Chapter Two

Dear Friends,

Chapter Two…

…….…prior to which our Narrator…
1. …received cautious news that his colon cancer was “in remission”. Hearing this…
2. …he was unaccountably reluctant to share the news or blog about it; when…
3. …shortly (3-4 months later) during a carefully aggressive monitoring using CT scans and followup PET scans, doctors discovered that two marble-sized colon cancer tumors had lodged and grown rapidly in the nourishing environment of his liver, far from easy access to surgical excision; in response to which…
4. …able surgeons, stubbornly immune to mere logistical difficulties, responded with rapid alacrity and admitted our Narrator—almost immediately after discovery of the tumors (and just before Christmas)—to the hospital, to undergo a long and complicated liver resection operation to remove the tumors; in response to which…
5. …Monica and I await our oncologist’s recommendations about next steps; and…
6. …we continue, prayerfully, to stumble into the unknown future.

Detail

I don’t have the necessary medical training to possess easy command of the proper terminology and vocabulary, but… following are a few of the most important things I believe we are, today, understanding about cancer:

Genesis

Microbiologists now understand that specific cancers (there are many different kinds, each with their individual characteristics) have insinuated themselves into the fundamental genetic construct of our DNA. It is quite possible that the initial insinuation into our human genome took place thousands of generations ago. If this is correct, then cancer (which Siddartha Mukerjee defined in his admirable and thorough recent “biography” of cancer as “The Emperor of all Maladies” has, perhaps, co-existed with us humans for millennia. This evokes a very different awareness of Pogo’s “We have met the enemy, and he is us.” The various cultural metaphors that claim that both good and bad resides in each human being are also thus vindicated in the physical biological realm and put in shocking high relief.

Action

Oncologists have long studied the behavior of cancer cells and their unbridled growth. Cancer cells exhibit a unique attribute in that, once stimulated into activity, they appear to lose a normal cell’s inborn mechanism eventually “to die” and cease activity. It is as if cancer cells have discovered a way to achieve a kind of immortality. Indeed, cell biologists, today, study cancer cells in their laboratories that have directly descended from cells originally taken from one woman, a patient who, herself, died, now, decades ago! Certain chemotherapies exploit this constant and rapid replication by targeting rapid cellular growth as loci at which to deliver toxic chemical substances designed to kill the cells. Refinements are continually sought to distinguish the rapid replication of dangerous cancer cells from the rapid generation of beneficially evolving cells like hair follicles or digestive wall membranes.

Apart from the incontrovertible biological evidence about the workings of cancer cells, there are cultural echoes, again, principally in mythology, cautioning against the lure of the “fountain of youth” or describing the unintended consequences of Midas’ touch.

  Pathways

A focus of increasing attention for epidemiologists are the biological/cellular pathways through which cancer cells appear to communicate with one another to “stimulate” (one might be inclined to use the word “infect”) other cells. In my case, for example, it came as no surprise to my medical professional care-givers that my colon cancer reappeared, next, in my liver. There exists ample convincing evidence that this is one of the preferred evolutionary pathways colon cancer, particularly, exploits. Just what mechanisms enliven the pathways or stimulate the transmission of cancerous activity at one spot in the body to another are not yet known. The identified preferred pathways exist, at least, as promising targets for future research and therapies.

Stimulants

Finally, biologists are beginning to identify what substances, chemicals, infinitesimal elements can stimulate dormant cancer cells to “life”. These stimulants are more properly known as carcinogens. While the list of known carcinogens is growing (cigarette smoke, second-hand smoke, asbestos particles, certain petrochemicals, soot, some foods, etc.) precisely how they evoke a response in cells that appear to lie in wait in all human beings, why in some and not in others, in what concentrations or under what circumstances, is all rich ground for the minting of future MD’s and PhD’s.

So, for the time being, I will be subject to, perhaps crude, certainly experiential, therapies and remedies that will be prescribed by young doctors and clinicians who wish to find the proper therapies as much as I wish for them to do so. I cannot compete with their sophisticated understanding of what I’ve crudely outlined above, even though I can, perhaps, grow in my appreciation of what scientists have come to understand and how dreadfully complicated is what is not yet known. Be that as it may, I am confident and happy to turn over the care of my medical condition to the experts who have generously eked out a career in this forbidding territory.

What I may be better able to learn from, for my own well-being, if not specifically my body’s, is to examine the cultural and spiritual echoes that seem to resonate and whisper with each scientific discovery.

We’ll see… in future cancerblogs.

Chet