ENCORE #17 ! – Neulasta!!! What’s It DO???

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry also appeared in November of 2011.

What’s “neulasta” and what does it do?

Chemically, “neulasta” is N-(3-hydroxypropyl)methionyl, 1-ether-alpha-methyl-omega-hydroxypoly(oxyethylene). Complex. Lots of chemicals.

But what’s it DO?

“Neulasta”, is a special protein that’s based on sugar (an oligo-saccharide, meaning that the molecule has only a few small units, in this case a sugar ) that’s attached to a protein to form a glycoprotein.

The glycoprotein is a very important part of a cell wall – the cells that are being targeted are white blood cells. The white blood cells are also called neutrophils, granulocytes and stem cells and are the main part of the blood that destroys microscopic body invaders like bacterial infections, viruses or other germs. The glycoproteins help the white blood cells recognize the germs.

Neulasta makes the marrow in bones produce more white blood cells to replace the ones killed by Cytoxan, Adriamycin and Taxotere (which I talked about above) while they are busy killing cancer cells that are growing out of control.

The “colony” in the “colony stimulating factor” is the white blood cells in the bone marrow.

So – “neulasta” is injected just under the skin and gets into the bloodstream. It goes along until it reaches the bone marrow where it forces (also known as “stimulating”) the growth of new white blood cells to take the place of the older ones killed off by the chemicals in chemotherapy.

Side-effects? Sure. Any one of us who’s seen the Red Devil injected in his wife, mother or girlfriend knows what I’m talkin’ about here. With stuff like THAT going into a human body, to expect NO side-effects would be the crazy thing! There are “minor effects” – did any of the researchers experience any of these symptoms? If they had, would they have called the effects “minor”? – of the injection, things like hives; difficulty breathing; swelling (face, lips, tongue, or throat) as well as bone pain; pain in your arms or legs; or bruising, swelling, pain, redness, or a hard lump where the injection was given.

More serious side-effects (though according to the test trials, these rarely happened: sudden or severe pain in your left upper stomach spreading up to your shoulder; severe dizziness, skin rash, or flushing; rapid breathing or feeling short of breath; signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness.

My wife didn’t seem to experience any of the side-effects. In fact, though we expected WORSE, the chemotherapy (while horrible in its own right) only threw us a few curves. Because of the neulasta injections, she didn’t seem to catch any sort of germ at all and stayed (on the chemotherapy scale of things in our “new normal” world) pretty healthy.

References: http://en.wikipedia.org/wiki/Pegfilgrastim, http://www.drugs.com/neulasta.html

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg

BREAST CANCER RESEARCH RIGHT NOW! #35: Research Suggests that Omega 3 Fatty Acids MAY Help Prevent Breast Cancer and Help In Recovery

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: http://www.breast-cancer-research.com/content/17/1/62

In May, a technical article published in the journal Breast Cancer Research gives some indication that Omega 3 Fatty Acids may assist in the prevention of and recovery from breast cancer.

So – what does “Omega 3 Fatty Acid” MEAN exactly?

First off, the “omega” in this is there for one reason only: as part of the name, it indicates to people “in the know” (now that you’ve read this, YOU), where the first double carbon-carbon hook up is in the chain of atoms that make up the structure of the chemical. (Make no mistake, a fatty acid IS a chemical!) Omega – as in “I am the alpha and omega”, or more English-ee, “I am the ‘a’ and ‘z’”.

The double bond is at the end of the molecule.

The molecule of what?

The molecule of a fatty acid. Uh…that’s sort of complicated, but let me give it a try. “…a carboxylic acid, with a long unbranched hydrocarbon tail.”

All of this has to do with how atoms hook up. So for starters, most of the stuff that makes up a Human is either carbon, oxygen, or hydrogen. The “carbs” that are bad for me, is a shortened form of the biology word, “carbohydrate”. This means that the molecules in bread that don’t help my figure are made up ALMOST exclusively of carbon, hydrogen, and oxygen.

