Chemotherapy Round 1.

Until two weeks ago if you asked me what chemotherapy was I would have told you it was some kind of medicine you give bald kids in hospitals. I've figured out a few more things since then which I'll share with you. First, 35 year old hairy men get chemo too. Second, the term chemotherapy encompasses dozens of treatments consisting of different cocktails of anti-cancer drugs. The drugs target cells which are in the process of dividing, and if there is one thing monkey faced cells are good at doing it is dividing rapidly and gumming up your lymphatic system. Hopefully, if things go well you kill off more cancerous cells than hair cells or heart cells or whatever.

I started my treatment yesterday with the ABVD regime. Each letter stands for a drug. Adriamycin, Bleomycinm, Vinblastine and Dacarbazine. They come from the weirdest places. Vinblastine for instance is only found in a tiny African flower called the Madagascar periwinkle. I find it amazing that an obscure little plant from an island I'll probably never go to will save my life. Thanks periwinkle.

The photo above illustrates roughly what goes on in a chemotherapy session. Except instead of a Bacta tank there is just a regular bed, and instead of robots there is a nice nurse from Bury St. Edmunds named Lorraine. And unfortunately I had to leave my trousers on the whole time.

The nurse inserts something called a cannula into the veins in your hand, which is basically a needle with some tubes hanging out of it so she can easily switch between the various drugs. She then gives you a bunch of steroids and anti nausea pills and then you wait for a bit. First up was Adriamycin, which was injected into the cannula with a big needle. It felt cold and turns your piss the colour of cranberries. Then came Bleomycin and periwinkle juice (meh). The only discomfort came from the giant IV bag of Dacarbazine, which dripped for 40 minutes and felt like someone was shooting freeze dried icicles up my vein. Putting a heating pad on the arm seemed to relieve things. And that was it. I just went home and watched movies. So far no side effects, nausea, tiredness, death etc. It's basically just wait and see how the cancer responds.

Hasselhoff points

 I like math, there's a certainty about numbers that you don't get from politicians, lovers and real estate agents. What's 8 times 8? 64. Always. Not 64 before an election but 65 afterwords. Not 64 but you don't call me enough and the love is gone. Not 64 but it could be 63 if you put down a 15 % cash deposit. You can count on math. So I asked my doctor about the mathematical chance of me making it through this thing and he told me all about the Hasenclever index. In the Hasenclever system, you get points for bad things about your lymphoma, and every point reduces your chance of survival by 7 %. The aim of the game is to score as low as possible. So let's add them up.

I get 1 point for being a man, because Hasenclever was a man-hating German. None of my tumours is greater than 10 cm in diameter, so no points there. All the cancer is above the diaphragm, so sorry Hasenclever, nil for you. Thick blood? Nope, 0 points. Lots of white blood cells? Damn, you got me there Hasenclever, my blood cell counts are bustin'. Point to you. Cancer in my bones? No. Older than 45 years? Not a chance. That's two Hasselhoff points for me out of a possible 7. So that means there is an 85 % chance I'll be alive in 5 years. I'd prefer it to be a little higher, but I appreciate the honest answer math. You will always be 100 % alright with me.

Scan results

 I got the data files for my PET scans from the hospital and made some images. Let's take a look inside me shall we? Yep, there's a whole bunch of ribs. Looking nice and ribby. A pelvis, nothing too much to worry about there. I've got a spine, a bright red brain, and a....  JESUS MARY AND JOSEPH WHAT THE SHIT IS THAT RED BLOB BY MY HEART?!!? That's not at all right. That thing is like the size of a fucking grapefruit. Like alien-popping-out-of-your-chest huge. How do I even breath with that thing in there? No wonder I can't stop coughing.

The doctor told me it's pretty standard for Hodgkin's, and placed me at an early to intermediate stage of the disease (IIA, non bulky to be precise).  He said he's treated patients where the tumors have taken up 1/3 of their chest which freaks me out a little. I read a blog about this guy who had a football sized tumor that burst and then he puked up a sink full of blood and almost died. So on a relative tumor scale I guess I'm doing alright, but it's a little disconcerting to have an evil twin made out of cancer growing inside my thoracic cavity.

And, uh,  I apologise for the strategically placed hotdog but it was really cold in there.

The Man Bank

There are lots of bad things about chemotherapy. You could go bald, become bloated/emaciated, break out in sores and rashes, experience periods of nausea and vomitting, lose your sense of taste, have your fingernails thicken and discolor, and your urine turn red. An oh yes, it makes you sterile. Usually fertility comes back after treatment is over but in some rare cases it doesn't and you've lost your chance to contribute to the gene pool forever. For some people this would be a wondrous gift to humanity (I'm thinking of you Russell Brand, you shaggy haired twat). For me, I'd like to keep it as an option.

