Category Archives: Uncategorized

Two years a eunuch. The strange world of cancer therapy.

7 Replies

In the past I have written posts on the adventure of having two stage 4 cancers and the journey down the rabbit hole one takes as treatment goes forward. Three years ago I had surgery, radiation and cis-platin for throat cancer. Three years later my throat or oropharyngeal cancer is undetectable. Of course, this is good news.  What remains of the experience are the lasting effects of intense radiation exposure in and around the target volume. I developed the normal array of after effects: stunted salivary glands resulting in chronic dry-mouth; periodontal disease and the loss of a few teeth; a substantial loss and distortion of the sense of taste; inadequate thyroid function requiring medication; difficulty in swallowing dry foods; radiation scarring on the neck; and lymphedema where 33 lymph nodes were removed from my neck. I’ve adapted and manage quite nicely to plod down the timeline much as before.

My situation with the stage 4 prostate cancer (Gleason 8) is stable. One of the treatments for prostate cancer is chemical castration. Since testosterone has the effect of accelerating the growth and spread of prostate cancer cells, the commercial drug Lupron is used to down regulate the production of testosterone. Loss of body hair and muscle mass as well as the onset of hot flashes were some of the highlights of my experience. A substantial nulling out of the sex drive happens as well.  Effectively I spent about two years as a eunuch.

It’s been nearly a year since the Lupron injections have stopped. I’m getting a more strength and some body hair is returning. I’ll leave it at that. The radiation treatment was intense in the target zone, but largely without significant discomfort overall. The tricky part of external radiation treatment of the prostate is it’s proximity to the bladder and the bowel. Fortunately, modern IMRT equipment is capable of modulating the x-ray beam intensity as well as shaping the beam with a multileaf tungsten collimator as it rotates around the patient.

After 11 months since the last Lupron shot, my PSA has increased only slightly from being non-detectable.  The return of testosterone after having it shut down for 2 years is a weird experience for a fella. But weirdness is normal in the world of cancer treatment.

Now we’ll pivot to a different topic.

A delicate parting thought for friends and family of those with cancer. Invariably a well intentioned friend or family member will say that their thoughts and prayers are with you or that a prayer group is holding you in the light. Another expression of sympathy might be that there is a reason for everything and that God has a plan for all of us, and as the story goes, our lives have purpose after all. Such sincere well wishes are expressed with the best of intentions, but for myself and other non-theistic people it rings hollow and offers little consolation. A prolonged and agonizing illness is part of some plan? Seriously? If a person set forth such a plan we would rightly consider this foul individual a psychopath worthy of punishment.

People express these sentiments when presented with an existential conflict- it is when the need to connect their belief system with reality the observable world is confronted with the paradox of the divine sanctioning of pain, suffering and untimely death. The need is met by the supposition that there must be divine purpose rather than the unthinkable alternative of the illness happening in the stark emptiness of a godless universe. If such a universe existed, what possible purpose could there be in existence? Well, yada yada. I’ll take this topic up in a later post.

Here is an alternative for your non-believing friends and family. Consider renewing and expressing gratitude for their love and friendship. Confess what the person means to you and commiserate with their condition. Let your emotions flow. Hold their hand. A bit of listening goes a long way too. Mirth is always welcome- the regaling of past exploits, funny stories or people, jokes or the sharing of what experiences you have in common. A light heart and cheerful smile is always welcome in sickness and in health.

 

CSB has released final reports on Macondo Disaster and the West, TX, explosion

Leave a reply

The US Chemical Safety Board has approved and released the final report on the Macondo /Deepwater Horizon  blowout and explosion of 4/20/10 in the Gulf of Mexico. The report is in two volumes and does include an animation of the sequence of events. I have found the CSB animations to be particularly helpful in understanding the key features revealed by their investigations.

The CSB recently released their final report on the ammonium nitrate fire and explosion in West, Texas on 4/17/13. A few months after the release of the final report the ATF announced a reward of up to $50,000 for information leading to the arrest of person or persons responsible for the industrial fire and explosion that killed 15 people.

