ENCORE #39! – Lymph Node Excision, Mosquito Bites and “A Return To ‘Normal’”

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 July 2012 and is my most popular post!

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…

Here again, just in time for the season!

After my wife came home from a lymphedema expert at the hospital, I asked her how it had gone. The answer was that the swelling is receding slowly and that the pressure sleeve would be here soon.

She asked how often she would have to wear it, the doctor replied, “Forever.” She added, “Oh, and don’t ever get a mosquito bite. That’s one of the worst things in the world.”

*blink in startlement*

I don’t know about where you all live, perhaps someone lives in Arizona or New Zealand or Hawaii where mosquitoes aren’t a big deal. But in Minnesota, we (somewhat facetiously; but only SOMEWHAT…) call the mosquito our “state bird”. They are everywhere.

Granted, susceptibility to mosquito bites ranges from, say, me to say, my wife…

I get bitten, make no mistake. But my wife? Let me illustrate: we went to a recent fireworks fest celebrating one or another of some small town’s heritages. Great times! We sat in camp chairs set up in the middle of the street. The next morning, she showed me a pair of fist-sized welts, one on each side of her back that had been “exposed” (even though they were covered by T-shirt material!) where NUMEROUS mosquitoes had bitten her!

Take this little tidbit and add it to the doctor’s admonition and you get a recipe for me *blinking in startlement*.

So what’s the problem with mosquito bites?

First of all, let’s review the lymph nodes, which I talked about in depth here: http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html.

Excision means to remove or cut out. When the breast cancer was initially diagnosed in my wife, the doctors were very, very interested in how far it had spread. If it remained only in the breast, it was “less dangerous”. But if it had spread to the lymph nodes in the armpit (usually), the diagnosis was more terrifying and led to identifying the stage of the cancer. For a complete explanation, try this site:  http://www.breastcancer.org/symptoms/diagnosis/staging.jsp They found cancer cells in the node and bumped the diagnosis from 0 to IIIB. This required them to removed lymph nodes – 21 in all and eventually the news that lymphedema would be a FOREVER concern.

Now to mosquito bites. Why are they such a concern? “...some insect bites probably are inevitable...treat them...to lessen the histamine effect, which can cause increased swelling in that area. Benadryl or hydrocortisone creams are two treatment options for insect bites. An ointment with aluminum sulfate as the active ingredient can also help decrease the effects of bites and stings...Treat an insect bite like any break in the skin on your limb at risk. Wash and dry the area completely and apply antibiotic cream to the area...take along a specialized first aid kit. The kit should include alcohol wipes to clean off any skin break, antibiotic cream for application on the skin, and bandages to protect the area…An insect repellent is a good idea...natural repellents, usually with citronella as the active ingredient, and these can be less detrimental to your skin...avoid putting insect repellent on your skin and then wearing a compression garment over it...”

Now you can be prepared for summer camping. As prepared as you can be!

Reference: http://www.lymphnet.org/lymphedemaFAQs/riskReduction/summerTips.htm

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

ENCORE #38! – The Next Five Years

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 December of 2011.

All right – the mastectomy is done (not OVER, there are still deep emotions attached to that surgery that will never “disappear”). The chemotherapy is done (same thing there: deep emotions and memories that will be carved into my mind forever). While it’s never completely gone, the gut-wrenching worry has passed.

What now?

For the next FIVE years, in addition to some cosmetic surgery, checkups and maintenance, there are more DRUGS. Specific to breast cancer is the one I’ll talk about today: anastrazole.

Chemically, this is called 2,2'-[5-(1H-1,2,4-triazol-1-ylmethyl)-1,3-phenylene]bis(2-methylpropanenitrile).

But what’s it DO?

In a nutshell it slows down the production of estrogen in a human body (BTW – men make estrogen, too, just not as much as women do. Women make testosterone, just not as much as men do).

So?

Estrogen, which at puberty initiates the maturation of a woman, causes among other things, the increased growth of the cells in the breast. This estrogen comes from the ovaries and is a totally normal response to a person growing up. Estrogen levels in the blood increase during every menstrual cycle – which means it stimulates the growth of breast cells.

Estrogen doesn’t just stop affecting the woman after puberty. “…life-long exposure to estrogen…plays an important role in determining breast cancer risk…the number of menstrual cycles a woman has, and hence the length of exposure to estrogen during her lifetime, affects her risk for breast cancer.”

So every time a woman has her period, estrogen travels through the blood. The molecule of estrogen affects cells in the body – but only certain kinds of cells like the ones found in the breast and uterus. These cells have “keyholes” in their walls that are called estrogen receptors. The estrogen and the estrogen receptor hook together to make a single molecule that enters the nucleus of the cell. Once it locks on the cell’s DNA, it directs it to do many things. Among the things it tells the cell to do is GROW.

You know by now that cancer happens when cells grow totally out of control. So every time the breast cells get a message from the estrogen, they grow. Breast cancer is the out-of-control growth of breast cells stimulated by estrogen.

Anastrazole BLOCKS estrogen from giving its message to breast (and other) cells. On the website listed below, the author states: “…the medication is directed at preventing recurrence [of cancer] other than just in  breast tissue….The American Society of Clinical Oncologists stated recently: ‘To lengthen disease-free survival and lower risk for [cancer] recurrence in nearby tissues or distant tissues…’”

So in a single sentence – anastrazole blocks estrogen from giving its message to cells that like to take up estrogen and start growing wildly.

