Monday, June 6, 2011

Miss Scarlet, in the Drawing Room, with the Arsenic...


Arsenic is a classic murder weapon. The height of its popularity occurred in the Middle Ages and Renaissance. Today, it mainly lives on in murder-mystery novels and the game of Clue.

Later today, arsenic will also be flowing through my veins. Although receiving 50 doses of what has traditionally been considered a poison is a little disconcerting, it is better than having Prof. Plum or Col. Mustard wack me 50 times with the lead pipe or the candlestick to knock out my disease. I continue to be amazed by the medical advances that have been made for a condition that only strikes 800 people in the U.S. each year.

The full name of the drug I'll be taking is Arsenic Trioxide. It is a manufactured compound that is different than the traditional poison. The drug causes cell death. Specifically, it kills cells that have material on the chromosomes 15 and 17 swapped (these altered bone marrow cells create the leukemic blood cells). It can also cause those cells with the swapped genetic material to rehabilitate themselves into normal cells.

The front page article in the Wall Street Journal today discusses cancer treatments that target specific genes. This drug is a perfect example of that. The head oncologist during my hospital stay attended the conference referenced in the article, and told me that Phase Three of my treatment may be affected by decisions made at this bi-annual meeting.

In a recent study, 90% of patients who received the 12 week course I start today (five days a week for five weeks, two weeks off, 5 more weeks of five days each week), were still in remission three years later, versus only 70% of patients who did not receive the Arsenic Trioxide. Although this phase of my treatment will take effort (schlepping to the facility five days a week and a lot of needle jabs), that 20% improvement in my odds will make it well worthwhile.

Additionally, the compound is less toxic than the chemotherapy I received in the hospital. Many patients do not have any side effects after the first week, once the body has adjusted. Of course I am hoping I will be in that group. There is a risk of some serious complications, which is why I will be having an electrocardiogram every Monday, blood tests twice a week, and will be given a list of symptoms to watch for. But I am learning quickly that if you're the patient and not the doctor, you are better off ignoring the bold outlined warning boxes on drug manufacturers' websites. As my grandma, who is also battling cancer, says, "The doctors can worry about that.  I just do as I'm told."

**The facts I included above are from the official website for Trisenox and from the following article, which was an easy, informative read: Researchers Use Arsenic to Treat Leukemia.

As interesting and optimistic as the arsenic treatment is, I still managed to have panic attacks periodically throughout this past weekend. It was the first time I'd cried since those bad bone pains in the days immediately after discharge.

Although less toxic than chemo, the arsenic is still a new drug entering my system, and thus the unknowns associated with how my body will handle it make me uneasy. The more predominant cause of my angst is that beginning this treatment cycle is a return to reality. Since I left the hospital, I have been in recovery mode. For me, that has been "forget" mode. As I began to feel more energetic, I was able to ignore my diagnosis. Now again I must face that I have APL and must work to keep it in remission. Not only do I have to go through treatment and watch for signs of a relapse in the future, but I will have to monitor for latent side effects of the intense drugs that will have wiped out the cancer-causing cells.

My family, and I, remind me again and again how lucky I am this disease has such a high cure rate. I wish that didn't make it feel so overwhelming right now. I have received some great stories from survivors over the past week, and will put together that summary. This past weekend would have been a good time to focus on that. I just couldn't. I am trying so hard to be positive, but I can't be perfect at it all the time.

Growing up, Clue was one of my favorite board games. I always wanted a Billiard Room and Conservatory like the ones on the game board. I'd never anticipated I'd want the bottle of poison. But if I can have the poison, why not the pool table too? Maybe during the two hour Arsenic drip today, I will Google used pool tables. Though if I find one, then I'll have to research expanding our home to include a billiard room. This could get involved, but it would take my mind off chromosomes 15 and 17. A normal person would suggest I simply play a round of the game with the nurses during the treatment at far less expense and hassle. But one positive of cancer is that it causes you to dream big. I can already envision that the trees on the north side of our property will need to be ripped out...