January 10, 2012

Clots and cancer

I have a new life-threatening condition, and it's not cancer. My new condition was picked up in a CT scan done at the end of chemotherapy. This CT was done to re-stage my cancer, but what it actually did was save my life.

I have several blood clots, in the lungs. It turns out that cancer is an independent risk factor for developing blood clots. This means that cancer alone predisposes someone to developing a clot. Cancer treatments like surgery and chemotherapy also increase the chances that someone will develop a clot.


Deep vein thrombosis (DVT) is the name given to a clot that forms in veins in the legs or pelvis. A pulmonay embolism (PE) is a clot in the lungs. Often, clots that form in the legs or pelvis (DVT) travel to the lungs (PE) and taken together these conditions are called venous thromboembolism, or VTE.

Where my clots formed is unknown, but four are now stuck in a mid-section of the left lung. I have no symptoms (for hypochondriacs already asking Dr Google if they have a PE, symptoms would include chest pain, shortness of breath or a fluttering heart beat) and if not for the CT I would be none the wiser (radiologists are some of the unsung heroes of cancer treatment and care).

What is known is that people with cancer are 4 times more likely to develop a blood clot than other people; 20 % of VTEs occur in people with cancer; and developing VTE is associated with a poorer prognosis (depending on the type of cancer).

Clots are more common after abdominal surgery (tick) and neurosurgery, periods of immobilization (tick), and after certain chemotherapeutics such as 5FU (tick). Clots are also more common in overweight (cross) or older people (cross) and people with brain, pancreatic, stomach, ovarian or blood cancers (all crosses). The propensity to develop clots can also be genetic (unknown, testing to follow).

Clotting curve ball

People with cancer get used to curve balls. They come at us from unexpected directions and have a way of sneaking up on us with speed. I'm adding 'pulmonary embolism' to my List of Cancer Curve Balls. It occupies position 4 in my cancer chronology. 

List of Cancer Curve Balls

Number 2: finding out the tumour was bigger than expected and trying to eat other tissues
Number 3: springing a leak in my newly resected colon
Number 4: four blood clots near my lungs

Crushing the clot

I am on a high dose of heparin (a blood thinner) for the next 12 months. I have to inject this myself into my thighs or abdomen. This particular anticoagulant (blood thinner) has a reputation for coming in blunt-ish needles and for stinging like hell and causing bruising. I can confirm all three.

The fact I can now inject myself, knowingly inflict pain and cause impressive bruises all adds to my street cred. These new traits are up there with my scarstattoos and the fact I can poo in any position (courtesy of the bag). 

January 3, 2012

Me and my immunity

Macrophages, killer T cells, memory cells, helper cells, natural killer cells, phagocytes, antigens, B cells, neutrophils. The spleen, thymus, lymphatic system and hormones.

This is the Immune Toolbox. This set of tools didn't really work for me before, but it's the only set I have and these are the tools I now need to trust, nourish and cherish.

These tools stands between me and more cancer. It is what will capture and terminate any cancerous cells and microtumours that pop up in the future.

Radiation, chemotherapy, surgery and more chemotherapy were tough; some people even call them toxic (I don't).

These treatments can be difficult to endure, but for me they were an excellent safety net: stuff was being done. Ionizing radiation was hurting the tumour, chemical soups flowed through my body 'cleaning' it up, someone was cutting out cancerous tissue, another was examining lymph nodes for travelling disease. It was all hands on deck and my Immune Toolbox could take a breather.

Not now though. Rest over. All my systems are go. Action!

The immune system is complex and how it is affected by what we eat, drink, do and think is an emerging field called Psychoneuroimmunology. Obviously something wasn't right with my Immune Toolbox before because I don't have a known genetic disorder, I exercised, was a very low meat eater and didn't smoke (all known risk factors for colorectal cancer).

And recently a leading UK cancer organisation released a study showing that at least 40% of cancers result from lifestyle factors, factors that can be controlled.

So what am I going to do differently now that treatment is over? I'm not sure.Treatment only finished 12 days ago, and the chemotherapeutics would have only just been metabolized.

I'm still working it out. Watch this space.