has subsided. Conclusion: the guts were not awake enough for Chinese food.

When I get home, my oby-gyn calls to see how I am doing, having heard that I went back to the hospital. “Well here is some good news, she says, the pathology report says there is no papillary serous.”

I can’t believe my ears. I’m ecstatic. I want to cry with joy and thank her for telling me. Why hasn’t the surgeon/oncologist called? Doesn’t he know that my future has been teetering on a pin head, hanging from a thread, dangling on edge? (Am I forgetting once again how many patients he has?) Relief makes it easy to forgive him. I cannot eat anything but saltines and water; I cannot sit up without assistance; all my internal female parts and more have been extracted, but I am not one of the 10% of endometrial cancer patients* who have papillary serous.

*Uterine papillary serous carcinoma (UPSC) accounts for 10% of endometrial carcinomas but a higher proportion of deaths due to its aggressive nature and poor response to chemotherapy and radiotherapy.

Faratian D, Stillie A, Busby-Earle RM, Cowie VJ, Monaghan H.
Department of Laboratory Services (Pathology), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK.

I mourn for the women who are afflicted with this aggressive cancer.

A few days later the oncologist’s office calls to make my follow up appointment, at which time he will discuss my prognosis. His assistant gives no indication that there is no papillary serous carcinoma. Should I believe my good news any less? My trust in the accuracy of diagnosis is tentative. A misplaced test tube, a switched slide, the wrong stain, the misspelling of a name. So many things can go wrong.

When I go back to the oncologist he says, “The good news is you do not have papillary serous. You do not have to have chemotherapy, only radiation. But you still have a stage two cancer. It can show up again anywhere in your body, in any organ, at any time.

Tributes 2010

Jan 19, 2010:  Kate McGarrigle, Canadian singer-songwriter, dies aged 63; had been battling cancer since the summer of 2006. The cancer started in her small intestine and spread to her liver.

We watch a PBS Special about opera auditions at the Met and fall in love with a 30 year old black singer, Ryan Smith, who, with little formal training makes it to the finals and embarks on his singing career. We feel triumphant until the credits. Just months after the film was completed, November 2008, he died of lymphoma.

Out of Balance

When I get home, there is nothing I can do but heal and think, learn to navigate with severed abdominal muscles, research cancer, and try not to anticipate what the pathologists have found. I feel tender, smaller that the diminished sum of my parts. My belly swells over a ledge of sutures. I sit in a recliner and watch the world spin outside my narrowed boundaries. I read a book called ANTI-CANCER by David Serban-Schreiber, a doctor who survived brain cancer. He suggests that health and well being depend on the balance of our bodies’ various systems: autonomic, hormonal, emotional, and on the communication between these systems. If the communication is good, health emerges. If not, it vanishes. He uses this diagram to illustrate this idea:

The Balance of Being

The triangle is suggested by the correct positioning of the circles and their missing wedges, but they do not touch – implying that health is delicate, improbable, ineffable, like gravity. The slightest nudge could knock one of those circles out of orbit. Within a few days of being home, something has nudged one of my wedges.

Out of Balance

“Don’t worry,” says the advice nurse. “You have a yeast infection. The antibiotics you were on during surgery killed the bacteria that keep those yeast in check. We’ll give you a cream that will knock out the yeast. Start taking acidophilus.” “And what about giving myself the Lovenox where the yeast is? Will this shove them inside and wreck some other havoc?” “I don’t think so, but how about giving yourself the shots in your thigh?” I try this. The skin is tougher there and it hurts, but not a big price to pay as I nudge myself back toward balance. The implication here is that if health is so delicate, then some wispy hair trigger may control cancer.

Where do Sharps Go and What About All Those Dying Frogs?

Before the nurse discharges me, she shows me how to administer shots of Lovenox subcutaneously. “What’s it for?” “To prevent blot clots. Squeeze a small mound of belly flesh, gently insert the needle, slowly depress the syringe. Do it twice a day for the next 10 days.” She hands me the Lovenox kit. It is a box decorated with the faces of people over fifty. They smile against a background of butter yellow and baby blue – peaceful colors, calm colors, colors that say “Your blood will not clot, you will not have a post-surgery stroke.” Inside the box are multiple prefilled syringes and a red plastic container, a “sharps” depository, where I am supposed to put the used syringes. Then what?

Where Do Sharps Go?

On My Way Home

After the surgery the nurses give me four days of solicitous care. Round the clock, with patience and forbearance, they combat pain and discomfort. The sleepy intestines wake up in fits and starts, having been doused from one end with drugs that induce queeziness, from the other with drugs that suppress it. My stomach muscles are as sore as ever and there seems to be a disconnect between my brain and leg muscles. Remember those experiments – amputated frogs’ legs strung up to wires and zapped with electricity. Lo and behold they still twitched – with no brain attached. I could use a little zap right now to get things working properly. Regardless, the surgeon checks my wound again and says I can go home the following day. It’s good news, though I feel glass fragile. I’m about to leave under the weight of a staggering number of presents and flowers, wondering if he will stop by to bid me farewell, when I hear someone charging down the hallway.
Ready to Leave the Hospital

“Take it easy. It will take you about 6 weeks to regain your stamina. Eat whatever you want to. We’ll contact you after I hear from the pathologist and call you for a follow up appointment.” He gives me a big hug and is gone, on to the next conquest.

I believe in him. I believe that he routed out all those virulent papillary serous cells and I will embark on life again.