Resilient cancer cells that may have been plotting to invade again met a new enemy this week: external beam radiation therapy. It was uncertain if the ionizing radiation six-week attack, meant to damage DNA, would help stop the cellular aberration for good.
Despite undergoing chemotherapy and a mastectomy, I was still likely not free of cancer. I was scared. Experts say that about 20 to 30 percent of breast cancer patients are considered at high risk of recurrence after a mastectomy. Cancer cells that had managed to escape my breast made it to my lymphatic system and were capable of migrating to nearby tissue to form another tumor and grow again.
Researchers have estimated that fewer than 2 percent of solitary cells are able to grow in a new site, and fewer than 1 percent are able to maintain the growth. But some suspect that a more specialized subset of breast cancer stem cells that are relatively resistant to chemo and radiation may be driving the spread. And doctors say there are no effective methods to target them yet.
“This is a major clinical problem that basic science breast cancer researchers are working to solve,” Michael Lewis, Ph.D, a Baylor College of Medicine researcher specializing in molecular and cellular biology and radiology, said in a press release. “These cells appear to be responsible for recurrence of the disease and for spread to other organs in the body.”
Earlier this month, the University of Miami’s Dr. Alberto J. Montero presented a study illustrating the problem at the 34th Annual San Antonio Breast Cancer Symposium. The study concluded that metastatic breast cancer patients spend too much time on therapies that do not thwart disease progression.
The hopelessness of the attempt to engage in a “war on cancer” that the medical community seems to be losing, while I lay in bed feeling defeated and damaged by chemotherapy and a mastectomy, has prompted a period of isolation and sadness.
My thoughts this week may be offensive to some. But my only intention is to share what is in the mind of this breast cancer patient, who has spent more time crying this month than in the past five years.
Despite my feelings of powerlessness, I decided I would not be eating baking soda or Palembus Ulomoides Dermestoides, an insect that allegedly cures cancer and other maladies. I do not believe that the cancer cure has already been developed, and that selfish capitalists have prevented breast cancer patients like me from getting to it.
I do believe in the kindness of the people who follow Japanese spiritual practices such as Reiki, Sekai Kyusei Kyo and Sukyo Mahikari. The practitioners believe that the “energy” or “divine light” that they transmit through their hands is meant to “purify and revitalize the spirit, mind, and body.” The claims are unfounded and are not backed by any sound scientific research. Interestingly enough, one of these organizations promises scientists that if they give and receive “light energy” they “will begin to perceive the existence of even deeper levels … that can provide answers to many of the questions that are still perplexing in their fields.”
If only all of that were true. When it comes to delivering unseen energy, the trilogy linear accelerator at the University of Miami’s Sylvester Cancer Center in Miami is the one I trust. Its robotic therapy system rotates around the cancer patient to deliver precisely shaped ionizing radiation beams from a wide variety of angles.
It takes a team of people to make sure that the treatment goes as planned by the radiation oncologist. Human error is possible. While a dosimetrist calculates the dose of radiation, a medical radiation physicist makes sure the machines are delivering it accurately. A certified radiation therapist prepares the patient with small tattoos to target the same area. The therapist also raises the table toward the linear accelerator and levels the patient’s body with the lasers. For a moment the lasers in the dark room reminded me of the Ultra Music Festival.
“We can see and hear you during treatment. You just have to remain still,” UM radiation therapist Karen Brown said before stepping out of the room. The radiation beam rotated to different angles, while making a buzzing sound. The process takes about 20 minutes. The possible complications, which could take years to happen, may include the remote possibility of developing a secondary cancer, chronic pain, and/or a rare rib fracture.
“You will experience some skin irritation and fatigue, the skin will heal, but it may not be as elastic as it was before,” Brown said. In the meantime, I would just have to lie there and believe that the treatment was going to work.