I saw my oncologist this afternoon to get the results of my CT scan and blood work following the second round of my second course of chemo. I had been concerned that the tumors were continuing to grow because one blood test, a measure of the carcinoembryonic antigen (CEA), had increased by about 40% (from 2.3 to 3.2) since the last blood test three weeks ago. The good news is that the increase was not meaningful, and my tumors were either unchanged or apparently smaller in a couple of cases. The pemetrexed seems to have had a positive effect. Consequently, I had another round of chemo following my doctor's appointment.
To explain why the CEA values were not significant, the doctor showed me a graph of another patient's CEA values (with the name obscured, of course). His scores had risen from 100 to 400 at the start of therapy (for non-small cell lung cancer) but had declined back to around 50 over the course of a year, and he said he had patients with much higher values than that. He said that the increase in CEA at the start of treatment may be the results of dying or stressed cells producing more of the antigen. We'll see in three weeks if the values continue to rise, but it will six weeks before the next CT scan.
All in all is was a good afternoon at the hospital.
January 25, 2012
January 21, 2012
Cancer Cells Can Change over Time
Cancer cells do not always stay the same throughout the duration of an individual's disease. A recent blog post on Discover Magazine's web site describes how the cancers can change through mutation and selection over time. The post describes changes in acute myeloid leukemia, a disease similar to Jana's chronic myeloid leukemia, but the process can occur in any cancer. The changes parallel the way in which new species arise through natural selection.
http://blogs.discovermagazine.com/loom/2012/01/12/inside-darwins-tumor/
http://blogs.discovermagazine.com/loom/2012/01/12/inside-darwins-tumor/
January 7, 2012
Single-Drug Chemotherapy: Second Round
Another round of chemo to document.
Tuesday, Jan 3: Had my blood drawn early in the morning and got the results online before noon. The tests determine whether or not my blood counts are adequate for the chemo. Everything looked good. Began taking the steroid Dexamethasone to reduce side effects of the chemotherapy. The steroid revs up the body, and I felt good and energetic. Only slept about four hours that night even though I had taken a benadryl.
Wednesday, Jan 4: Started my oral anti-nausea medicine in the morning and worked on installing the new dishwasher. Had a doctor’s appointment at noon and began my infusion about 1:30 pm--an anti-nausea drug and pemetrexed. It took about an hour or so. All went very smoothly, and when it was done, I felt no different than when I went in. Went home and worked on the dishwasher. Taking the steroid made getting up and down on the floor easier. Again only about four hours of sleep that night.
Thursday, Jan 5: Stopped taking the steroid but continued the anti-nausea medication. Finished installing the dishwasher. Felt good all day.
Friday, Jan 6: Not so energetic because no more Dexamethasone. Continued anti-nausea medicine. Did not do all that I had planned for the day. Read Michael Connelly’s The DROP.
Saturday, Jan 7: Got up and fried some ham and scrambled eggs for breakfast. Then began feeling fatigued so I took a two-hour, after-breakfast nap. Still not much interested in doing any work around the house. Tiny pimple-like spots forming at the hairline on my neck. Occasional coughing and tendency to gag. Slight tingling in my hands. Big snowflakes falling outside.
Sunday, Jan 8: Didn't have the same fatigue as Saturday morning. Took a nap after noon. Occasional waves of feeling ill and a little short of breath. Pretty much the same as yesterday, but I did get out and shovel and sweep some light snow.
Monday, Jan 9: Pretty good day; however, felt bad at times in the evening. I hope the feeling doesn't presage a bad day tomorrow. Last time, Tuesday was a bad day.
Tuesday, Jan 10: Today was not as bad as the first Tuesday of the last round. Occasional waves of feeling ill stopped, but I easily became short of breath. Had a cough and a low fever (99.2). Mouth sores larger than last time.
Wednesday, Jan 10: Better today. No waves of feeling ill, cough less, no fever. On the mend. Unless there's something else to report this will be the last entry for this round.
David
Sunday, Jan 8: Didn't have the same fatigue as Saturday morning. Took a nap after noon. Occasional waves of feeling ill and a little short of breath. Pretty much the same as yesterday, but I did get out and shovel and sweep some light snow.
Monday, Jan 9: Pretty good day; however, felt bad at times in the evening. I hope the feeling doesn't presage a bad day tomorrow. Last time, Tuesday was a bad day.
Tuesday, Jan 10: Today was not as bad as the first Tuesday of the last round. Occasional waves of feeling ill stopped, but I easily became short of breath. Had a cough and a low fever (99.2). Mouth sores larger than last time.
Wednesday, Jan 10: Better today. No waves of feeling ill, cough less, no fever. On the mend. Unless there's something else to report this will be the last entry for this round.
David
January 3, 2012
An Epigenetic Day
About a year ago in the post entitled "Uncle Sam and Gini," I speculated that poverty and income inequality might have negative biological affects on children that take multiple generations to overcome. That could happen through changed in which genes are turned on and off during development through the action of epigenetics.
Well, yesterday was an epigenetic day. First I read an article in the Denver Post that was reprinted from the LA Times. The article reported on research that suggests that the conditions of women during their pregnancies in the 1950's laid the groundwork for the obesity epidemic we see today.
http://www.latimes.com/health/la-he-obesity-causes-20111219,0,6170668.story
Then later in the day I caught part of "Talk of the Nation" on NPR which discussed how identical twins are not truly identical because of epigenetic differences. They may have the same genes, but interactions with the environment impact the activation and deactivation of those genes which result in differences between the twins.
http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=144583977&m=144583970
If you find these article interesting, then I'd like to share a recent Science New article that goes to the molecular level to explain how lincRNAs coded from the parts of the DNA that do not code for proteins may orchestrate the differences between cell types within the organism and may be involved in epigenetic differences. These RNAs appear to be involved in cancer promotion and/or prevention.
http://www.sciencenews.org/view/feature/id/336570/title/Missing_Lincs
David
Well, yesterday was an epigenetic day. First I read an article in the Denver Post that was reprinted from the LA Times. The article reported on research that suggests that the conditions of women during their pregnancies in the 1950's laid the groundwork for the obesity epidemic we see today.
http://www.latimes.com/health/la-he-obesity-causes-20111219,0,6170668.story
Then later in the day I caught part of "Talk of the Nation" on NPR which discussed how identical twins are not truly identical because of epigenetic differences. They may have the same genes, but interactions with the environment impact the activation and deactivation of those genes which result in differences between the twins.
http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=144583977&m=144583970
If you find these article interesting, then I'd like to share a recent Science New article that goes to the molecular level to explain how lincRNAs coded from the parts of the DNA that do not code for proteins may orchestrate the differences between cell types within the organism and may be involved in epigenetic differences. These RNAs appear to be involved in cancer promotion and/or prevention.
http://www.sciencenews.org/view/feature/id/336570/title/Missing_Lincs
David
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