News From The Cancer Front

I went to see my oncologist Monday, and he's still happy with me. And when he's happy with me, oh, I'm happy too. I do a pretty thorough "lump-check" on my body every few hours on my own, and lately I haven't found anything untoward. But it's always a comfort when he does it and he can't find anything untoward either.

I'm due for a PET scan in a few weeks, but it's for monitoring, not diagnosis. So far - fingers crossed - I have no active cancer going on.

My only real complaint has been the persistent swelling of my left leg, which the experts believe to be caused by the scar tissue and general destruction in the left side of my groin, some of it courtesy of chemotherapy and some of it courtesy of radiation. But I've noticed in the last week that the swelling seems to be abating somewhat. It doesn't look any different, at least not unless you know exactly what to look for, but it certainly feels different. My shoe is getting looser instead of tighter. I can bend my knee through a larger angle. It's easier to get in and out of cars.

Conduct this experiment: bend your toes downward, and notice the way wrinkles tend to form on the sole and side of your foot. For a long time I couldn't even bend my toes downward, and if I did, there were no wrinkles - my leg was so swollen it was like an overstuffed sausage, so tight that wrinkles never formed at all. But I'm starting to see wrinkles again, and I can bend my toes.

As victories go, it probably doesn't rank up there with the big ones - Trafalgar, Pharsalus, Kursk, Midway, Waterloo, the Battle of Britain, Vicksburg, Actium. It doesn't even rank up there with the not-so-big ones - Pea Ridge, Empress Augusta Bay, even French Lick. But it's a big deal to me personally.

This leads me to wonder what the most significant battle in human history was. I think every battle is hugely significant, if only to the poor bastards that had to fight it, and a lot of battles that are considered "great" were in fact meaningless. Cannae comes to mind in this regard - yeah, sure, Hannibal inflicted a terrible defeat on the Romans and killed umpteen thousand legionaries, but in the end, what did it get him? The Carthaginians still lost, Hannibal still went into exile, and today we recognize Roman notions of civilization as the underpinnings of modern civic life, not Carthaginian notions of civilization. For all the good it did Hannibal, Cannae might as well not have happened at all. Another one is the Battle of Leyte Gulf. Huge naval battle, full of stories of sacrifice and courage, especially on the part of the men of the escort carrier group Taffy Three, but even assuming the US Navy lost the battle, Japan would still have lost the war.

I usually vote for the Battle of Poitiers, also known as the Battle of Tours, where Charles Martel and a bunch of grubby Franks defeated Abdul Rahman. It is said that this battle finally ended Islamic invasions of Europe. Maybe, and maybe not. But it did cement the primacy of the Franks in western Europe and paved the way for Charlemagne, and that's pretty dang significant.

The most significant battle in modern history, I think, is the Battle of the Atlantic. I've written about this subject before, but I'll repeat just a little. Given the power of the US industrial economy, and the vast scale of US and Canadian resources, the only hope the Germans had in World War Two was severing Britain and the Soviet Union from their principal sources of supply (points not often noted in the books I've read is how the massive infusion of US-built trucks gave Soviet tank armies considerable mobility in the later years of the war, and how vast supplies of US and Canadian grain allowed the Soviets to draft far more men off their farms than they could have otherwise, not to mention how most of the high-octane av-gas burned in all those Lancasters and Spitfires came from Texas, or how many of those Lancasters and Spitfires seemed to have Canadians at the controls).

So, if the Germans were to have any hope of winning the war, they had to win the Battle of the Atlantic. This comes basically down the question of whether German U-boats could stop Atlantic convoys, or if the escorts could get the convoys through on a reliable basis. And it turned out, they could. Some of my more patriotic associates don't like my notion that it was largely British and Canadian convoy escorts that won the war, but it seems inescapable to me. This is not to say that the United States had no role to play - look at how many of the Royal Navy's escort carriers were US-made, or how many US aircraft the Coastal Command operated. But the point is that the campaign against the U-boats was for the most part planned and executed by the British and the Canadians, though perhaps using a good deal of US hardware.

Besides, it seems obvious to me that the US Navy was always chiefly interested in defeating Japan, not Germany. And it must be said that US Navy fast carrier task forces and submarines went about that task with great and terrible efficiency.

And that, me buckos, is one gigantic digression.

