It's That time again . .

I find myself in a situation where I can actually sit at the computer and spend some time writing in this blog. This is completely unexpected. When I first learned that I had Oesophageal Cancer the advice I was given was that I had probably a few months to live. After some considerable distress I accepted that I had no longer to live and made arrangements to finalise as much of my affairs as I possibly could. Since then I have had the privilege of living far longer than anyone expected.

As I head towards the second anniversary of my diagnosis I am pleased to say that I am still alive and still kicking. Indeed I have been told that I am able to go back to full time work and so have been doing this and trying to make back some of the financial costs that were incurred.

Let's just hope that this next year also sees a further opportunity to continue living - life is too precious to waste on illness and stress!

Happy and Healthy new year to everyone

Have scientists discovered how cancer spreads?

In a fascinating story coming from Reuters on 7 December 2005 the following:

Updated: 1:51 p.m. ET Dec. 7, 2005

LONDON - Scientists have discovered how cancer spreads from a primary site to other places in the body in a finding that could open doors for new ways of treating and preventing advanced disease.

Instead of a cell just breaking off from a tumor and traveling through the bloodstream to another organ where it forms a secondary tumour, or metastasis, researchers in the United States have shown that the cancer sends out envoys to prepare the new site.

Intercepting those envoys, or blocking their action with drugs, might help to prevent the spread of cancer or to treat it in patients in which it has already occurred.

Pete's Points:

I am amazed at what we are finding out these days. One of the things I note in the article above is how differently the English language is spelled in the American vernacular.

Fancy that

CBS reports that

Researchers in California and in Cambridge, England, are successfully training man's best friend to smell out one of his worst enemies.

Researchers say dogs can be more accurate than current cancer tests and represent a breakthrough in cancer detection.

In September, a leading medical journal in Britain, the BMI, gave its blessing. The journal published the results of the first ever meticulously controlled, double blind, peer-reviewed study on the subject, stating, “The results are unambiguous. Dogs can be trained to recognize and flag bladder cancer.”

Pete's Comments:

A friend in the USA is reported as saying that immediately after your dog starts to lick you a lot get yourself down for a CAT scan.

How appropriate! When it's raining it is raining cats and dogs!

Some information for those that need it

Oesophageal Cancer

In case people have not yet realised this, all of us who suffer from this disease had to learn about it, about treatments and about the odds of survival.

I welcome visitors to this web site and encourage people with similar illnesses to discuss their situation.

The Ivor Lewis Method

http://www.vh.org/adult/provider/surgery/EsophagealCarcinoma/12E.html

http://www.rcsed.ac.uk/journal/vol45_5/4550006.htm

http://www.vesalius.com/graphics/archive/archtn.asp?VID=773&nrVID=772

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10075357&dopt=Abstract

Definitely NOT for the squeamish

P. S. you will need a medical dictionary for some of the words. After all my degrees I still have no idea what some of them mean.

One of the options for assisting people with this form of disease and its consequences is to have a place in which people can discuss their own situation, ask their questions and obtain information from others who are in the same boat.

There is such a site in the USA which is called the EC Café at

http://www.eccafe.org/

Within the ACT there is also a wonderful site which presents a one stop shop for cancer sufferers and this at:
http://www.hotkey.net.au/~string/listing.htm

Try it you will find it useful

There is NATIONAL AUSTRALIAN STUDY of Oesophageal Cancer underway

ASK YOUR DOCTOR about whether you can and/or should participate.

You can find out more at :

http://www.qimr.edu.au/research/labs/adeleg/

http://www.qimr.edu.au/research/labs/adeleg/barrets.html

and especially at:

http://www.acs.qimr.edu.au/menu/faq.html this URL providing information for participants!

http://www.acs.qimr.edu.au/menu/oes/index.html

In addition to the above, there is also information about clinical trials in the USA which can be located at:

http://www.nci.nih.gov/Search/SearchClinicalTrialsAdvanced.aspx

NOTE: To use this site it is necessary to have an idea of how to use a search engine and to know the stage of the disease that you are looking for.

Chemo Therapy

There is a web site in the UK that is helpful in providing information about chemo therapy substances:

http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrugs/

The specific site for 5FU is at:

http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrugs/Fluorouracil

I hope this is of assistance to people.

News for consideration

Reuters reports that: Selenomethionine May Protect Against Esophageal Cancer.
See the full article on this subject at:http://www.cancerpage.com/news/article.asp?id=8903

The Good and the Bad News

I am consistently amazed by the fact that I am still alive! After having been told the bad news - you have a few months to live, it has come as a pleasant surprise to find myself still alive and kicking. The bad news is that there are people I know and like who have not been as fortunate. Alas they have fallen victim to some form of cancer or other ailment well before what I would have thought of as their allotted time.

