Friday, May 15, 2009
MRI Results
Which is, of course, excellent news. Except for two little things:
First, it doesn't explain the whole dizziness issue, except that I guess it really is stress, and I should see my dentist about fitting me for some kind of device to wear at night to relax my jaw and facial muscles.
And second: Mary, this means that the MRI Collage we had planned for the summer is going to be a little less colorful....
Tuesday, May 12, 2009
Everything Gives You Cancer
The title comes from a great song by Joe Jackson, as Dowling mentions.
The world is not a place for the meek, becoming paralyzed with fear when things seem difficult. It's enough to make Bill Rodgers skip a run and go back to bed.....
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Everything gives you cancer
In a world where even joss sticks and broccoli are said to be carcinogenic, Tim Dowling spends a day trying to avoid a tumour
I wouldn't say I've courted cancer exactly, but I have hitherto been pretty heedless of the warnings. Now, however, I have reached a stage in life where I think it may be time I stopped meeting cancer halfway. Fresh from a three-week holiday that combined lashings of alcohol, lashings of stress, plenty of sun, a good deal of red meat, a lot of passive smoking and a certain amount of aggressive smoking, I think perhaps I should try to be a little less helpful to cancer. At the very least I could avoid known carcinogens, even if for just one day. I resolved to give it a try.
My first mistake came shortly after waking up. Toothpaste, I have since discovered, contains several compounds (fluorides and sodium lauryl sulphate among them) that are at least suspected carcinogens, as do shaving cream, soap and shampoo. Breakfast, as well as being the most important meal of the day, is also a cocktail of cancer-causing substances. Heterocyclicamines - highly mutagenic, possibly carcinogenic - are created by cooking or burning foods, and are commonly found in coffee and toast.
Aflatoxins, produced by naturally occurring fungi, are found in small concentrations in milk and cereal. Aflatoxin B1, the most deadly of all the aflatoxins, has been shown to cause cancer in mice, rats, hamsters, rainbow trout, ducks, marmosets (this is a partial list, by the way), tree shrews, guinea pigs and monkeys. Luckily, breakfast is not the most important meal of the day to me, so I'm happy to skip it.
It quickly becomes clear that total carcinogenic abstention is more difficult than it sounds. When that noted oncologist Joe Jackson first proclaimed that "Everything/Gives you cancer", I think most people understood him to be speaking about all the good things in life -smoking and drinking and red meat and DDT-based pesticides. But a quick look at even a partial list of known human carcinogens proves that he may as well have been speaking literally.
Going out in the midday sun presents an obvious risk, but thanks to the radon seeping into your home from the soil below, so does staying indoors. Taking to the air is no better: high-altitude flights routinely expose passengers and crew to radiation, and the free peanuts, with their traces of carcinogenic fungal toxic metabolites, aren't much help either.
Shortly after not having breakfast, I decided to retreat to my office at the very top of the house, the furthest I can get from cancer without getting cancer, where I read up on the 15 known carcinogenic substances commonly used in roofing material.
Hunger eventually drove me back to the kitchen, with an eye towards whipping up a cancer-free salad, but here again there was no escape. While the risk of getting cancer from fruit and vegetables remains small, most of that risk is said to come from naturally occurring carcinogens, generally the organic pesticides produced by the plants themselves to keep predators at bay. Broccoli, apples, onions, oranges, strawberries, lemons and mushrooms all contain acetaldehyde, a natural by-product of oxidation and a known human carcinogen. If you close your eyes you can practically taste it.
Nitrates - which can be converted by the human body into carcinogenic nitrosamine compounds - are present in such seemingly inoffensive foods as celery, lettuce, kale and rhubarb. Nitrites, halfway to being nitrosamines already, are found in cured meats. There are carcinogens specific to tap water, basil, beer and mustard. Cancer-causing PCBs are found in varying levels in all foods. It is generally accepted that there is no such thing as a diet free from carcinogens, so there's no point in worrying about it, although it is unclear how the second part follows from the first.
