Archives of The Cheerful Oncologist, Volume 2

I’ve managed to knock my new blog site off of the ScienceBlogs main menu. Is this akin to letting a toddler dust off the Hummels resting peacefully on the highest shelf of the bookcase?

This is just another grim reminder of the vas deferens between the wired age and us baby boomers, who look at an I-Pod with the same facial expression Grandma had when she stood in front of her new dishwashing machine, as flabbergasted as a skunk in a perfume factory.

I do have a new post over there, entitled “Look Backward in Anger.”

Thanks for moving over to the new site, where the writing will continue to entertain, if not reverse the aging process itself.

UPDATE: It looks like I’m back on the ScienceBlogs main menu! Hip Hip Hooray!

Oh, Lordy, what have I gotten myself into?

I am excited to join the distinguished bloggers at ScienceBlogs as their resident sage and crazy-uncle-in-the-attic.

All new posts can be found at this site: http://scienceblogs.com/thecheerfuloncologist/

This is a wonderful opportunity for me to display an extremely refined level of incompetence as I try to unravel the Byzantine mysteries of working with Movable Type. One must remember that when I was in computer classes in college we fed a stack of cards into some machine that looked like a wood-chipper and then spit out a card that announced that yes, we had indeed successfully recorded the time and date for all posterity.

Wish me luck…and come on over for more shenanigans.

P. S. I apologize for the messy look of the new blogsite. I’m working on it.

“Big Pharma expected to dominate key cancer meeting” screams the headline tonight.

Hey, I thought Big Pharma was our enemy - out to ruin us average Joes with their secret plans to vacuum up all the money in this country. What gives?

It appears that three new treatments against metastatic renal cell carcinoma, all developed by Big Pharma (as compared to teensy-weensy biotech bodegas) are getting publicity at the annual ASCO meeting, where the latest research results are presented urbi et orbi. The three are:

1. Sutent (sunitinib), an oral targeted therapy

2. Nexavar (sorafenib), another oral targeted therapy (Oops! According to the news in this link Wall Street has nixed Nexavar for announcing negligible survival benefits compared with that ancient bane of alchemists known as placebo. Oh well - that’s life in a capitalist economy!)

3. temsirolimus (no brand name yet), an intravenous targeted agent

I’m not certain what is more thrilling about these results (Hey, I’m an oncologist. We hyperventilate over stuff like this) - the fact that we now finally have some new weapons against kidney cancer, a tumor that has been totally resistant to all chemotherapy, or the fact that these new targeted treatments (as well as others) will now be tested in patients with other more common tumors such as lung, breast and colon cancer.

We live in exciting times, don’t we? What will they come up with next?

Is this a club that I am not allowed to become a member of?

Individuals who “downplay the fear, anger or other negative emotions” found in recalling memories of sad or unpleasant events may improve their overall mental health.

Two studies from Concordia University in Montreal suggest that “healthy individuals work to build a positive narrative identity that will yield an overall optimistic tone to the most important recalled events from their lives.”

When asked to describe their emotions about both positive and negative events that occurred in the past, subjects who “reflected on positive events, like a dating relationship or marriage, recreation, or attaining a personal goal, they reported feeling just as happy as they had felt at the time of the event, as well as similarly intense feelings of love and pride. Again, however, they also reported feeling less anger, embarrassment, guilt and other negative emotions than they had initially felt.”

Oh, I get it - those of us who gloss over or conveniently discredit the pain, embarrassment, anguish or humiliation of past life events best described as “worthy of immediate incineration” are not only happier but have higher self-esteem. As one of the study authors states:

“Mental health is maintained or improved by people’s attempts to make sense of their life experiences.”

Oooh…goody goody gum drops! So on top of everything else I’ve been doing wrong ever since the first issue of Psychology Today hit the stands, now in order to save my soul I must transform any unhappy memories of loss, failure, unintended spittle, off-key warbling, trousers worn a tad too high in the waist, less than stellar parallel parking and generalized love life incompetence into phony remembrances of

More happy love! more happy, happy love!
Forever warm and still to be enjoyed,
Forever panting, and forever young;
All breathing human passion far above,

Give me a break! I believe that honestly recalling sad times for what they truly were conditions the mind and spirit to better accept the vicissitudes of life and lays a foundation of appreciation of the many blessings that dangle before us like sweet treasures of the Sugar-Plum tree, if we would just open our eyes and acknowledge them.

