ENCORE #68! – The NEXT Five Years – Anastrazole!!! 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 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) – it’s the picture you see above.

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

GUY’S GOTTA TALK ABOUT…Alzheimer’s #9: Tired of the Struggle

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

I woke up this morning with a "missed call" notification from my dad. He called at 11:22 and didn’t leave a message. It’s early morning right now and I can’t call him just yet. If he was up late, then he’ll still be sound asleep. Waking him now would just confuse him more.

He’s been calling more lately, continuing his…delusion seems harsh, hallucination sounds like an LSD trip…illusion. I like the sound of that better. When I think of the word illusion, I think of “magicians” and “magic tricks”; sleight of hand in other words – making me think something happened but it didn’t in the way I ASSUME it did.

An Alzheimer’s group in Canada has this to say in defining this experience:

“Delusions are false beliefs. Even if you give evidence about something to the person with dementia, she will not change her belief. For example, a person with dementia may have a delusion in which she believes someone else is living in her house when she actually lives alone…”

“Hallucinations are incorrect perceptions of objects or events involving the senses. They seem real to the person experiencing them but cannot be verified by anyone else. Hallucinations are a false perception that can result in either positive or negative experiences.”

Lately, Dad has been having an increasing number of both. Things like the door closing to his apartment and him believing that Mom just left for work. He has these often and so far, they have always been about Mom. He even called one day from the “floor phone” to tell me that I wouldn’t believe it, but he had just been talking to Mom in his room and he wanted me to come over right away to see that he wasn’t crazy! That would be hallucination, something he sees, hears, tastes, touches, or smells.

He’s also convinced that he’s moving “back home” (he’s recently started asking the staff where he lives if he can have a box. I already confiscated one because I’m afraid he’ll trip over it. He got himself another one.) and that a bunch of guys stop by to pick him up regularly to go to work – at a place that does charitable stuff. Also there are times that he thinks Mom left him because she wanted a divorce. These are delusions – something he believes.

But I’m going to start lumping them together into an illusion.

But I was specifically wondering WHAT was going on in Dad’s brain. While there doesn’t seem to be any recent discoveries, I found this from 2014 (http://www.sciencedirect.com/science/article/pii/S1064748113002832):

“Delusional thoughts are common among patients with Alzheimer disease (AD) and may be…linked to [the fact that they] cannot recall accurate information, which leads to inaccurate beliefs and [that they can’t] appreciate the illogic of beliefs…Delusions in AD are associated with dysfunction in specific frontal and temporal cortical regions. Delusions are…linked to memory deficits but not to insight.”

Of course, this doesn’t change anything. Dad’s illusions will continue to increase until his brain reaches a point where it can no longer function – Stage 7. Here’s a quick review the stages:

Stage 1: No memory problems are evident.

Stage 2: Minor memory problems but not distinguishable from normal age related memory loss.

Stage 3: Friends and family members begin to notice memory and cognitive problems like not being able to find the right word during conversations, forgetting new acquaintances, an frequently losing valuables.

Stage 4: Clear cut, classic symptoms of Alzheimer’s disease are apparent.

Stage 5: Need help with many day to day activities. Significant confusion, forgetting person information like phone number but still able to bathe and toilet independently. They also usually still know their family members and some detail about their personal histories, especially their childhood and youth.

[Dad is probably here-ish.]

Stage 6: Confusion or unawareness of environment and surroundings, behavior problems, assistance with activities of daily living, recognizes only friends and relatives, loss of history, incontinence, wandering.

Stages 7: Lose ability to respond to their environment or communicate, assistance with all activities of daily living is necessary, and many lose the ability to swallow [Dad has trouble with this already].

So, there you go. Living in his illusory world is hard for him – but it’s got to be one of the hardest things I’ve ever had to deal with.

Later…

Resource: http://www.alzheimer.ca/en/Living-with-dementia/Understanding-behaviour/Delusions-and-hallucinations

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg

ENCORE #67! – 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 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:

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

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

Looks like the picture up top. 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.

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

GUY’S GOTTA TALK ABOUT #36…When Breast Cancer Has No More Symptoms, Is It Cured?

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…

I was going to write about what I’ve been thinking about my wife being cancer-free for the past five years and to prep for it, I Googled the subject. The I wrote the title of this post and I paused…thinking.

While she hasn’t had overt symptoms, I realized that ever since the diagnosis there have been symptoms of many, many kinds.

