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Postcards From Lebanon: Part 2 in a Series of Cancer-Related Commentary

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Follow the yellow brick...

If you followed my first commentary, you will remember that I have Chronic Lymphocytic Leukemia (CLL) and was scheduled to participate in a study prior to beginning chemo treatments. This part will highlight the study as, drum roll please, I did participate in the study and didn't chicken, ergo those yellow bricks, out. No, I'm only borderline anemic.

A brief reminder: The study is headed by Dr. Alexey V. Danilov, and involves an organic chemical, vincristine (a vinca alkaloid), derived from the Madagascar periwinkle flower shown in the picture above. This chemical is currently approved by the FDA for use with other cancer treatments such as Acute Lymphoblastic Leukemia, but not for CLL.

The purpose of the study is to learn whether or not vincristine will aid in inhibiting cancer cells from growing during chemo. If you are interested in reading about the study, you can find it by clicking on the following: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm315027.htm.

The first step in the study was having a "screening" visit at Dartmouth-Hitchcock Medical Center, during which I was given a physical exam where my vital signs and blood work were reviewed. It was during this visit that I met Dr. Danilov, who has been involved in CDK inhibitor research (CDKs are instrumental in regulating the cell cycle, such as division) for a number of years. We also discussed what would be expected of me should I participate and any side-effects.

These side-effects range from being minor (fever and chills) to more serious ones requiring hospitalization (removal of a limb where the vincristine was injected, to the ultimate side-effect -- death. Why they call death a side-effect when it is truly an endgame is beyond me. But so be it. Here is where my selfish, second thoughts crept in. It's not every day I put my life on the line for science. Of course, I needed to know what my chances were of dying. Another, more common side-effect, is an abnormality in the nervous system called neuropathy. This would involve a tingling in the fingers and toes -- I've previously enjoyed that sensation when highly excited from a pleasurable experience so I didn't think it would be too bad. I was informed that the dosage of 2 mg, which they are giving for the study, is not associated with significant risks of death or damage to the nervous system -- phew!

Initially only 10 CLL patients who have never been treated with chemo were to participate in this study. But they have increased the number to 16 based on initial positive results, and I was number 10. The results from this study may never benefit me directly, as FDA approvals take forever, but I participated because someone, someday, may be helped due to this small choice I've made.

I showed up for the infusion and played musical chairs as the first recliner in which they put me was, although empty at the time, already taken, so I was moved to the only free area, which was by the "busy doorway" where I was told no one likes to sit. The comings and goings were nothing compared to the monotonous noise made by the IV in the next cubical that kept malfunctioning and continuously pinging, which annoyed everyone. But the funniest (in hindsight) thing was when they tried to find a vein in my left arm for the vincristine: After three tries a fourth attempt was made by a wonderful nurse, Peggy, who told me to put my feet on the floor (I had reclined for fear of fainting -- yes, truth be told I'm a fainter when it comes to blood, and to think my father was a doctor) and to take deep, peaceful breaths which would allow my veins to remain relaxed. I had been tensing, which Peggy told me also tenses the veins so they are harder to penetrate. Success. Thank you Peggy.

In my right arm the intravenous went in during the first try, and out came the first vile of blood. They then injected 2 mg of vincristine into the intravenous in my left arm -- and I felt nothing. An hour later they took more blood out of my right arm, and three hours later still more blood out of my right arm. And then they released me. I did get a chicken salad sandwich on whole wheat bread and a fruit cup for lunch, and later a bag of M&Ms -- yum! That was it -- 5.5 hours after arriving, and no side-effects, I went home feeling proud for having participated.

After four days I started experiencing painful jaw sensations when beginning to eat, and my tongue felt as if it had multiple sores, but none were visible. After a week I began to have a numbing sensation in my thumbs and closest two fingers, examples of neuropathy. And recently I've started having stomach cramps. Stay tuned to find out what happens with these side-effects and if any new ones appear.

My next appointment is to review what I should expect during and after the chemo treatments. I have a list of questions and will fill you in on what I learn. Let me know if you have any questions you'd like me to ask.

Timing: preparatory meeting, Aug. 5., chemo beginning Aug. 12.

Oh, and I did report the few side-effects to Dr Danilov and his nurse, Brian Highhouse, who, along with Peggy, have all three been added to my list of angels here on earth.

Follow the yellow brick...

Photo Credit: © Kannika Kazama/123RF.COM

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