“Hydrocarbons”, like gasoline and motor oil, are made up of ALMOST all carbons and hydrogens (with NO oxygen atoms).

A fatty acid then is a molecule that STARTS with a group of atoms that are called an acid: a carbon, two oxygen, and a hydrogen attached like this: COOH. This group is hooked on to a long chain of carbons and hydrogens, or as Wikipedia puts it, “a chain of four to 28 carbon atoms (usually unbranched and even numbered)”. The length of the attached chain determines which one of the fatty acids it is. The double bonded (or hooked up to the carbon twice) molecule is in the last (omega) spot.

An omega 3 fatty acid then, has the COOH followed by somewhere between four and twenty-eight carbons that are hooked on to hydrogen atoms until the very end, where there’s a double bond.

OK – now that we have that cleared up, let’s get into the why of this. WHY would Omega 3 fatty acids do anything to breast cancer cells? Does it dissolve the cells, the way stomach acid dissolves food or battery acid dissolves blue jeans?

No. As the article says, “The net effect if EPA and DHA are present in sufficient amounts relative to AA is anti-inflammatory or inflammation resolving…a reduction in oncogenic protein signaling through disruption of plasma membrane lipid rafts; a reduction in cytokine production; and an increase in apoptosis following activation of plasma membrane...”

A definition of some phrases:

EPA and DHA = marine omega-3 fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)]

AA = proinflammatory omega-6 arachidonic acid (AA)

“anti-inflammatory/inflammation resolving” = makes swelling/irritation go down

“reduction in oncogenic protein signaling” = doesn’t let cancer cells communicate

“reduction in cytokine production” = see the essay I wrote here: http://breastcancerreaper.blogspot.com/2014/12/encore-3-hold-on-there-baba-louie.html that details what cytokines are and what they do.

Apoptosis = the natural death of cells

To clarify then, let me replace all the high-falutin’ talk with my definitions here:

“Marine omega-3 fatty acids present in sufficient amounts relative to proinflammatory omega-6 makes swelling/irritation go down …a reduction in cancer cells communicating and ends with a reduction in cytokine production; and an increase in the natural death of [cancer] cells…”

I hope this helps to clarify the role of the Omega-3 fatty acids that you can take in the form of fish oil pills!

Image: https://upload.wikimedia.org/wikipedia/commons/thumb/0/0f/ALAnumbering.svg/444px-ALAnumbering.svg.png

ENCORE #16! – Cytoxan!!! What’s It DO???

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in November of 2011.

Though I talked very briefly some time ago about what the various chemotherapy drugs that my wife was treated with were “for”, I never really went into any kind of detail.

Now that chemo is “over”, I wanted to explore what some of the long-term and lasting effects of the treatment are. Because she reached that time – what with the odd numbing of her upper lip, the incision pains, swollen ankles and dry skin, I’d like to know which of those things is chemo-derived and which ones are not.

So we’ll g0 here next:

Cytoxan is the “third” drug of the cocktail she was force fed through the tubes and into her port every three weeks for six months. “Cytoxan is a cyclophosphamide that has been converted into a non-toxic ‘transport form’. This transport form is a ‘pro-drug’, subsequently actively transported into the cancer cells. Once in the cells, enzymes convert the drug into the active, toxic form that kills the cancer cell.”

Plain English, please!

OK – first stunning surprise is that Cytoxan is a cytotoxic chemotherapy agent similar to mustard gas.

Although used today as anti-cancer drugs, they can theoretically also be used for chemical warfare. Nitrogen mustards add chlorine atoms to the DNA of cancer cells, in effect poisoning the cancer cell.

Mustard gas was stockpiled by several nations during the Second World War, but it was never used in combat. Mustard gas and its related compounds are strong and long-lasting blister agents. Production and use is restricted.