Well, this is just one oncologist’s opinion, but if I’m wrong and I am forced to train my mind to whitewash all painful memories in order to maintain my cheerful disposition I’m going to have some difficulty turning the events of April 9th, 1976 into a “positive narrative identity.” Even if Newton, Einstein, Hawking and Mr. Spock huddled around the chalkboard they could not compute an equation that would have saved me from unintentionally entertaining my fellow calculus classmates that afternoon with a brief but indelible impression of a black rhinoceros extracting his foot from a Congolese mud wallow.*

There are some memories that defy extinction, both good and bad. One shouldn’t be punished by the psychology nannies if one chooses to live in harmony with the Janus-faced past.

*With apologies to P. G. Wodehouse

I received a disturbing shock last week while walking through a local shopping mall. It involved the ghost of one of my patients who had recently died. The horror of the situation didn’t hit me at first, but within seconds I was overcome with panic and hurried my pace, afraid to turn around and look again. After I recovered my senses I spent the rest of the afternoon pondering the significance of the event. My emotions alternated between embarrassment and dismay until I finally reached a reconciliation with myself and was able to move on to the remainder of my day.

You see, what happened was not that I saw a ghost, but that I wanted to see a ghost but couldn’t.

While strolling down the hall I saw the wife of a patient of mine who struggled for months to live with metastatic cancer. He was a weekly visitor to my office before finally succumbing to his disease, a patient whose suffering was heartbreaking to observe - truly a memorable patient.

Or so I thought. As I crossed the path of his wife that day, walking just fast enough to be past her before my brain could identify her place in my memory, I suddenly realized that I could not recall the name nor the face of her husband. Too humiliated to turn and call out to her, I wandered on aimlessly, searching and searching for a face to go with hers, the face of a man I once knew well, a face that withered before my eyes and then, like a mask left behind after an elegant affair, was placed inside an old trunk, forgotten forevermore.

Eventually I remembered him and how he sat quietly next to his wife through all those visits, full of misery and apprehension. Now he exists only in the mind, a ghost who can only appear if summoned from the tangled nest of names and faces that, no longer noticed, have faded from memory.

Wherever my patient is now I want him to know that he has not been forgotten - he is welcome to haunt me at his leisure, which I assume is limitless. Like Hamlet pacing on the ramparts of Elsinore, doctors also need to see ghosts. It reminds them of the gravity of their work, of the sorrow that strangles a woman as she walks alone down a corridor crowded with strolling lovers.

“Marijuana Use Does Not Raise Lung Cancer Risk”

[Editor’s Note: In keeping with the policies, rules, regulations, voluntary self-flagellations, edicts and Ouija board messages of this website, upper management has instructed me to remind the gentle reader that neither The Cheerful Oncologist nor his staff, minions, roadies, ancestors or anonymous love-letter-writing admirers condone the use of illegal drugs.]

I remember the day as clearly as if it was today. The sun gloated in the pale cream sky as it baked a gaggle of kids lying around the city pool. I was dazzling the girls (or so I thought) with a recap of last night’s episode of “All in the Family,” which was our favorite show as well as a national phenomenom back then. Inevitably our conversation turned to forbidden activities, as it did frequently during our junior high school years, and the topic of marijuana drifted into sight. Only the roughest kids in school were awarded the distinction of being bad-ass pot smokers, which in those days was unquestionably acknowledged as the highest caste in our rigid social system. The rest of us just jabbered about marijuana like a busload of women on an Elderhostel tour. I would be lying if I said we never wondered what the feeling was like to be high. Most of us never got the opportunity to find out, and those who did never really took up the habit, mainly out of fear of breaking the law. We had a vague uneasiness about smoking marijuana, the same feeling one gets when touching a match to charcoal soaked in lighter fluid.

Some of us grew up to be doctors. At least one of us became an oncologist who, among other duties, implored his patients and friends to make healthy choices. One of the choices he advocated was to minimize the risk of getting lung cancer by not smoking cigarettes - or marijuana, which is known to contain the same carcinogens found in tobacco. In fact, most doctors assumed that marijuana smoke was more harmful than tobacco, and it would only be a matter of time before scores of long-term pot smokers would march out of their homes like the zombies in Night of the Living Dead, mortally stricken with lung cancer.

Now this report appears: “In the study, the heaviest smokers were those who had smoked more than 22,000 marijuana cigarettes, or joints. Moderately heavy smokers were those who had smoked between 11,000 and 22,000 joints.

“The heavy marijuana smokers did not have an elevated risk of developing cancer. People who smoked more marijuana did not seem to have a higher risk than those who smoked less or none, the study found.”

