|Wilson Cancer Update 5 - June, 2010
|Metastasis (Greek: displacement,
μετά=next + στάσις=placement, plural: metastases), or metastatic
disease (sometimes abbreviated mets), is the spread of a disease from
one organ or part to another non-adjacent organ or part.
Cancer usually starts in a particular place in the body and then it sends off little offstpring that inhabit other systems. Eventually this is how most Cancer overwhelms the body. The outlaws spread and hijack what they can.
|I asked Dr. Jahan, my UCSF oncology research doctor, why did cancers spread liket that. His answer was "happy feet". Quite a delightful answer to a troubling question. I guess the latin would be pedus felicitas. Click the arrow to see the processes of metastasis at work|
|My cancer started in the lung
and then metastasized to the bones. I had no sign of any problem
when it was in the lung. By the time I had "bone mets" it was stage 4
and impossible to cure surgically because it had spread throughout the
Pragmatic warning: If you suspect anything pursue it. This is why breast cancer has such a better survival rate now.. People catch it early and have it surgically removed before it can metastsize.
This is a good news/bad news tale
Hear a good news sound
|Once metastasis has set in,
there is rarely a cure. Mostly treatment is focused on scanning
the body for new cancer outbreaks and trying to temporarily stop or
slow them. CT scans are used every few months.
|The last 6 months of ct scans
have showed all organ
systems clear of new cancer activity. The chemo and alternative
treatments seem to be doing their job of slowing metastasis. This
is considered a great outcome.
|Mystery - even
though the CT scans were clear, the CEA blood marker for tumor activity
was going up each time it was read. 5 - 15 -30- 45 - 60 -
80...... 5 is normal - not any tumor activity. Why?
The doctor ordered a brain MRI. (The CT scans can't read ithe brain.)
Hear a bad news sound
MRI brain scan showed 5 very small mm sized tumors - a somewhat scary
outcome. The chemotherapy does not cross the brain membrane
barrier so it could not work on cancer cells there.
This was one of darker places of dispair I had yet experienced in this saga. There were cancer cells that no medicine was treating. It felt like the possible beginning of the downward slope.
Amazingly the doctor said that he would rather have brain tumors than in the other systems. The brain tumor radiation procedures are much more advanced. Tumors elsewhere might well require regular bloody surgery.
|Time for the
|The Gamma Knife is a device that can focus extremely
high radiation beams precisely at the location of tumors. The
beams pass through other brain tissue without any effect. When it works
correctly, it is a one day outpatient process. The patient can go back to work the next day.
process depends on precise MRI images that are linked to a titanium
armature that is pressure screwed against the head. Even if the
head moves slightly, the computer can adjust the beams to focus at sub
millimeter tumors since the armature provides unmoving reference points.
Ironically I have been taeaching students the computer 3d principles for years that underlie this process.
|The process is not comfortable. They must use gallons of local
anesthetic at the locations of screws and it drips for days swelling your eyes and face. Your head feels like it is
pressure compressed for days. There are possbile side effects. But it
beats old style cut-open-the-brain surgery by a mile.
For a few moments I shared a hospital elevator on the day of the procedure with a child on a gurney being moved. As is my way I tried to make comforting small talk but he retreated in horror to his mother's arm - I forgot what I must have looked like.
doctors think they zapped
the five spots and they will be stopped from ever becoming full size
tumors. But they warn there is nothing stopping new tumors from
appearing. We will scan and watch. If the tumors come
slowly, the gamma knife can be applied again. At some point that
process will probably quit working. This gamma knife experience is a
moment that combines hope and hopelessness.
Researchers around the world are brilliantly probing every aspect of cancer physiology. Hopefully they can work quicker than the advancing tumor army.
|Life Goes On
|Barring any unforseen side effects. We will be going on Cathy's 60th birthday cruise to the fjords and the midnight sun.
|I will be starting teaching
again part time in the fall. I won a small grant to collaborate
with a UC Berkeley researcher to create an energy harvesting art piece
for the UC Berkeley Art Gallery in September. A group of SFSU
faculty and students are working with me in a research group.
More information about energy harvesting art project
daughter Sophia navigated the labyrinth of college applications.
She is going to UC Davis, studying environmental policy.