I have now been to a number of funerals and I can tell you they are really even more depressing when they are about someone who is both younger than I am and someone who until their demise was considered to be a darn sight healthier.

Whenever I have another appointment with the doctors or have to have another scan I am consistently frightened by the prospect of what the examinations will reveal. To some extent I guess I wish to be able to return to the days when I was pig ignorant and felt that the rest of my life would be filled with healthy and happy days - as all the earlier one's had been. Being aware of your mortality is on the one hand good news - as you can try and take as many precautions to maintain the state as possible and on the other, bad news as you no longer feel either willing or able to take the risks that would have been taken with impunity at an earlier life stage.

When will the pattern of life return to a sense of normality? I fear never! All my life prior to my diagnosis I lived in the fairy tale world of "and so they lived happily ever after". No longer is this possible. I guess what is possible is to regain sufficient equilibrium to not worry too much about either the happily or the ever after and just try and enjoy what time is left.

For those with this dreaded disease some more information

Try the http://www.ecaware.org/index.html home site of the EC Aware organisation as well as the Acor web site for the EC Café as it is known.

Food for thought for anyone with an Adenocarcinoma

In New Scientist

A genetically-modified virus that exploits the selfish behaviour of cancer cells may offer a powerful and selective way of killing tumours.

Deleting a key gene from the virus enabled it to infect and burst cancer cells while leaving normal tissues unharmed, reveals a study by researchers at Cancer Research UK and Queen Mary's School of Medicine and Dentistry, University of London.

Viruses spread by infiltrating the cells of their host. Normally, the detection of an intruder by a cell triggers a process called apoptosis, which causes the cell to commit suicide and prevents the virus spreading further. However, viruses can carry genes that allow them to slip past this cell death process in normal cells, causing infection.

The UK researchers deleted one such gene in an adenovirus. This meant that the virus was immediately detected by normal cells and was unable to spread. But in cancer cells, which grow uncontrollably and ignore the cell death process, the virus was able to thrive and spread rapidly. It then multiplied so vigorously that it killed the cancer cells by making them explode.

"The great thing about this strategy is that the cancer cell does all the hard work," says Nick Lemoine, director of the Cancer Research UK Clinical Centre at Bart's Medical School, who led the team. "It makes more and more virus to infect its neighbouring cancer cells. But if a normal cell is infected, it commits suicide before it can make new virus and spread of the virus is contained."

Unexpected benefit

The gene the team deleted from the adenovirus is called E1B-19kD. But, as well as removing the cloak the viruses normally use to evade detection by cells, it had another "unexpected" effect, says Lemoine.

This was enabling the viruses to replicate much faster than normal, which in turn helped burst the cancer cells. Previous GM viruses have not shown this effect.

The team examined the effects of the GM virus on pancreatic, lung, ovarian, liver and colorectal cancers in the test tube, as well as on live tumour-bearing mice. The team plans to test the GM virus in clinical trials in people in 2005.

"In tests so far it has proven both potent and selective, although only clinical trials will tell us whether the approach can be an effective treatment in people, "comments Robert Souhami, Cancer Research UK's director of clinical and external affairs.

Lemoine adds that the GM virus could also be armed with additional anti-cancer weapons, in the form of genes producing toxic compounds. "The fact that we have taken a gene out of the viral backbone means we could arm the virus with something that deliberately kills cancer," he told New Scienist.

Since the testing is in 2005 what is happening with this?

CT Scans can be hazardous to your health

Seen on http://www.mercola.com/2001/may/30/ct_scan.htm

Regulators at the Food and Drug Administration (FDA) are concerned that the growing popularity of high-tech computerized body imaging for health screening could be exposing the public to risky levels of radiation.

Recent advances in computerized tomography (CT) technology have increased the efficiency and lowered the price of the scans. The changes have helped spawn a new nationwide industry of unregulated boutique clinics where patients pay $300 to $500 of their own money to get CT scans not for diagnosis, but for regular health screening.

The agency is worried that easily available screening with CT has the potential of exposing patients to unhealthy repeat doses of the X-ray radiation the machines use to form images. While FDA evaluates the safety and effectiveness of CT scanners and other medical devices for regular use, it has no power to regulate how those machines are used once they reach doctors offices.

Whole-body scans require higher doses of the X-ray radiation CT scanners use to make images. As more and more people visit clinics to be screened for lung cancer, heart disease and other ailments, they could be absorbing more radiation more often than the FDA originally intended.

It's an open free-for-all in many communities. There is a perception by the public that CT scanning is a benign thing.

The average whole-body CT scan delivers 0.2 to 2.0 rads of radiation, depending on the size of the patient's body. Studies of Japanese survivors of the US atomic attacks on Hiroshima and Nagasaki in WWII linked an increased risk of cancer to lifetime cumulative exposures of 5 to 20 rads.

At 2 rads per exam, we're not far from potentially dangerous radiation doses.