We are not just talking about lung cancer:

“Even in those heavy, long-term marijuana users, the risk of head and neck cancers including cancer of the tongue, mouth, throat and esophagus does not seem elevated compared with that in those who did not smoke.”

The cause of this surprising conclusion is still under study, but according to the lead author “tetrahydrocannabinol (THC), an active substance in marijuana smoke, may promote earlier death of aging cells, preventing the injured cells from becoming cancer cells.”

Great Caesar’s Ghost! Where do you suppose this line of research will lead to?

I must emphasize, as do the study authors, that smoking both marijuana and cigarettes increases the risk of getting lung cancer or head and neck cancer, so to you smokers out there who think they can protect themselves by playing an old Cheech and Chong album while toking up, my advice is this:

Enjoy the comedy, but foreswear the coffin nails - and go easy on those cosmic brownies!

“Forsan et haec olim meminisse juvabit.”

After 20 days and 20 nights without television, internet access or an answering machine the ship finally arrived at Plymouth Rock and unloaded such goodies as cows, maize seed, farm implements, broadband cable access, bolts of gingham, four satellite T.V. receivers, corn whisky (who ordered that??), apple seeds, geese (complete with little knives in which to slice pate de fois gras - hey, we can dream can’t we?), Hudson Bay blankets, Sirius satellite radio, leather boots (in reasonably good shape, although one black pair seems to have the initials “H. G.” inside them - ?), barrels of flour and sugar, and a new answering machine.

Yes, the C.O. is back online at home, striking fear into the hearts of those who have vowed to devote their life to wiping out bad prose. See you soon…

As I type this a highly trained team of specialists is at my house diligently trying with all their might to hook us back up to the universe known as the internet.

It has been a trying 19 days, 7 hours and 28 minutes with no home access to all of the extremely vital web sites that I need to keep the Cheerful Oncologistic ship of state, laden with a trove of linguistic treasures, sailing faithfully toward your port.

In the meantime I shall continue to blog here in the office (after my clinic is over, of course).

[Editor’s Note: We recommend that you read this interesting letter to the editor all the way through before clicking on the footnotes.]

To The Editor:

I want to bring your attention to two recently published scientific studies that have health implications for us all. The first study found that incarcerated females who are exposed to hazardous doses of ultraviolet B radiation and have around-the-clock access to exercise (using the typical machine offered in prison [1]) are less likely to develop skin cancers compared to a control group exposed to the same UVB, but without access to exercise (those cruel prison guards [2] - may they drop dead)!

Forgive me for getting emotional [3]. In the second study, individuals with a genetic mutation that puts them at a very high risk of developing colon polyps (which can progress into cancer) were sold into slavery [4] and given access to a similar exercise program as mentioned above. Shockingly, these poor citizens were fed the same amount of food [5] and water as the control group (also afflicted with the genetic mutation) who did not have access to the exercise machine, thereby ensuring that the more physically active group went into a negative energy balance (again, a horrific crime against murinity [6] if you ask me).

Pardon my editorializing. Well, as you might guess, those subjects who exercised all lived, whereas one fourth of the poor comrades who were confined to their cell died - within ten weeks, I might add.

I appreciate your efforts in relaying this exciting bit of news to the general populace. If more of us would just get out and exercise, we will not only reduce our risk of acquiring skin and colon cancer, but decrease our chances of being captured by the Evil Empire [7]. After all, none of those fatsos [8] could ever catch us in a foot race, let alone fit through the doorway of our home [9].

Jerry [last name withheld for privacy reasons],
Mus Musculus, Mississippi

footnotes:

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

Yesterday a fine representative from our local cable company pulled up in his van, got out, walked up to our front door and left a hand-written note there. He did not knock, ring the doorbell, pass gas, light a firecracker, give out a Tarzan yell or perform any other act designed to get the attention of the person inside our house (who at the time happened to be my wife). He then drove off.

The note, which was discovered later that day stated that he, the cable guy, was not going to be able to run a line from the pole to our house, thereby ensuring that our little homestead (which rests in a part of town that has no access to DSL) will continue to have the same opportunity to access the World Wide Web that is enjoyed by residents of the moon, not to mention Mars and various other planets not beginning with the letter “E.”

Not one to be discouraged, I shall call them back and, using a well-known technique of persuasion, get someone from this billion-dollar company to come out and hook us up to all you wonderful folks out here in the blogosphere. Courage.