Just In Case

You know, just in case anyone was wondering, it's really awfully nice knowing that I don't have cancer, at least at the moment.

I've been working nights lately, which is interesting. It's very dark and quiet in the plant; I'm basically the only one there. But I get a lot done, and the days (or nights) just fly by, for some reason. It probably has something to do with not having to go to any meetings. There's usually one or two meetings right at the start of my evening, but then it's just me and the code.

And when I get home, the garage is fairly cool and the bugs have largely gone to bed, so I'm able to tinker at the workbench for a while without either sweating myself to death, or having to fight an onslaught of bugs. The other day I opened my tube of white glue for some reason or another, and a stupid wasp crawled right into the spout and became entombed in white glue. Well, better that than flying into my cup of coffee.

I note a lot of mosquitoes these days, though, which I don't like. I'm not sure where they're coming from - there's probably an old tire with water in it somewhere nearby. But every time I hear the whine of a mosquito, I can't help but think "West Nile Virus..." No laughing matter, but I am somewhat relieved by the fact that my immune system is more or less back to normal and I'm not liable to be laid low by whatever virus comes along.

CANCER:

I came, I saw, I kicked its ass.

Who's next?

The Nature of Things

My oncologist says that it is the nature of cancer to grow, to the point that growth is defining characteristic of cancer.

With that in mind, I got my PET scan results yesterday, and they showed no change compared to an earlier scan in April. No change = no growth = no active cancer. It doesn't mean I'm cured, but it does mean that nothing is growing inside me, and as of right now, no treatment is called for. No poisonous chemicals, no horrid bone marrow transplants, no beams of highish-energy X-rays. We wait, we monitor, we observe, and we watch.

It's the best news I've had from a doctor in a long time.

The CT portion of the scan shows widespread tissue damage in my groin - thickened skin, dead nodes, general wreckage. I imagine the tissue there probably resembles the Somme just after World War One. It is this general wreckage that is thought to be responsible for the swelling in my leg, and I find that I can live with that. I'll have to go to a lymphedema clinic to learn how to manage the swelling, and if the leg doesn't drain, I may may have to have some kind of vascular surgery to restore drainage, but that's not so bad.

Vascular surgery I can live with; it's cancer that's a bummer.

I think to celebrate, I may go to a hobby shop on the way to work today and score me some Star Trek models. Can't have too many Trek models, can you?

PET Scan

I had my PET scan today - part of the normal follow-up after radiation therapy, but my leg is also swelling up, so it'll also make sure that my leg swelling isn't being caused by a tumor. Which it might be. Hodgkin's has a lot of symptoms, and for me, my leg swelling up is one of them. But the doctors also think that there's so much scar tissue in my upper leg, leftovers of chemotherapy and radiation and biopsies, that the swelling could very easily be caused by that and not cancer.

We'll see. It'll take a few days for someone to look at my PET scan and decide one way or the other. I can interpret a PET scan; why don't they just give it to me? Liability issues, I'm sure, but I still COULD. It's pretty hard to miss an active cancerous node on a PET scan, unless it happens to be in your liver, heart or brain, which are all pretty active on a PET scan anyway.

I'm not fond of this waiting business, but I find that the more stuff I go through, the less difficult the waiting becomes. Cancer teaches one patience, I guess.

I don't like going to the PET scan place very much. It's one door over from where I got ABVD chemo, and just walking in the front door of the medical center causes my body to tighten up a bit, like it thinks I'm going to turn right instead of left and go get me some poison. And it's hard to look at the cancer survivors with their wispy hair, sunken eyes, and gaunt faces. Even though I was one of them. Am one of them.

You may have noticed that my blog has taken a turn for the geeky lately. This is deliberate. It struck me the other day that cancer or its treatment has invaded practically every part of my life, and there are times (LOTS of times) when I'd just as soon not think about cancer or its treatment. I'm not naive and I know that ignoring it won't make it go away, but as I sit here, there is nothing I can do about cancer one way or the other. And since there's nothing I can do about it, why think about it?

So I rooted around in the castle of my mind and found parts of my life that cancer has never managed to invade. Dumb things, to be sure, but still, cancer-free things. Star Trek. Science fiction goofiness. Physics. I have not, and never will, wear Spock ears to a Star Trek convention, but it doesn't bother me if people think I'm a Trekkie or a geek. There are worse things. (Honestly, which would you rather be called: a Trekkie, or a tandem bone marrow transplant patient? I rest my case.)