It's well known, of course, that certain foods have anti-carcinogenic properties: organosulphur compounds, flavonoids, tannins and carotenoids have been shown to inhibit some forms of cancer. Unfortunately, these anti-carcinogens tend to be found in foods that also contain carcinogens - well-known killers such as broccoli, onions, strawberries and cabbage. Even while these vegetables are preventing you from getting cancer, they are giving you cancer.
Ingesting carcinogens directly is now regarded as a rather old-fashioned way of getting cancer. These days, simply exposing oneself to one's environment for prolonged periods - what used to be known as standing around minding your own business - is plenty carcinogenic enough. Diesel exhaust, asbestos, the formaldehyde in ordinary home air and crystalline silica of respirable size (ie dust) have all been listed as carcinogens.
You can get cancer from the wax on your floors, the paint on your walls and the dyes in your shirt. We are all constantly exposed to vinyl chloride, a gas emitted by PVC plastic, which is sometimes known as new-car smell. Then there is isoprene, which the US National Toxicology Programme describes as "reasonably anticipated to be a human carcinogen". Isoprene is emitted by rubber products (natural and synthetic), automobiles and trees, and is commonly found in exhaled human breath. When you breathe in you get cancer; when you breathe out, you give it to someone else.
The popular idea that absolutely everything gives you cancer is finally confirmed by the fact that many cancer treatments, such as cisplatin, are themselves known to cause cancer. So even while you are dying of cancer, you may also be getting cancer. This is somehow a less worrying prospect, a bit like finding out that mustard gas is carcinogenic (which it is).
If you are ever unsure as to whether something you're doing or eating or inhaling is giving you cancer, the internet is always there to confirm your worst fears. Go to any search engine, type in the name of any common product or substance (herbal tea, nail polish, jellied eels, fabric softener), then type in cancer and hit the return key. You won't be disappointed.
Ultimately, however, this notion that all things are carcinogenic is misleading; risks vary wildly depending on dose, length of exposure and countless other factors. Most "known carcinogens" have only been tested on animals, in huge concentrations. Some of these substances cause tumours in mice, but not in rats or hamsters. In any case, most of them are unavoidable. You can't stop drinking water, or breathing air.
In short, one can do little to avoid cancer apart from the obvious: the vast majority of preventable cancers are caused by smoking, drinking and poor diet, which also just happen to be the major causes of dying from things other than cancer. Mildly carcinogenic vegetables are the least of your problems, and it's doubtful that anyone ever got cancer solely from eating broccoli. But because luck also appears to play a big part, cancer tends to inspire more superstition than any other disease. I realise I'm running a huge risk of contracting cancer just by writing about it. I think I'll stop here.
Saturday, May 9, 2009
Happy Mother's Day
As a Mother's Day tribute, here's a link to a video by an FoLBB (Friend of Lympho Bob Blog -- I'll give you a hint: he's a lymphoma survivor) that I think perfectly sums up how all of us feel about mothers.
Click here for your tribute, moms.
Friday, May 8, 2009
Another Good Visit
As usual, he did blood work, and everything continues to be within normal range. He did a physical exam, and thinks the most active node cluster might be a little flatter, if not smaller -- certainly not bigger. All of that is good news.
The only area of concern is one that I brought up. I'm still having the slight dizziness every now and then that I've been having for close to two months now. Dr. R wants to get it checked out. I have an MRI scheduled for Tuesday.
I've been to an Ears/Nose/Throat doctor about it, and a few weeks ago, the ENT did some tests. He found nothing -- brain, inner ears, eyes all seem to be functioning just fine. His best guess now (as it was a month ago) is that it's stress-related. Jaw and facial muscles can tense up, causing imbalance and dizziness when the pres against the inner ear (or something like that). I've been to the dentist to talk about getting a device to wear at night to keep my jaws relaxed.
A diagnosis of "stress" seems to me to be the kind of thing they say when they don't know what else to say (like the pediatrician saying "it's a virus"). I was actually doing much better with the dizziness until Wednesday night, when it flaired up again, which maybe gives some support to the whole stress theory (as an oncologist appointment comes up).
