Chemo, Round One

Mom had her first and second chemotherapy appointments, and she gets next week off to try to recuperate. She’s back on the same chemotherapy regimen she did when she was first diagnosed (gemcitabine + cisplatin). The plan for her is to do 3 cycles of chemo (one cycle is 2 weeks on, 1 week off) and then get a CT scan to see what effect the chemo is having.

An extremely, extremely basic background on how her chemo works, for anyone who cares: the chemotherapy enters the bloodstream via IV. Cancer cells rapidly divide, and her type of chemo targets these rapidly dividing cells.  This means it kills cancer cells, but also indiscriminately slaughters any other fast dividing cells. This especially sucks for hair follicles, bone marrow, and the lining of the mouth and digestive system. That’s why the most common side effects of chemo are often low blood cell counts, hair loss, mouth sores, etc.

Right now fatigue and nausea are hitting her much harder than last time, maybe because her body is older and has already been pumped full of gem + cis so many times before. When you start chemo up again, you don’t get to start over fresh. Your body remembers.

Modern cancer treatment feels, by turns, impressively advanced and shockingly medieval. Part of what’s kept Mom alive this long are yearly surgeries where she is treated with radio-frequency ablation (where radio waves are passed through a probe into her liver and generate enough heat to kill her tumors). While not considered the preferable first-line treatment for her kind of cancer (that’s resection, whenever possible), by doing this every summer since she had her resection, she managed 4 years (aside from few month of adjuvant treatment) off chemo. This treatment wouldn’t have been an option 15 or 20 years ago. Eventually chemotherapy will probably look as barbaric as treating rye mold-induced mass hysteria with some casual witch hanging (probably not that bad, but definitely EXACTLY AS BAD as using just enough drugs to cause cell death while walking the tightrope of trying not to kill the host of said cells).

The three main ways cancer is treated are old as hell. They are basically the first things anybody thought of that weren’t leeches and holy water. Surgery as a treatment began to be used regularly in the 1850s, radiation at the start of the 20th century and chemotherapy in 1949. Although there have been significant improvements (some of the first mastectomies were done WITHOUT ANESTHESIA), modern day oncology is the Stephen Colbert to early 20th century’s Johnny Carson (NOT IMPRESSED, GET THESE OLD WHITE DUDES OUT OF HERE, etc). For anyone interested in the history of cancer treatment, The Emperor of All Maladies is very good (obviously encourage you to be a better person than me and buy it from a local bookseller, if you can).

It makes me hopeful that since my mother was last on systemic treatment for her cholangiocarcinoma, the medical community has begun talking tentatively about immunotherapy and targeted therapies based on specific gene mutations for people with many types of solid tissue malignancies. These treatments, though, are still largely experimental and limited to clinical trials. The cost of testing a tumor to see if it could possibly have any mutations for which there might exist a specific therapy which could potentially be helpful is currently $5,800. Luckily insurance companies cover it as a matter of course (LOL JK).

At some point, that’s the route we’ll pursue. Until then, Mom has to deal with chemotherapy, as flawed as it is. The Cancer Fighting Kitchen has been helpful for recipes and specific information on nutrition’s importance for cancer prevention and relevance during treatment (without ever straying into the hope-exploiting wasteland that is FORGET BIG PHARMA, YOU TOO CAN CURE YOUR CANCER WITH VEGGIE SMOOTHIES AND DAILY COFFEE ENEMAS!!&!)

Some pictures of what we’ve been up to the last few weeks:

hiking the Butte

they call the first snow on the mountains termination dust, because it signals the end of summer/fall, and by extension, happiness.

this is nice

Mom is actually pulling off the beret, i think

Bert hates me so much