I like to think of my mind as being like a castle. Some parts of the castle are airy and open and kind of overly ornate, like Disney recreations of Neuschwanstein or even Versailles, though I suppose there is in strict terms a difference between a castle and a palace. Other parts are darker and grimmer, like the forbidding Krak de Chevaliers in Lebanon. The Trekkie stuff comes from the airier wings; the determination to keep going through chemo even when your body is screaming for it to stop comes from the darker precincts.

Two Weeks

Two weeks of radiation in the books, and so far, so good. Radiation has thus far presented me with no side effects at all, or at least no side effects that I notice above and beyond the side effects of chemo that still persist (neuropathy in my feet and hair-trigger fatigue, mostly).

I still think it's working. My leg feels better. Sometimes it gets a little sore, but nothing like it was. And the swelling still seems to be going down. Not as gratifyingly quickly as when I first started ABVD, but my leg is functional, and that's enough for me.

On a side note: I do believe that from here on out, I'm going to hew to the "country club" model of political debate: I won't tell you about MY political beliefs if you don't tell me about YOURS. Everything is so politicized today I want to throw up. Consider this (only slightly fabricated) conversation:

"Want to go get some lunch?"

"I don't know, what are your views on the Arizona immigration law?"

"I think it's irrelevant to the issue of seeking sustenance."

Nobody ever wants to talk about anything even remotely interesting these days. Nuclear energy policy, SETI, the fact that North Korea blew a South Korean corvette in half with a torpedo, synthetic organisms, annoying Facebook super-users that live way larger than you do, the shambles that is US space policy, the technology of oil wells. It's always the same stuff, over and over, the same Obama Rerangement Syndrome business.

Radiation

A week of radiation treatments is now in the books, and it's safe to say that I think radiation therapy is better than chemotherapy in every imaginable way. It doesn't make you sick, it doesn't take long, it doesn't hurt, it involves lots of cool machines and lasers, and it doesn't leave you feeling like you just got your ass kicked by the entire Bolivian Army.

Will it work, though? That remains to be seen. I have reason to believe that it is working, but I have four more weeks to go, so even if I'm being premature, there's still time.

Botanical news flash: we planted a tomato plant in one of those Topsy-Turvy upside-down planters. Rabbits eat basically everything we plant except for some of the pricklier varieties of cacti, and we thought the Topsy-Turvy would be a good way to grow a tomato plant without just feeding the rabbits. And it actually works - the tomato plant seems happy enough to grow upside down, and the rabbits haven't eaten it. But the birds think it's a sort of amusement park and keep breaking off chunks of the tomato plant as they play.

Can't win. Just can't win. But I don't care. I'm so happy to be going through radiation therapy instead of chemotherapy I just can't seem to work up any outrage about the poor tomato plant.

One last item: I calculated the other day that the energy in a single dose of radiation therapy was the same as having Sigourney Weaver thrown at me at the speed of 0.52 miles per hour (I picked her because I've always liked her as an actor, and she seems like she'd be merciless and ruthless to cancer cells).

3DCRT

Turns out I'm having "three-dimensional conformal radiation therapy." Sounds like something they'd do on Star Trek. "Scotty! I need you to emit a three-dimensional conformal x-ray beam from the main deflector dish!" And Scotty wails "Ach! Me bairns!"

The whole point of conformal radiation therapy is that a computer builds a model of the tumor, which is then used to steer the beam so that the radiation primarily impacts the tumor and not normal tissue ("conformal" means, I guess, that the pattern of radiation exposure "conforms" to the contours of the tumor). This allows the doctors to increase the intensity of the radiation, inflicting maximum harm on the tumor while sparing the neighboring tissue from undue harm.

While I'm on the subject of Star Trek... I really did enjoy the new Star Trek movie - it was amusing and entertaining and, in most respects, a faithful homage to the original. But did they really have to destroy Vulcan and spawn another damn alternate timeline? Those things are the bane of Star Trek - you need a wall chart and a ground spotter to keep the timelines straight. And why Vulcan? Was it destroyed just for sheer goshwowness? Couldn't they have written the story in such a way that they didn't destroy such a fundamental part of the Star Trek universe?

