Cancer and Me

“Congratulations!”

“Er, thanks — what for?”

“For beating cancer!”

Congratulations are certainly due but not to me. I was just the patient; all I had to do was be on time for my many medical appointments, follow my oncologist’s instructions and avoid crowds following my chemo infusions while my immune system was recovering. The real heroes are the pioneers who, some 30 years ago, figured out which cancers respond best to which treatments involving IV infusions. (“Not poisons,” I was gently reminded on my first visit to the chemo ward, “We don’t use that word here.”)

I lucked out big time. What originally was thought to be an infected mouth ulcer turned out to be large B-cell lymphoma. That was found in the biopsy recommended by another hero, a physician’s assistant at Open Door Community Health Center who was suspicious of my original diagnosis. A PET scan followed, confirming lymphoma both in my jaw and trachea. Three chemo treatments and several months later, a follow-up PET scan recently gave me a clean bill of health.

While the literature is full of militaristic terms when it comes to cancer — we battle it, it’s the enemy, if treatment succeeds, we’ve won a victory — I find it hard to think of my cancer in such terms. After all (with a few viral exceptions), our own bodies create cancer with no outside assistance. Each second, some four million cells in my body divide to create two identical copies of themselves. Mostly identical. Nothing’s perfect and sometimes — fortunately for us — a mutation occurs. Fortunately because without mutations, life would still be stuck as it began on Earth. But because some copies are mutations slightly better adapted to their environment, they have the edge over their non-mutated siblings when it comes to reproduction and survival: Darwinian evolution. And here we are, 4 billion years later.

Along with mutations leading to more complex forms of life (good, from our POV), mutations also result in abnormal cells that have the potential to invade and spread to other parts of the body (bad). Cancer cells are different from normal cells. While normal cells obey certain rules — they need to be “told” when to copy themselves and when to die off — cancer cells are rogue desperados, subject to no laws but their own.

Chemotherapy takes advantage of these differences, in particular the fact that cancer cells divide much more frequently than normal cells, which is how they can spread uncontrollably. Because both normal and cancerous cells are most vulnerable when they’re in the process of dividing, most chemotherapy drugs work by disrupting cells during this part of their life cycle. (Other less potent chemo drugs kill the cancer cells directly.)

Since chemotherapy drugs can’t tell the difference between normal (healthy) cells and cancer cells, the treatment also damages normal cells, causing side effects such as fatigue and nausea. But while normal cells recover over time, the more vulnerable cancer cells don’t. That’s the theory, anyway. The trick with chemo is finding the balance between killing cancer cells and sparing normal cells.

In my case, I received a tried-and-true chemo cocktail known by the acronym B-CHOP, with each batch of infusions taking five to seven hours in Providence St. Joseph Hospital cancer wing. While the hospital has been getting a bad rap in our local media lately over Providence’s abortion policy, I can’t say enough about the care I received from my oncologist and the staff in the hospital’s oncology department. I’ll be under surveillance for several years, with regular PET scans to check for a return of the lymphoma, but for now I’m one of the many post-cancer patients who can thank modern medicine for resetting my body back to “healthy.”

Barry Evans (he/him, barryevans9@yahoo.com) was told by his oncologist that his only real risk factor was his age, 82. Apparently, that’s considered “old.”

This article appears in ‘A Big Family’.