Another way to understand chemo

One of the friends who comes to our dramatic Thanksgiving dinner, Peter, is a biologist who used to work at Genentech, the California biotech company that developed the monoclonal antibody, Herceptin, that is part of my chemo regimen. Actually, monoclonal antibodies are not exactly “chemo,” but never mind.

Peter says that at one point, Genentech scientists attached some sort of marker to chemo drugs so that they could see how the drugs traveled through the body. He says when you watch a video of this, the drug comes in through the IV, then is shunted quickly to the heart. Then, pump-pump-pump, the heart pushes the chemo out and it billows out to every artery and vein in your body. And then, almost as quickly, most of it gets shunted into the bladder. Aha! So that’s why I’m always rushing to the bathroom with my IV pole about halfway through a four-hour chemo infusion.

So, how does the chemo work if it’s in the body such a short time? Well, it turns out it’s kind of like a drive-by shooting, or a sleeper computer virus. Most chemo drugs mess with the DNA of cells. So the chemo passes by most of the cells in your body over the course of an hour or two, throwing a molecular wrench into a cellular structure that’s key to cell division. The old-line platinum drugs, like the Carboplatin I’m taking, damage “micro-tubules” that are key to RNA. RNA, in turn, is key to pulling chromosomes apart so that they can make copies of themselves to be used in newly-divided cells.

The damaged microtubules set off a crisis in the targeted cells. They try to divide, and try to divide. After seven to ten days of this, the cells give up. If they can’t divide, they die. That’s when your hair falls out, and that’s also when you have the lowest white blood cell count, the “nadir” at which you have to be most careful about washing your hands and avoiding direct contact with toddlers and public bathrooms. It’s when even a mild temperature, say 101F, is a go-straight-to-the-ER ticket.

I love this image of chemo as a hit-and-run. I’m reluctant to say that it’s a “fun” idea, because little about cancer is a laugh riot. I’m writing this two days after a chemo infusion and I feel like my head is full of cement. My stomach is doing back flips, I have a headache and no energy. I have no idea how I will ever get ready for Christmas or unpack the last of the moving boxes. But this new way to understand chemo makes me smile. Take that, cancer cells!


About leftbreast

I have had breast cancer. I was diagnosed at 47, and am now 49. I have finished "active treatment," two surgeries, chemo, radiation, monoclonal antibodies. These days, I only take a drug to suppress my uptake of estrogen, since my tumor was highly reactive to that hormone. I have been married to my husband Pete for 21 years. I have a stepdaughter, Maureen, 30, and a daughter, Erin, 10. I've been a freelance magazine journalist for 20-plus years, covering everything from Chinese foreign policy to Catholic nuns to endangered species. I have had a great life. I have lived in Asia and all over the United States. I have spent nights with tree-sitters in Oregon and with astronomers at the Mauna Kea observatory in Hawaii. I've been to a cocktail party on the poopdeck of a British destroyer docked in Shanghai. I've taken the bus to Tibet, and tramped through the cloud forests of Panama with biologists. A magazine sent me on a raft trip down the Colorado through the Grand Canyon; another sent me to cooking school for a week. I have spent time with celebrities, presidents and heroin dealers. I love my work. I have a loving, supportive family and more friends than I probably deserve. I have had the space and time to camp, ski, cycle, garden, cook and spoil my pets (an Australian shepherd, a German shepherd and a tabby cat). If it all ended tomorrow, I would have to say that it has been a really, really good ride. When I was in thick of treatment, I was simply fighting for more time. Now, I'm trying to connect the experience of cancer with the rest of my life, with the time that's been won. I hope the cancer never comes back, but if it does, I'll be ready. That's what this blog is about.
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6 Responses to Another way to understand chemo

  1. I love your drive-by analogy to cancer. Take that cancer indeed! For some reason, your vivid and powerful description makes me think of the drive-by shooting scene in the classic, Some Like It Hot. In the case though of your cold cap, it’s a matter of some like it cold.

  2. urbandecaydance says:

    I have to say that is a very light-hearted way to look at how the drugs work. I was just imagining the drive-by shooting of cells and it was probably the most, reluctantly spoken, hilarious of mental images. Kudos for sharing that with us! My friend just went through Chem for Thyroid Cancer and she never talked about it. I wish I had seen this before, so I could say please talk to me, and have shared this with her.

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