And why, while I'm at it, does Spock's little whirligig spaceship leave an actual damn exhaust plume? The fastest ship known to 23rd Century Vulcan science leaves smoke trails? I don't think so. Hell, we've known since about 1965 that smoke trails are a serious liability in air combat (and, presumably by extension, space combat). The North Vietnamese almost didn't need radar at all to track US F-4 Phantoms; all they had to do was keep an eye on the sky and look for the characteristic black smoke trail from our J-79 engines. Elimination of smoke trails from missiles and jet engines wasn't the only goal of subsequent work, but it was a goal.

But don't get me wrong, I did like the movie. I just think that the annihilation of Vulcan is a symptom of the same tendency toward self-one-upmanship that afflicts later seasons of Lost. I eventually had to give up on Lost for that very reason. Well, that and the fact that it started out mysterious and kind of eerie, but then turned incomprehensible and, if you ask me, kind of irritating.

But anyway. The point was three-dimensional conformal radiation therapy. I calculated yesterday that a 45 Gray dose of X-rays is equivalent in terms of energy to dropping a ten-pound cannonball from a height of 39 inches. That should get the job done - I hope.

Barbus Magnus

Doesn't that mean "Great Whiskers" in Latin? Something like that. Here we have a cell phone camera self-portrait of moi, snapped after getting in the car at the end of my day at work - hence the hang-doggishness of the whole thing. I do draw your attention to my whiskers. No great shakes in the beard department, but since I haven't grown so much as a single whisker in months, this counts as a pretty significant eruption of hair.

The better news is that thus far I have no lumps, bumps, tumors or weird symptoms, which is better than growing hair. Trust me on that.

It could just be me, but I don't think I look like someone who's been through a year of chemo. I seem insufficiently grey and pasty for that. But I'm not complaining.

Baxter

I miss Baxter, our goofy orange cat. I'm allowed to play with the dogs a little, but so far I'm not allowed to be near cats. Apparently, despite their reputation for cleanliness, cats carry litter box residue on their paws and are for now pets non grata. Baxter has been confined to the spare bedroom while my immune system gets itself worked out, and I haven't seen him for months. The other day I crept into his bedroom just to see him, and found him sleeping in the closet, on top of a pad of foam rubber we bought for one craft project or another. He looked up at me, blinked, and hissed.

Fine, you little fink. I risk deadly infection to see you and you hiss at me? Jeez.

Meantime, I'm suffering from a horrible attack of nausea. Chemo, the gift that keeps on giving.

Tubeless

I had my last Borg implant removed last week. The central line in the left side of my chest was removed quite some time ago, but I had the central line (technically a Hickman catheter) removed from my right side last week.

It's an amazing procedure. Now, bear in mind that the Hickman catheter consists of a plastic tube that goes up into your neck and then down into your superior vena cava, terminating just above the heart valve. This is as deeply embedded in one's circulatory system as anything can get. And how do you think they remove such a thing?

They grab it and yank it out. It's amazing to me that they could yank this thing out of my jugular vein without microsurgery and electrocautery and whatnot, but they not only can, they did. And it didn't even bleed. It was painful, but only momentarily, when the scar tissue let go.

Now I have groovy scars on my chest that look like old gunshot wounds, and it's ever so much easier to take a shower.

My Latest Bullshit Theory

I feel terrible today. I felt terrible yesterday, but today I've felt easily as bad as during the darkest days of chemo. But I have a theory. It's probabl a bullshit theory, but a theory nevertheless.

We know that the cells that line the digestive tract suffer heavy damage from the act of digestion and tend to die off and reproduce with some haste. Most of the time, the cells are arranged in mixed generations so there isn't a massive die-off at one time; instead the cells croak a little at a time and the host never realizes what's going on.

But in my case, I think chemo wiped out most of my randomized generations of epithelial cells. I've got basically one generation, and when it dies off en masse, I go downhill. It's been about seven weeks from my last chemo, so I'm speculating that my epithelial cells tend to die every three and a half weeks. We'll see how I feel later in August and see if my theory is complete crap or not - or maybe by then the generations will have randomized sufficiently that I don't notice this sharp decay in how I feel.

I have a swelling in my neck. I found it the other night, and it scares me considerably. It feels just like a Hodgkins node, with one exception: it hurts when I press on it, which Hodgkins nodes (generally) don't do. I think it's just a muscle strained from moving all the gravel last weekend, or maybe I just hope it is.

I think I'm going crazy.