Dr. R thinks it could be stress, or it could be a bunch of other things, though it's unlikely to be lymphoma-related. Still, he'd rather be sure (and maybe take off some of that stress) by getting some pictures. I'm good with that. I'm not much of a fan of MRIs -- too squishy in that tube -- but it's better than another barium milkshake and intestinal distress. Plus, it's at 10:45, so I can go for a nice big pastrami sandwich at Katz's Deli across the street when I'm done.
Mmmmm....pastrami.....
Thursday, May 7, 2009
That's What You Do
Rodgers is a prostate cancer survivor. Here's what the article says about how he got the news:
Aside from the broken leg at 55 and a bout of plantar fasciitis at age 40, Rodgers hadn't a single health problem in his adult life. He was in Barbados for a 10-K in December 2007 when his doctor called with grave news: Rodgers had prostate cancer. "I was with a couple of friends, and we were having a lot of fun," he recalls.
"And as soon as I got that call, I was like, 'What now?' You don't know what the hell to do."
So what did he do?
"I ran the 10-K," Rodgers says. "That's what you do."
I think the whole "that's what you do" was supposed to show how dedicated a runner he is. Runners don't stop for anything. That's what you do.
But, really, it's what being a cancer patient is about, too. You get the news, you're confused, then you're devastated, but you get out of bed that next day and you move forward. That's what you do.
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I have an appointment with Dr. R tomorrow. I'm not expecting any big changes. I'll let you know.
Tuesday, May 5, 2009
Nodes of Gold


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Whenever I hear Specter's name, one particular memory always comes to mind:
February 1999, and President Clinton is being impeached. My son John had been born a few days earlier, and my mother-in-law was visiting. Specter, of course, has always been independent-minded, and not one to go along with what his party is doing just because it's his party (be warned, Democrats -- that 60 vote caucus is nowhere near guaranteed). When it was his turn to vote on impeachment, Specter didn't just vote "not guilty," he voted "not proven." My mother-in-law, who had been insisting the whole time that she was remaining neutral through the impeachment trial, shouted at the TV, "Shame on you Arlen Specter!" It was the harshest I've heard her speak in the 19 years I've known her.
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Arlen Specter, U.S. Sentor from Pennsylvania, congratulations. You've taken Joe Biden's place as the Democratic Senator most likely to say something that the Democratic leadership needs to distance itself from the next day, and...
You've got Nodes of Gold!
Saturday, May 2, 2009
More from AACR
Those wacky folks from Yale who say I should drink more wine also say I should exercise more. A study from Yale's School of Public Health says that oncologists should recommend exercise to their patients, since it results in better quality of life and better prognosis. However, they also suggest that oncologists stop recommending supplements (vitamins, minerals, antioxidants, etc.), since there is little evidence that they help make cancer better. All that said, I still plan keep up with both anyway. I'm not yet willing to give up hope on my omega-3 fish oil (there's an interesting study I'm following that seems to show that omega-3's help combat inflamation associated with prostate cancer and helps keep the cancer from growing). It seems to me that even if there is no effect on my NHL, there is plenty of evidence that omega 3's will keep my heart healthy, which is just as important a long-term health issue (especially if I'm still doing all of that running).
Of course, there was also a study from AACR that looked at a whole bunch of other studies about diet, nutrition, and cancer. The author of that one says that we can't really trust any single studies on the subject. His team looked at some of the research that's been done on cancer and lifestyles that has gotten a lot of media play, and found that once multiple follow-up studies are done, the results of that research look cloudier. For example, the idea that grilling meat to the point of charring may create carinogens has been around for a long time. It may be true, but if you look at all of those studies together, there has been nothing to show more than a "mild to moderate" effect in causing cancer. Then he specifically questions that Yale study on wine drinking, and says that while this small study shows some promise for NHL patients, other studies show that even moderate alcohol consumption can increase breast cancer risk. So, looking at the big picture, drinking wine may end up causing problems as it helps others.
He really didn't need to burst my bubble that way.
All of that really sums up the difficulty of "lifestyle" research, I think. Unlike testing for the effects of a specific drug, for example, there just seem to be so many variables to take into account. Not that I would want to discourage such studies. But we're fooling ourselves if we think there are easy answers -- a bottle of wine, a piece of dark chocolate, and you're safe.