Most doctors who work with CT scanners know to monitor the cumulative radiation doses patients receive. Professional societies also put out guidelines designed to promote the safe and effective use of the machines. But the self-pay nature of many CT boutiques allows patients to visit several different clinics as often as they like.

A Good Result

The last time I wrote it was about having that "lovely" experience of going into the hospital to have someone look at my insides once again.

Well, the news was good this time, or to use the phrase applied in my documentation, 'very encouraging'. I am not sure who this comment was aimed at the doctor who referred me, the person undertaking the examination or me for some reason. Regardless of all this - at least the news was not what I dreaded - namely that there was a problem with my colon.

Still I am not out of the woods yet, it might well be that the iron deficiency is a sign of something else that is dreadful. Let's wait and see.

The experience of going to the hospital provided one bright moment before everything went black and this was the finding that one of the lovely young nurses who had taken care of me in the ward when I was recovering from my operation had transferred to this new job and was going to have the dubious delight of attending to yet another part of my anatomy. It was nice to have a sense of 'old home week' although I have to say I would prefer it if I did not see people in the hospital for any reason other that social.

Thursday

Well, next Thursday is the day when I can look forward to another round of people sticking large black hoses where the sun normally does not shine and looking into my well being.

The procedure is not painful nor distressing as they are careful to make sure that we have no memory of what happens. The preparation is disgusting - insipid foods for two days and then nothing but liquids for the next day with some horrible stuff that makes you purge everything to leave a nice clean colon to be looked at.

Well, I can cope with all this - but keep up the prayers folks because having another tumor is not what I would like to see.

Some interesting news

I sometimes wonder whether it is a good idea to go and visit a doctor. Every time that I attend the surgery I am prompted with attendance at a new test and new results that reveal something new and disturbing.

The last of my attendances at the GP was caused by a sore shoulder and some questions about the blood tests that have been conducted.

What an idiot I must be to raise questions.

The next thing I know I am off for x rays and an ultrasound and some more intensive blood tests.

What do they find?

Well in the first place a nice torn ligament in the shoulder. Requires more tests like an MRI and then perhaps surgery depending on the damage. Lovely! Another fortune in body analysis and repairs.

Then there is the blood test. No news is good news I always say and in this case I am right again. The test reports that I have low iron in my blood. OK so what does this mean? Take supplements? Well, not necessarily, it could mean I have bowel cancer.

WONDERFUL - as if oesophageal cancer was not enough I now have to find out if I am to enjoy something else as well.

So I go home to think ruefully about what is happening to my life and my body and the doctor goes off on a well earned weekend with the family suggesting that in the next week she will try and make arrangements for a gastroscopy to find out whether I am bleeding internally somewhere and whether that is cancer or not.

That of course leaves me with the anxiety and a feeling of total helplessness as I wait for their intervention.

Ain't the world grand?

Waiting for the Other Shoe to Drop

I have just had the devastating news that one does not want to get - my friend's father has metastases!

I am devastated for this friend and for his family. I know exactly what it feels like to have the tests and to wait for the results I know what if feels like when the doctor tries to avoid your eyes and tell you that he/she has found some results that are most unpleasant. I know what if feels like to know with considerable certainty that you are a walking dead person.

In some ways it is a blessing in disguise. Once you have been diagnosed for cancer it is not at present possible to believe anyone who says, 'congratulations, the operation was a success and you are cured." Rather it is the situation that in most instances you can believe the phrase, 'congratulations, we have staved off death for a period, we don't know for how long but we are hoping for the best. '

I am absolutely sure that this gives the doctors who make the statement a considerable sense of triumph and warmth and a sense of purpose achieved.

I know that for loved ones it provides them with the opportunity to hope and to thank God for a little more time with that person. For the individual with the illness it is a time for waiting for the other shoe to drop.

On the one hand, it is nice to know that for the time being life can return to some level of normalcy. After all to look at, one is OK. The various parts of the body work and get the job done day after day. One is able to eat, drink sleep and perform most of the functions which are required.

On the other, it feels as though one is on death row waiting for the inevitable schedule for execution and with no hope of a reprieve.

I have recently had some postings from people who are still in the state of anger over the news that their husband, son, daughter has cancer.

Anger? Anger with whom?

With an unjust God who seems to reward evil people with long and health lives while those of the loved one is being cut short? Anger with the people in the world who get rich pumping chemicals into our food chain and into the air we breathe and the water that we drink just to make another million or so that they can't spend in their life time? Angry with the governments that have a pandemic on their hands with one in three people succumbing to cancer and who have not found a cure? Angry with all of those people who are daily inventing 'treatments' and getting rich instead of finding a cure?

I guess there are a lot of people to be angry with. Indeed for many of us, when we think back on the abuse we have been responsible for by smoking, by not taking exercise, by . . . we can also be angry with ourselves.