How did we get from WWII mustard gas to anti-breast cancer drugs? During WWII, nitrogen mustard gases were studied at Yale University and classified human clinical trials of nitrogen mustards for the treatment of cancer started in December 1942. Also during WWII, an incident during the air raid on Bari, Italy led to the release of mustard gas that affected several hundred soldiers and civilians. Medical examination of the survivors showed a decreased number of white blood cells. After WWII was over, the Bari incident and a Yale study came together prompting a search for other similar compounds. The nitrogen mustard became the first chemotherapy drug mustine and proved effective in both destroying the DNA of cancer cells (which are fast growing and as a result, replicate their DNA much more quickly than regular cells – which ends up killing them FASTER than their neighbor cells.) and, when attached to a carrier molecule, would attach themselves almost exclusively to the fast-growing cancer cells.

Many people taking cytoxan do have serious side effects. Side-effects like nausea, vomit, bone marrow suppression, stomach ache, diarrhea, darkening of the skin/nails, hair loss or thinning of hair, changes in color and texture of the hair, and lethargy. Cytoxan can cause cancer, it can lower the body's ability to fight an infection as well as an unusual decrease in the amount of urine, mouth sores, unusual tiredness or weakness, joint pain, easy bruising/bleeding, existing wounds that are slow healing.

But it’s primary purpose – a rare combination of having a poisonous effect on DNA replication and being targetable – make it an idea cancer treatment drug.

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg

GUY’S GOTTA TALK ABOUT #16…Breast Cancer STILL...

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

The cancer is gone.

The hoopla is gone.

The surgery pain is gone. And yet, all of these remain as shadows, hovering.

We celebrate the anniversary now of the end of chemo – not like with a party, but it’s marked on my calendar.

I thank God, the doctors, our families, our friends for their support – in my mind. Nothing spectacular, just a calm, measured reflection of what’s gone on before.

But I'd like to talk to someone who understands...You notice in the picture over there that the guys are definitely NOT talking. Posing, they are. Being strong. Supportive. Not talking.

Niggling things, like the lymphedema; forgetting to bring the sleeve rack along and having to struggle to get the compression sleeve on by hand (did that LAST summer on our ten day trip to OK!); mosquito bites that bring a bit of panic or a burn on the right hand, the one that still doesn’t drain lymph very well, staying under careful scrutiny for days to make sure it doesn’t turn into a major event; little or no contact with the cancer clinic is also bothersome.

What – don’t they care anymore? They don’t seem to…at least that what it seems like.

After recovery, after the excitement, isn’t there anything left to do? Aren’t there issues left to deal with...

Men STILL don’t talk about breast cancer.

Even after four years, when I do a search for “breast cancer husband support”, all I get is articles and books.

Talk seems to be missing – and lest you think that I should “just get out there and start a group then instead of whining about it!” I tried. I tried connecting with the cancer hospital we were at, but there WASN’T a group and no one seemed interested when I talked about it.

In the four years I’ve had this blog up, while I KNOW people stop by, I’ve never had anyone talk to me about BC and what men should do.

Like I said, there are discussions and books, but no talk.

What is it that’s so intimidating about TALKING about our wives, and partners, and lovers, and mothers, and sisters with breast cancer? Now there’s a subject for study!

Even so, Marc Silver, who wrote a book I never read, was reviewed by Library Journal. They said this: “An editor at U.S. News & World Report, Silver was a clueless as the next man when his wife, Marsha, was diagnosed. Failing to find a manual showing men how to offer the most support and care, he wrote his own. Silver gathered information from medical professionals and men in the same boat, covering every conceivable challenge to life with breast cancer (including suggestions on how to wash a woman's hair while she is wearing drains).”

That’s all great and stuff, but I still wish there were other men; men of the survivors now, that I could talk to.

Just sayin’, eh?

Resource: http://www.amazon.com/Breast-Cancer-Husband-Diagnosis-Treatment/dp/1579548334
Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg