A cancer treatment primer

Hi! Yesterday I had my second cycle of Ipilimumab, the antiCTLA-4 drug that is part of the clinical trial I'm doing right now. My friend, Colin Hutt, served as my chauffeur through some rough winter weather and kept me good company for the day. It was his first time in an oncology clinic--I told him that was a good thing--and he asked some good questions about the different cancer treatments I've done. I thought if he had questions, others probably did too, so I'm posting a quick primer in case anyone else has trouble keeping all this stuff straight.

1. surgery -- surgery is usually the best option for cancer treatment. It is most effective in early stage cancers or when a tumor is causing problems with a bodily function. The removal of a mole, a masectomy, and my craniotomy are examples of surgery.

2. radiation -- radiation is the use of radio waves to target and kill a tumor or tumors. It is typically used in areas where surgery is not an option or when a large area of the body needs to be treated. The radiation is harmful to healthy tissue as well as cancerous tissue, so it has to be done very precisely in high doses (as was the case with my gamma knife procedure) or applied to a wider area in low doses (as was the case with my whole brain radiation) to minimize damage to healthy tissue. Receiving a dose of radiation is very similar to getting an x-ray or CT scan. The patient lays on a table, everyone leaves the room, and the radiation is applied to the affected area. Side effects of radiation vary depending on where it is applied. In my case, the whole brain radiation damaged most of the hair follicles on my head so I lost large patches of hair on both sides of my head but no where else. That's why I have a goatee and a stubbly mohawk right now.

3. chemotherapy (aka chemo) -- chemo is the use of toxic drugs to kill cancer throughout the body. Chemo drugs may be administered orally or infused through an IV. Chemo drugs target fast-replicating cells because cancer cells replicate faster than normal cells. Unfortunately, the drugs also affect healthy cells that normally replicate quickly, such as hair cells or the cells that make up the intestinal lining. This explains the common chemo side effects of hair loss (over the whole body), nausea, and diarrhea (among others). The main thing to remember about chemo drugs is that they are poison. A person who is on chemo treatment is being poisoned. I tell people that you cannot understand what chemo is like unless you've done it yourself. In many cases, it is a horrible experience for the patient.

4. bio agents -- what I call bio agents are drugs that boost the immune system. Usually infused through an IV, these agents work with the body to help the body's natural disease-fighting components to destroy the cancer. Interferon and interleukin are the two bio agents that were part of my biochemo treatment in Houston. The antiCTLA-4 drug I take now is a bio agent. Because bio agents work with the body, they tend to have mild side effects compared to chemo. Rashes, diarrhea, and fatigue tend to be the most common, although autoimmune disorders are a possibility. Here is something that might help you see the difference between chemo drugs and bio agents: When a nurse accidentally drips a chemo drug on the floor, the area around the drip becomes a toxic waste site. People have to wear protective gear and use special methods to ensure the area is safe. When a nurse accidentally drips a bio agent on the floor, however, she simply wipes it up with a kleenex and throws it in the trash.

That's a very broad overview of four common cancer treatments. It doesn't cover everything and it certainly isn't complete. Hopefully it gives you a little better understanding of the whole cancer treatment process.

Finally, on an unrelated note, I've got to send out props to Colin for his help and companionship yesterday. He made the day much more pleasant than it should have been. Thanks also to our good friend Dale Cox for snow blowing the six inches of snow off our driveway last night after what I'm sure was a long day at work for him. We are so blessed to have neighbors who take good care of us!

Jeff

PS. What kind of an uncle am I? I forgot to mention the best news of the past week: my brother, Michael, and his wife, Victoria, are the proud parents of Timoree Jade, a beautiful little girl born Dec 26. You can see pictures of her on Michael's My Space page.