If the forensic aspects of industrial accidents is of interest to you, I’d recommend having a look at the CSB website. Knowledge of various initiation and propagation modes in past industrial accidents is useful for those of us trying to prevent initiating events on our own sites.

Things I’d like to see

2 Replies

Here are three items on my wish list for the future. There are more but this is enough for today.

  • The nomination of Donald Trump as Republican candidate for president in 2016. This political intestinal disease needs to run its course. Hell, let him win in 2016. Why? Given that a win means the electoral system has spoken, the GOP will have to reconcile this unforeseen event to the rest of the electorate and to the Citizen’s United beneficiaries who were accordingly disappointed. Perhaps there will be leadership purges at both the RNC and DNC. Even more fantastical would be a rethinking of what the parties stand for. But … nah. It won’t happen.
  • Fewer movies about Nazis. It is a tired and tiresome meme. Move on.
  • I’d like to see the Rupert Murdoch empire taken to task over their FCC broadcast licenses. Recalling that the public airwaves are just that, I’d like to hear them explain how his use of broadcast spectrum really merits the public trust. The same goes for other news outlets and cable providers. But before Murdoch croaks, I’d like to see him squirm.

<< cue theme song>>

 

Company gets public spanking from CSB

Leave a reply

The US Chemical Safety Board (CSB) has publically expressed dismay and disappointment in a letter to Tesoro Corporation in San Antonio, TX. It is in regard the apparent unwillingness of the company to allow CSB investigators to come on site and continue with the investigation of an industrial accident or, if you prefer, incident. Apparently two workers were splashed with sulfuric acid and had to be choppered out for treatment.

From what I gather from the CSB letter, Tesoro doesn’t believe that the incident rises to the level of seriousness to justify a CSB investigation. That is my own interpretation.

At first blush it would seem that Tesoro has a point. While it is something that OSHA would cover, does it really necessitate attention by the CSB? By itself it seems questionable. But when you consider that Tesoro had an 7-fatality explosion and fire at its Anacortes refinery in April of 2010, perhaps the scrutiny seems less unreasonable.

The refinery explosion was determined to result from high temperature hydrogen attack within a 40 year old shell and tube heat exchanger. Catastrophic structural failure on startup after a scheduled tube cleaning resulted in an explosion and fire with immediate and delayed fatalities.

It seems to me that the failure of a high temperature heat exchanger after 40 years of service handling hydrogen and naphtha has more to do management policy on equipment service life than anything else. This speaks to prudent administrative and engineering controls on plant safety. A shell and tube heat exchanger has no moving parts to fail. It just sits motionless doing it’s function. There are no failing parts to replace other than leaky tubes and valves. Perhaps no one considered that the inherent nature of the gas and thermal cycling was deleterious to the integrity of the metal shell? Perhaps there was no enthusiasm to define official hours of operating life. Plant managers are always under pressure to minimize operating costs. This is especially true of plants producing high volume low margin commodities.

But here is the rub. Everything has a failure rate. This is especially critical for equipment under high temperature and pressure. The first layer of administrative control is for management to make allowances for materials in extreme environments. Anacortes is not the only recent incident where component failure has occurred in equipment performing under demanding conditions. Before the engineers can make equipment specifications for this, management has to conform to the notion that some parts of a plant should have better definition on service life. They should demand it of their design people and support engineering when the time comes to replace a component.

If the CSB believes that a company has weak administrative controls that influence plant safety, then I think they should investigate.

Attacking Syria for nerve gas use in Ghouta

3 Replies

In the news there are reports of pending action by the US in Syria. Maybe I have a blind spot. Maybe there is some fundamental principle I am missing here. But how is it that a mass killing by gas elicits a response from the US when a larger mass killing by bullets and high explosives does not? Where are sympathetic Arabs in the region? How are they exempt from delivering bombardment as justice for the dead?