What's the point? Each minute that we spend being angry is another minute that we cannot enjoy being alive. Each angry outburst is merely an exercise in frustration.

Live life for as long as you have and consign worry to the dustbin. Bad news will come soon enough and you need your energy to cope with it when it does.

The way it was

I am consistently amazed by the ability of the human body to recover from abuse.

This picture was taken when I was on a full course of both chemo and radio therapy. You will note the thinning hair and the blank look. Consider this as being the results of 'chemo brain'.

You will also note the layers of clothing and the blanket. No this is not because we were in the middle of winter without heating. It is because the loss of weight and the chemicals which are infused into your system seem to have an effect that causes an enhanced sensitivity to cold. Even though the house was heated to 5 degrees Celsius I was always freezing and in need of hot water bottles to stay just right.

To those people who are now seeing me back at work, with hair and able to walk again and able to generate my own body heat again - this picture is simply a reminder that it is possible to recover from the devastation of cancer and its treatment.

I have no idea how long this recovery will be and I have no expectations that the cancer will not return and devastate me yet again and this time with results that will be less favourable than the one I have survived to date.

I guess I just want to place on the record that it is worth fighting and it is worth going through the horrors of the therapy if you can have the chance to have at least a few more days and weeks of life without pain and without the debilitating effects of the disease or its treatment.

One more birthday

Well, the unexpected has come in my life, yet again!

This time the news is a little more pleasant than last time. Instead of being told I have only a few months to live I have now celebrated one more birthday than I had any right to expect.

I have no idea how others cope with having a terminal illness. My own bizarre way is to accept that I have no choice about it and to hope that God's administration is as faulty as most of the administrations I have worked with here on this planet.

Let us assume for example that there really is a golden book in which all of our names are inscribed when we are born and into which all of our exploits in our lives are added so that on the Day of Judgement our record can be interrogated and an appropriate judgement made.

Now let us assume that the clerks in God's domain are as efficient as those who are here on earth. In that case there is a high probability that his record keeping is less than useful and he has actually discovered that the day of my demise (no doubt written into the book at the very beginning) was somehow overlooked. Like any good functionary he wants to keep his job and so has utilised one of the time honoured tactics of all good bureaucrats and found a way to "cover his arse". In short, there is a good chance that his error may not be discovered for some time. This means of course that my being alive at present is merely a clerical error and I hope that this is ONE clerical error that is not discovered for some time.

Alas, I suspect that God also has auditors and so one day it is likely that the error will be found and I will be for the high jump. Of course there is the remote hope that I can have an opportunity to plead my case and suggest that since I was not dispatched at the correct time it is the clerk who should be punished and not me - so could I please have a new demise date set?

My next hope then is that as on earth so it is in heaven and the bureaucracy will grind exceedingly slowly and I will have yet more time on this mortal coil.

One of the advantages of having reached the status of a sound middle manager in a large bureaucracy I know how to make it function for me. It can be speeded up if you know how and of course it can be slowed down.

In my case it is painfully obvious that what I want to achieve is for the first time in my life to make the bureaucracy as slow and useless as possible as this will be to my advantage.

Let's hope that I succeed, because then you can read more of my diatribes on this subject over time.

Penumonia

One of the most dreaded possibilities that can arise in the treatment of cancer is the possibility of pneumonia.

Advice is provided to patients undergoing radio and chemo therapy that in the event that they feel even the slightest rise in temperature they should get to the emergency ward of nearest hospital.

With chemo and radio-therapy there is a lowering of both the white blood cell levels and also baby white cells called neutrophils. The count can reduce to very low levels which means that the body is really defenceless against even the most minute infections.

In my case I know that I stayed at home between treatments and rarely ventured outside the home to minimise the possibility of catching something. Visitors were restricted during and in between treatments for the time that white cells usually need to recover a ten day period generally.

In spite of this I was silly enough to venture outside into the garden and lay out feed for the wild birds that abound around our home. This simple act of charity during the winter months in a four year drought proved to be my undoing. I managed to get a spore from a bird feather or something that infected my lungs and I was taken down with a rare form of bird pneumonia.

With temperatures fluctuating between 38° and 42° Celsius, ice packs applied to the neck and forehead to reduce the temperatures I spent around ten days hovering between life and death with doctors frantically pumping me full of antibiotics to help me beat the infection. All treatment for the cancer was stopped while we dealt with the more immediate threat to my life.

I have no advice for anyone about what they should do in their own situation. All that I can say is that the realisation that the body is completely defenceless should be known and taken into account in a conscious way.

In my own case - too late of course and with the benefit of 20/20 vision in hindsight, all of the things that I normally take for granted have to be examined with a view to assessing the risk in the new circumstances.

Hopefully there will not be a need to do this again. However a lesson learned is better than one that is forgotten.