Cancer 8/8/21

Thoughts by Richard Bleil

This is a difficult post to write.  I myself have never faced cancer, and yet I have so many friends who have.  Today (as of the writing of this), a very good friend, beautiful on the inside and out, posted a short video of her “ringing the bell” at her cancer center indicating the end of her treatment.  Another friend in Florida will never have that opportunity. 

Let’s be honest, cancer is horrible.  The body has no idea it’s doing anything wrong as it slowly has growths that are out of control and will, if left untreated, kill itself.  In graduate school, we had a student who, in his first year, found a lump in his penis.  It turned out to be cancer, and yes, it killed him just a few months later. 

The theory behind traditional cancer treatment is horrid.  Cancerous growths occur because something goes haywire in the replication process, causing cells to divide out of control.  Rather than growing what is needed for a particular organ, they just divide constantly.  This division is called “mitosis”.  The theory between chemotherapy and radiation treatment is that, since cancerous cells are more likely to be dividing, by targeting and killing any cells mid mitosis will kill more cancerous cells than healthy.  While this is generally true, there are also certain organs like the liver and bone marrow that have cells that are naturally faster growing than other organs.  This is why radiation and chemotherapy causes such harm to these organs. 

Some years ago, an Ohio medical center developed a technique of focused radiation therapy.  This was a breakthrough, where the radiation treatments focus on the region of the body where the cancer is growing.  One of my very best friends had cancer some years ago, and the radiation treatment for her was to have her drink an iodine tincture that was so highly radioactive that after drinking it, for several days she had to isolate herself from her family.  After this isolation period, they literally had to throw the bed sheets away because they were dangerously high in radiation.  Unfortunately, to the best of my knowledge, chemotherapy is still general and not targeted (beyond cells that are mid-mitosis).

Surgery typically precedes radiation or chemotherapy, but this is so very deadly in and of itself.  Cancer apparently grows “tendrils” from the central tumor.  If the surgeon should nick on of them, the cells from the tumor can get into the patient’s lymphatic system or blood and spread the cancer much farther than the original tumor.  I guess this is why chemotherapy is still so commonly used to follow up after a surgery.  The surgeon, then, must cut well beyond the cancerous growth and into healthy tissue just to try to avoid an unforeseen tendril.  The good news here is that modern imaging techniques makes it far more likely to see those tendrils and avoid them, but it’s still not perfect. 

These days there are very promising gene therapy treatments that are highly personalized to the cancer patient and showing marvelous potential.  Unfortunately, the treatments are still experimental and many insurance companies will balk at paying for these very expensive treatments.  In essence, a sample of DNA from the cancer victim is studied to find the faulty gene causing the cancer.  A gene sequence is developed, a kind of retrovirus to replace this faulty gene sequence with a new healthy one.  If successfully spliced into the patient’s DNA, the new cells with the healthy or “corrected” DNA will replicate and become part of their normal genome.  This is not very different from the Covid vaccination which acts by splicing information on how to make the T-cells necessary to fight the Covid virus right into our genetic makeup.  Unlike this vaccination, though, the flaws giving rise to cancer is highly specific to the patient, so one shot will not work universally.  Each new patient must have the treatment developed specifically for them, which is why the treatment is so very expensive. 

Hope is on the horizon.  Cancer victims are far more likely to survive today than just thirty years ago, and new treatments are showing great promise.  That is little consolation to those facing cancer today, especially for those unfortunate terminal patients like my friend or those we have already lost.  Unfortunately, progress will always be “too little, too late” for some people.  It’s a matter of timing, I guess.  But to my friend, I’m so very happy you could ring the bell, and while I understand the battle for cancer survivors is never over as vigilance must be maintained to keep an eye out for cancer’s return, enjoy your respite.  You fought the battle, you won, you deserve the vacation. 

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