So off I go to the fertility clinic to make a deposit at the man bank. I imagined a waiting room full of hairy knuckled sex pests in trench coats but it was mostly nice middle aged couples waiting for IVF. The alarmingly well manicured German doctor took me off into a room for a little chat, and then handed me a nondescript, tube-shaped plastic container and told me to go to work. Thankfully he left the room first.

I was told before the appointment that if I wanted some 'inspirational material' I'd have to bring it with me. Now I know this is an era of budget cuts and austerity and whatnot but really, can't the NHS afford a dog-eared copy of "Jugs" or "50 and frisky" or something? The fate of future generations of British taxpayers depends on it. I must remember to write my MP about this, it's a killer campaign issue.

EDIT: I've now visited the man bank again and have enough genetic material on ice to repopulate the world after the apocalypse comes, which was the whole point really.

Radioactive man

The next step in this thing is to get properly staged. Cancer has four stages, which tell you how far the disease has spread around your body. Stage I means it's localized in one area, while stage IV means that your body is essentially swiss cheese except instead of holes there are tumors. Accurate staging is important because it means the doctors can choose the best treatment for your particular case.

Today I met the lymphoma specialist who will be looking after my treatment. His name is Dr. Follows, and he has nice hands but sadly no moustache. He sent me for a high-tech PET scan at the hospital. As scary as cancer is, you get to see some pretty amazing technology in action. In a PET scan, they inject you with a radioactive tracer, which decays via positron emission, eventually yielding two 511 keV gamma rays that fly off in opposite directions and are picked up by a detector. This is cool physics. Apparently monkey face cells hog all of the radioactive tracer, so wherever the detector sees gamma rays, that's where the cancer is. The scanner is basically like the picture up there except it has a hollow tube that you lie in for 30 minutes with your hands over your head. I spent my time thinking of hamburgers because you are not allowed to eat for 7 hours before the scan and I was starving. So now, I wait two days for the results and a follow up meeting with Dr. Follows. In the meantime I am radioactive and am not allowed to be around pregnant women and small children which totally screws up my plans for the afternoon.

Top Tip: If you don't like needles and you get bored sitting around in waiting areas for hours at a time listening to Cheryl Cole hits on the radio then I would strongly recommend avoiding cancer, since you'll experience plenty of both.

Buck-toothed monkey face syndrome

I am a scientist, so I like to understand things. Since I have a bit of time off work I've been reading through the literature to try and figure out exactly what is wrong with me. Well, there a lot of things wrong with me, but we'll just stick to the Hodgkins. Basically it's a cancer of the lymphatic system where the body screws up the production of a certain kind of white blood cell called a lymphocyte.

Let's take a close scientific look at one of these cells. The figure above shows a healthy B-cell on the left, and one of the screwed up cells that are gumming up my lymph nodes on the right. I'm no medical doctor, but I think I can see the problem here. My cells are missing that little thing that looks like a purple straw sticking out the bottom. Ditto for the yellow Q-tip on the left, and the Y-shaped stick on top. Apparently someone forgot to water the little red beansprout because it didn't show up. No sign of Blk, Syk, Lyn, SHIP and the rest of those orange assholes. They couldn't even be bothered to get out of bed. Thank God we've still got the carrot thing on the bottom right, otherwise I'd be totally screwed. The pieces of cucumber sticking out over there look fine too. Nice job guys. On closer inspection my cells look like a bit like a buck-toothed monkey face. I know I'm going to spend the next few months in a doctor's office hearing 'blah blah Nodular Sclerosing Hodgkin's Lymphoma" but in my head I'll be hearing "blah blah buck-toothed monkey face syndrome".

Some news of the not so good variety...

So it turns out that the cough I've had for the past few months isn't a persistent chest infection. Surprise, it's cancer! Nodular Scleorosing Hodgkin's Lymphoma to be medically precise. My GP was on the ball, after various attempts at controlling my cough with antiobiotics failed, it was straight to the hospital for an x-ray which picked up the swollen lymph nodes in my chest. It took about a month from that point and a battery of blood tests, lung function measurements, a CT scan, further chest x-rays and a needle biopsy on my neck to be sure. I had a look at some swollen nodes with the ultrasound technicians and as far as I can tell they look like the stuff in the bottom of bubble tea.

So that's it. Last week I was a guy with an annoying cough, now I am cancer patient. I thought I'd put together this blog for my friends so that they can keep track of my treatment and stuff. And also because I am too lazy to write you all individually. If you're not my friend you can also read this too, but let's be honest, you probably should find better ways to spend your time.