Monday, October 12, 2015

The third cycle of chemotherapy

Chapter 10 – Mid-way through Cycle 3
As I said in my last post, my doctors suspended my chemo pills for a little over a week, and delayed the cycle-3 infusion by one week. Wow, it was lovely! Within 24 hours of stopping the pills I could feel my body's self-healing working again. The mouth ulcers healed up. My runny nose stopped being runny. I would be in great shape if it weren't for the chemo!

In the one-week gap, the hospital arranged for me to have an extra gastroscopy for the benefit of a research project I'm enrolled in. The project (called OCCAMS) is about attempting to measure the progress of a cancer by measuring tiny DNA signals in the blood. (Whereas some of my friends with cancer have cancer-markers that can be measured on a weekly basis, to reveal how things are going, in my case we are flying blind - there is no measure of cancer-up or cancer-down.) To help them use my blood in the study, they wanted to genome-sequence a sample of my cancer cells. So I popped in to a special research ward for an extra gastroscopy, which went smoothly. I'm looking forward to learning which mutation started the cancer - one fascinating thing I learnt about cancer is that a single gene, called TP53, is mutated in more than 50% of human cancers! Conceivably, knowing about the genome of my cancer might help me look into novel targeted therapies that might work better than the blunderbuss that is conventional chemotherapy.

Cycle 3 has been going a bit better than cycle 2. I have developed a runny nose and a cough again, but not quite so runny and cough as last time. My left-arm vein, which they infused me in for cycles 1 and 3, is sore and tender. I feel quite tired a lot of the time, but I have been getting some good work done. The pinnacle of the last year, from the work point of view, came last Friday when I went down to London for a press briefing for a Nature Comment piece that I wrote with Stoft, Cramton, and Ockenfels. As I said on my other blog, I view this article as the most important thing I have ever written. When I wrote Sustainable Energy - without the hot air, I wanted to improve and transform the public discussion of energy options, and I was delighted with the outcome; but that was just a book about energy arithmetic, and lots of other people have explained energy arithmetic before me and since me. Our Nature Comment, in contrast, makes a point that very few people are making, and if people listened carefully to our argument, I think it could be a game-changer for international negotiations.

I was really happy with how the press briefing went, and the Comment was published today. I'm grateful to the staff at Nature for recognising that we had an important message and helping us express it clearly in one and a half pages.

Anyway, halfway through cycle 3... What's coming up this week is a pneumonia vaccination, a check-up with my GP, a flu vaccination, and a CT-scan at the hospital to measure the unmeasurable (i.e., my cancer, which as far as we know doesn't show up on CT scans).

Apart from these four exciting outings, I'll mainly hunker down and work at home.

I'm eating well, and have a good appetite for snacks during the day as well as mealtimes. I've got my old juicer working and have been making lovely apple and carrot and ginger juice daily. I still feel tired and grey much of the time, and I do find myself wondering whether I'd be better off stopping chemotherapy.

At some point I think I will put some effort into researching the latest news about targeted cancer therapies. I've heard about quite a few - monoclonal antibodies, aspirin, warfarin... - but right now I can't be bothered to do the reading.

Instead I'm working on another work project - a completely different project, all about statistics, international standards, and how poor statistical protocols incentivise falsification of data.

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