Lymphedema (which I’ve written about quite a bit) is a symptom; lack of energy; thin hair; self-consciousness; pain from implants and the surgery; pain under the arm where the lymph nodes were extracted; fear of injuring the lymphedema arm – even so much as mosquito bites!; “fast” tiredness…and I can’t think of any others off the top of my head.

So, with all of these, is she cured?

Even with regards to the cancer itself, there’s no clear definitive answer: “Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared. If you remain in complete remission for 5 years or more, some doctors may say that you are cured. Still, some cancer cells can remain in your body for many years after treatment. Nov 24, 2014”

Of course, there’s good news, too: “Although as a whole, any kind of cancer can come back, Pilewskie says your chances of it returning can vary depending on the type of cancer you've had. ‘The more aggressive cancers may recur faster.’ With more aggressive forms of breast cancer, if it doesn't recur within the first two years, most likely you can be considered ‘cured’…Although many breast cancer survivors worry about their cancer coming back ‘sometimes I think that women overestimate their risk’, Pilewskie says. She encourages anyone who's completed breast cancer treatment to have ‘a good conversation with their doctor about their actual risk of recurrence.’”

That sounds great, and then she goes on to talk about the increasingly clear connection between breast cancer survival and exercise – though I’ve also dealt with that several times, too.

But what about the less-tangible things? How are they NOT symptoms of breast cancer? What about thin hair and self-consciousness? The residual pain of major surgery? The sense of loss from breast removal? The fear of getting even a few MOSQUITO BITES (which I’ve also written on before and it one of my most “pinged” posts) (What if you get stung by a wasp?)? How about, strangely enough, the discomfort of being a breast cancer survivor – they NEVER talk about that, yet for the first few years after my wife’s surgery and chemotherapy, she had no desire to “be celebrated” in the Relay For Life? What about the physical scars? In a weird twist of Human psychology, what about the anger that comes from everyone FORGETTING that you had breast cancer?

The articles I read blithely discuss the symptoms of breast cancer in terms of simple cell growth and cell non-growth, but the more I think about it and the more I read about it, the more I realize that while breast cancer in its cellular form might be in remission or even cured, the other symptoms will remain forever; and that means that a breast cancer survivor can NEVER be cured.

Sobering thoughts, to be sure…

Resource: http://health.usnews.com/wellness/articles/2017-03-28/can-my-breast-cancer-come-back, https://www.cancer.org/research/cancer-facts-statistics.html

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #66! – 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.

Many people taking cytoxan do have serious 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 lead to an unusual decrease in the amount of urine, mouth sores, unusual tiredness or weakness, joint pain, easy bruising/bleeding. As well, existing wounds are slow healing.

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

BREAST CANCER RESEARCH RIGHT NOW! #55: YOU, Robot! (Breast Cancer Surgery In the MRI!)

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:

In a shiny laboratory straight east of the city of Amsterdam; over the English Channel from London; over Pond, Gotham, and the Windy City from where I live; you will find robots performing breast cancer surgery.

This robot, the Stormram 4 (sounds like something from X-Men, doesn’t it?) can not only seek out and destroy breast cancer cells – with withering heat or sub-arctic cold – it does so INSIDE the MRI and under control of skilled microsurgeons.

Why is this such a big deal?

Stormram 4 is made entirely of PLASTIC! Not only that, it was made by a 3D PRINTER!

Significance?

First, metal negates the power of an MRI – remember it stands for Magnetic Resonance Imaging? It creates an image of what’s in the body by magnetizing the metal in OUR bodies. (“I don’t have any metal in me! I’m 100% organic!”) We ARE metallic, actually – calcium in our bones is a metal on an atomic level, and of course, iron is what makes up our blood. But it’s the WATER in our bodies that can be magnetized. Again (not what you think of, but here it is) the hydrogen is technically a metal and is magnetized by the super strong magnet of the MRI and lined up so they’re all North-South aligned. Then the magnetic field shuts off and the water molecules go back to normal. That’s what the MRI reads to build a picture of your guts.

Anyway, MORE metal in the picture (so to speak) screws everything up.

Stormram 4 is plastic – including the needle. A surgeon can first take a biopsy to verify the cancer; and rather than by a shaky human hand, the robot moves steady and rock solid. Once the cancer is identified: “Through the use of special needles, the tip of which can be very hot (thermal ablation) or very cold (cryoablation), it is possible to destroy tumor cells close to the tip of the needle. This enables the treatment of cancer without the need for invasive surgical procedures.”