References: http://envirocancer.cornell.edu/factsheet/general/fs9.estrogen.cfm , http://www.medhelp.org/posts/Breast-Cancer/Why-Arimidex-Anastrozole-after-bilateral-mastectomy/show/1314813

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #46: Computer Targeting Cancer Cells

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: https://www.sciencedaily.com/releases/2016/06/160607120818.htm

Targeting breast cancer cells seems to be a major new thrust in the fight against breast cancer. I talked about it a couple of months ago here as well as some years ago: http://breastcancerreaper.blogspot.com/2012/09/breast-cancer-research-right-now-2.html and here: http://breastcancerreaper.blogspot.com/2016/04/breast-cancer-research-right-now.html

But how do you get from the IDEA of targeting cancer cells to trying drugs to do it? Apparently, you can do computer models.

Now don’t get me wrong, I am NOT a fan of computer models. The model is only as good as the person who inputs the raw data and the person who writes the program. Computer models are notorious for spitting out inaccurate predictions and drawing false conclusions – not the machine’s fault, of course. Like I said, programmers and data entry folks. Also, the assumptions of the researcher can find their way into the model as well; but that’s happened since forever, so it’s not a new factor.

Here we have the following: “Researchers have built a model to investigate the metastasis of cancer by examining the metabolism of breast epithelial cells and look at the role of signaling. This research may contribute to the development of cell specific anti-cancer interventions.”

 In English, then: researchers are looking at how the cells that typically erupt into breast cancer cells use the nutrients they get from the body and the waste materials they give off. With that kind of a trail, scientists can design drugs to follow the trail and destroy the cancer cells.

Sounds simple enough – sort of like the old story of Hansel and Gretel: going out into the forest, the smart little girl leaves an easily followed trail that her and her brother can follow back home.

In this case, the cancer cell leaves a trail that well-designed cancer drugs can follow. Then they can destroy the cancer cell. The way it’s done now, is that drugs like Taxotere (which interferes with cell division), Adriamycin (which inserts itself into the cancer cell’s DNA so the cells can’t make new cancer cells), and Cytoxan (which sneaks in as a harmless drug, then is converted by the cancer cell into a toxin) – but they aren’t perfectly targeted. They kill hair cells and T-cells that protect the body from infections.

The researchers, programmers, and data entry people are working to reduce the amount of damage current cancer drugs do while still maintaining the attack on cells.

So, while I won’t CHEER this new model on, I will certainly watch to see what kinds of effective results it produces!

Image: http://cache1.asset-cache.net/gc/548000043-breast-cancer-and-cancer-protein-molecule-gettyimages.jpg?v=1&c=IWSAsset&k=2&d=jXBfeL7HXTly94gsrbGffrZCbmlQQB7uQmafeFqCiLubsdmsUAoAsKA8v6SiNhIkVXJPsJ%2BcpkKQNWEVsiyBqfGNwCRu6VgXAjrN6d6JLmE%3D

ENCORE #37! – All Quiet On The Western Front…

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 January 2012.

Like most of you, I recognized this blog title as the name of an old book – maybe an old war movie.

I’d assumed it was about World War II, I suppose because that’s the war I’m “familiar” with.

It’s neither and it fits even better my current state of mind.

The main characters of the book are German boys sent to the Western Front – the leading edge of the German invasion into France and a place where the war essentially “stopped”. From its closest approach to Paris in September of 1914 to the position the Allies pushed them back to 1916 and where the war stagnated, little of import happened there. That is the thrust of the book. From the ground, when you are young and the horrors of war can’t possibly match anything you’ve ever seen, “nothing happens”.

The problem is that while nothing appears to change on the Front, nothing also changes back home. When you return home, while everyone is glad to see you and everything is just as you left it – you are no longer the same person who went to war. You have seen things you can’t even explain to those who remained behind.

 In the book, ALL QUIET ON THE WESTERN FRONT, the main character, Paul Bäumer is a soldier who—urged on by his school teacher—joined the German army shortly after the war began, and who is all of nineteen years old. Some time later, Paul visits on leave to his home which highlights the cost of the war on his psyche. The town has not changed since he went off to war; however, he finds that he does ‘not belong here anymore, it is a foreign world.’ He feels disconnected from most of the townspeople…not understanding ‘that a man cannot talk of such things.’”

I can understand something of that feeling.

While the breast cancer threat has disappeared, we no longer have to go to chemotherapy sessions and the imminence of the cancer has seemingly faded; it’s not gone from my mind. I am still worried. I still wonder. When I rub my wife’s head, touching the soft hairs that have grown back in the months since chemo ended, everything seems so peaceful.

Everything seems “over”.

But it’s not and I can’t explain that it’s NOT over to people who only ask occasionally now, “How’s your wife?” Some of it is that I don’t have the time to talk about my fears of MBC or the long-term effects of the estrogen-blocking drug she has to take. Some of it is that I don’t want people to think I’m whining and say, “Oh, get over it! She’s fine now! The drama’s over!”

Some of it is that while the drama isn’t on stage any more under the bright lights and makeup, it continues in the body. It continues in my mind. It makes me say things like, “Liz is three-and-a-half-months cancer-free!” and smile and high five people.

It makes me feel things like I do “not belong here anymore, it is a foreign world...a man cannot talk of such things.” I suppose I’m also afraid that I’m “weird” in that I’m not “over it”; or that someone might just look at me and say, “Man! Get over it!”

I’m pretty sure now, nearly a year after the initial diagnosis, that I will never “get over it.”

[Update: Four years later, and I’m still not “over it”, though all the hoopla has faded. We live in this New Normal life.]

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg