Happy birthday Tumour

Dear Tumour,

I'm not exactly sure how old you are turning today, I know I am turning 29.

Some doctors say you must be at least 5 years old, because that is how long polyps take to turn into cancers. Other doctors say that polyps don't take anywhere near that long to turn into cancer in young people like me.

One year before you were found I had open surgery to remove my appendix, you must have still been hiding in the mucosa of my sigmoid colon then, otherwise you would have been spotted.

It has been a big year for us.

You breached my sigmoid wall, attached yourself to my rectum and are now waiting at the tissue boundary of my seminal vesicle and bladder.

I published some articles, discussed science on the radio, appeared on Chinese TV and a magazine cover, grew my company and visited The Philippines, Morroco, Malta, London, Madrid and Seoul.

What you achieved had more impact though because I didn't totally challenge anyone's world view, or threaten their life.

I've come to like you and everything, but I hope this is the last birthday message you get.

Ben Bravery

I was going to make you a cake in the shape of a colon but then decided to just get you some extra radiation

EFF YOU!

It was a clever chemist that decided to call 5-fluorouracil FU.

FU! is the name of my chemotherapeutic. I have a bottle of it attached to my arm connected to a tube that leads to my heart. FU! sits in a balloon in this bottle and slowly enters my body at 0.5 ml per hour, 24-7.

FU! is toxic to certain types of cells and is called cytotoxic ('cyto' is fancy for 'cell'). It targets cells that are dividing quickly. Cancer cells divide quickly because they are out of control and no longer follow the rules of the body.

It turns out that cells dividing quickly and frequently need a lot of uracil (this is the U in FU!). FU! is like uracil in disguise.

The disguise

FU! looks like normal uracil, but it has switched one of its hydrogen atoms for a fluorine one (the F in FU!). That's the only difference between the uracil in disguise (FU!) and genuine uracil - but that one change means it causes havoc inside cells.

The impostor gets messy

FU! looks enough like uracil to get inside a cell, but it isn't uracil, and so when the cell tries to use it things go wrong. The cell converts FU! into several different molecules that then interfere with how the cell copies DNA.

Remember that FU! has to look enough like uracil to get this far, otherwise the cell would break it down and clear it out. Clever FU!.

Dumb FU!

Cancer cells divide frequently, but so do cells in the mouth, intestines, heart and immune system. FU! dresses up and tries to get into any cell that needs uracil. This leads to a long list of potential chemotherapy side effects that include mouth ulcers, a weak immune system and bot-bot troubles.

I've had all three.

5-Fluorouracil (5FU)

A day in the life

Each day is different but here is a typical clinic day. I have one clinic day per week.

08:00 - Go for a 30 min jog. I don't measure distance anymore because my jogging speed depends on how worn out I am

09:00 - Make about 750 ml of fresh fruit and vegetable juice and have breakfast

09:30 - Wrap left arm in plastic and shower one handed, moisturise the skin that gets hit by radiation, brush teeth with baby soft toothbrush and herbal toothpaste (mouths get sensitive during chemo). Measure my temperature (the chemo reduces my immune system a little so I need to watch out for infections)

10:00 - Head off to the hospital

11:00 - Appointment with Medical Oncologist to review side effects and chemo treatment

12:30 - Down to the radiation therapy clinic four stories under the hospital for my daily dose

13:00 - Catch up with Radiation Therapy Nurse for check-up and to monitor side effects

13:30 -  Appointment with Radiation Oncologist to review side effects and radiation treatment

14:00 - Have blood taken to check red and white blood cell levels because new chemo bottle will be attached tomorrow

15:30 - Arrive home and go to bed

19:30 - Wake up and have some dinner

22:30 - Back to bed

On other days you can find me:

• in the Chemotherapy Day Unit having my PICC line dressings and chemo bottle changed
• at relaxation or meditation sessions
• receiving acupuncture
• at my computer working
• seeing an energetic healer
• in bed or on the toilet (these can take over the whole day)

Rest, rest and more rest

Fitty (per) cent

50 takes on cancer in Things Fall Apart

I am half way through chemoradiation therapy and I still look and feel human.

All together I will have 28 doses of radiation. This is called long-course radiation. Each day I lay on the zapper, am placed in exactly the same position (my tattoos help the technicians line me up just so) and hold still while three beams of ionizing radiation are directed at my tumour.

I lay on my belly and first have to pull my man-bits down (to move my baby-making machinery as far as possible from the beam). I became okay with manipulating my genitals in front of strangers at about the same time I became okay with baring my bottom.

Remember my yellow car, red car analogy for cancer? I used it to explain the basic difference in the way cancer and non-cancer cells behave. It is easy to think of cars because we all know what they are.

Red cars are out of control and no longer follow the road rules. The problem is a big cluster of them are parked at the centre of a yellow zone filled with yellow cars. For the radiation to get to the red cars it has to pass through a lot of yellow cars: this means normal healthy cells are being zapped during the radiation.

A cell from my small intestine being cared for and repaired

The yellow cars know how to repair themselves or know where to go and get fixed. When the red cars decided to abandon the road rules they also threw away the repair manual and directions to the mechanic: this means cancer tissue is not good at healing itself.

Damaged and without road-side assistance: cancer cells

This basic difference means that all the healthy tissues in the firing line can sustain damage without shutting down. The tumour isn't so lucky. The hope is that enough cells will get damaged by the ionizing radiation, shrinking the tumour.

Undie Sunday

By Cassie, Brisbane, Australia

When my best friend Ben asked me to write a guest blog about Undie Sunday, I immediately said ‘yes’. How do you say ‘no’ to someone with cancer?  

For followers of Ben’s blog, you will know that Undie Sunday (undies is an Australian term for underpants) is an event organised by Rotary Bowelscan to raise awareness for bowel cancer and Bowelscan testing.

I bought Bowelscan kits at the event and am keen to start smearing my poo on cardboard and posting it off to a lucky lab tech to analyse for hidden traces of blood. In my moments of hesitation about completing this test, two thoughts convinced me that it was a good idea:

1. I really can’t hide behind the old ‘it will never happen’ idea anymore
2. I am more than happy to let a stranger stick a cold metal pole up my vagina every 2 years to test for a cancer that is far less common

The event aimed to break the Guinness World Record for the largest number of people in their underwear in a public space, which is currently set at 547. We had to dance for 5 minutes in our underwear to “Shaking that Ass”. Other highlights were the ‘dancing granddads’, spotting Michael (the winner of the latest Beauty and the Geek) and watching Australia’s most accurate skydiver land in his underwear.

Unfortunately we we didn't hit the Guinness World Record. But we raised awareness and had fun.

Wearing underwear in public is a serious deal when it comes to world records. G-strings and lacy or see-through underwear were banned. Ben also advised me to steer clear of crotchless panties, even they though they weren’t officially prohibited. Interestingly, girls were required to wear a t-shirt but males were instructed to take theirs off.

Thanks to my friends for dropping their pants in public

The take home message from the day was that bowel cancer is a serious disease that is both preventable and curable and that early detection is important. I encourage everyone to buy a Bowelscan testing kit.

I am looking forward to dancing in my underwear with Ben’s cancer-free bot-bot by my side at next year's event.