While the procedure is only being used in the Netherlands at this time and is experimental – and requires the use of an extremely expensive and hard-to-come-by MRI (while I live in a major city and MRI machines are practically on every street corner, the actual machine is rare. Here’s a chart that shows the number of MRI machines in developed countries…not that there are NO developing countries listed: https://data.oecd.org/healtheqt/magnetic-resonance-imaging-mri-units.htm So for now, countries like Nigeria, Liberia, and Cameroon (to name a few) will have NO access to this new technology and treatment…) – it is clearly a new step forward and another tool in the treatment of breast cancer!

Resources: https://www.sciencedaily.com/releases/2017/07/170703121134.htm

Image: https://3c1703fe8d.site.internapcdn.net/newman/gfx/news/hires/2017/4-worldssmalle.jpg

ENCORE #65! – Adriamycin!!! 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 October 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:

Adriamycin is the “second” drug of the cocktail she was force fed through the tubes and into her port every three weeks for six months. At first we called it the “red devil” because it WAS red and delivered in two, brat-thick syringes attached to the port tube. The nurse always came dressed in surgical gown, goggles, gloves and a mask – because getting Adriamycin on your skin could cause BLISTERING. (“And you’re injecting that into my wife because…”

This all came clear after research:

“In the 50s, an Italian research company was trying to find anticancer compounds from germs that live in the ground. They found one that was promising in an area surrounding the Castel del Monte, a 13th century castle. A germ that was related to the common “strep” bug and was bright red worked in trials against certain kinds of cancer tumors. Some French researchers discovered the same kind of compound that the strep germ made, so they combined the name of an ancient tribe that had lived near the castle and the French word for ruby red and came up with the name of the compound: Dauno-rubicin.

They tested it against leukemia (blood cancer) and lymphoma (lymph node cancer) and it worked – but they found that it also damage the heart.

They tried mutating it and they got another, related drug that worked as well, but wasn’t so damaging to the heart. They named this new compound Adriamycin, after the Adriatic Sea. The name was later changed to “doxorubicin” to conform to the established naming habits of the drug and chemical industry.

Adriamycin acts by jamming itself in between pieces of DNA in cancer cells. Any cell needs to make new DNA to make new cells. Adriamycin messes up the work of an enzyme that uncoils DNA so it can copy itself – it forces the DNA to stay open so it can’t close up and start splitting the cell to make new ones. The original cells age, then die, never having made any new baby cancer cells to continue the destruction of a human being.

But Adriamycin is DANGEROUS. Aside from the usual nausea, vomiting, and irregular heartbeats, it can also kill white blood cells (that’s why my wife got a Neulasta shot the day after chemo), as well as causing complete hair loss. “A more mild side effect is discoloration of the urine, which can turn bright red for up to 48 hours after dosing.” (My daughter wrote about this one in her first or second blog post, “Toxic Pee”: http://twenty.o-my-soul.net/?p=24). From a Georgia Tech manual for handling toxic compounds, we find this:

“Doxorubicin (trade name Adriamycin)…is a mutagen, carcinogen, and teratogen, and is highly irritating to the eyes, skin, mucous membranes and upper respiratory tract.  Statistically significant…genetic damage have been reported in hospital pharmacists and nurses exposed to [it].  The toxic effects of doxorubicin may be experienced if swallowed, inhaled, ingested or exposed to the skin.”

Sheesh! No wonder the whole scenario creeped us out!

So besides slaughtering cancer cells, what’s the “rest of the story”? Grave indeed – “the risks of developing cardiac side effects…dramatically increase.” Doxorubicin makes the mitochondria (the place that makes the power to run a cell) in the heart muscles less able to make ATP – which is the energy used to run a cell: less energy, less strength for beating. Also, when Adriamycin reacts with the iron in blood, it can damage the heart cells, causing the fibers that tighten and loosen (making the heart beat) to disappear as well as eating holes in the cell’s jelly-like insides. Also, some patients may have weeping sores on the palms of the hand or soles of the feet, swelling, pain and a rash-like reddening of the skin – sometimes making the skin or hair a different color.

So there you go – a brief but chilling rundown of what THIS drug does to your beloved…

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