Obviously, gas attacks lie across a firebreak of some kind. What is the Syrian death toll now- 90,000 + by bullets and bombs? And that does not trigger international action? Apparently, grisliness is not a deciding factor.

This isn’t about justice at all. It is a smack down on setting a precedent with NBC warfare- nuclear, biological, and chemical. It is a genie we cannot allow out of the bottle … in the land of the genie.

So, here is the scenario-  the US will begin a strike at 3 am with cruise missiles to soften up the target area and air defenses. Stealth fighters will fly in to attack everything that flies. Penetrator missiles will demolish air, missile, and command and control bases. But what to do about the nerve gas armaments? Are they bombed or isolated? Who recovers them right after the attack? Al Qaeda? Let’s hope not.

This whole thing is a troubling moral discontinuity. By policy we watch many tens of thousands murdered by bullets and high explosives, but act on policy that triggers when gas is used. There may not be an answer, but there certainly is a smell. The smell of death.

The Squamous Chronicles. Finish one and start another.

10 Replies

8/27/13.  As of today, I have 3 more x-ray treatments culminating in a dose of 63 Gray to the throat. The pain has required narcotics pretty much continuously and the attendant constipative delights that go with that. Pills are difficult to swallow and the gag reflex is heightened. The final chemo was yesterday so I am done eating platinum.

I began hormone ablation treatment for an aggressive form of prostate cancer two weeks ago. While the throat cancer is substantially beatable, the prostate is a different story. Here is the deal fellas. While you can gauge with PSA numbers, it is the Gleason grading system that tells the tale. And to get that you must do a biopsy. In order of increasing severity, the Gleason score goes from 2 to 10. I pulled a 9.

Hormone ablation is delicate way of saying chemical castration. The spread of prostate cancer can be controlled somewhat for up to 2 years by shutting down testosterone production. This they do by injecting a synthetic peptide, Degarelix, into belly fat to control the dosing to the pituitary gland. Had my first hot flash a week ago. It was a eunuch sensation.

Interesting anecdote.  My medical oncologist described an MD patient who had been using sunscreen on the radiated area of his throat. He soon experienced an increase in surface burning of the throat on continued x-radiation. Turns out he was using a sunscreen that had titanium dioxide that was scattering/absorbing radiation on the affected surface. He stopped and the accelerated damage ceased.

The Squamous Chronicles. Radiation, biopsy, gastric tube and chemo.

6 Replies

As of today, I am 18/30 of the way through radiation. Last week I was unable to eat much, resulting in a large weight loss (ca 10 wt %) and necessitating the placement of a gastric tube. This was done under general anesthesia, but while I was awake. A fluoroscope was used to view the procedure. This was a bizarre experience. I could feel the stomach being punctured and sutured to the abdominal wall.

As weird as this experience was, it was nothing compared to the prostate biopsy the next day. Eight corings of the prostate though the rectum wall producing 8 little meat sticks of sample. It felt like the snapping of a tight rubber band against the tissue. The doc tried to ask about my hobbies during the procedure for distraction. Glad that is over.

The biggest side effect of this has been fatigue. I’ve experimented with more exercise to good effect. Freshly juiced vegetables help compensate for the drug induced constipation. And a large influx of calories through the gastric tube all add up to an improved energy level. I have been juicing beets and swiss chard.

In general, owing to the radiation on the throat (they say) my taste buds are operating improperly. Everything tastes really bad.

This week, a day past the third 90 mg drip of cisplatin, I am experiencing hair loss.

CERN to make announcement Wednesday, July 4, 1012

Leave a reply

According to the CERN website, a webcast on LHC experiments is planned for, Wednesday, July 4, 2012. Apparently a new particle has been detected. Could it be the big chalupa? The Higgs boson?

CERN has previously announced resonance data at the expected energy but cautioned that the correlation by the requisite number of sigma’s was not in hand. In the US, a similar announcement was issued the other day from Tevatron data in Illinois. Same problem- not enough sigma’s. Hmmm. I wonder what CERN is going to say tomorrow wink wink nod nod?

On a side note, according to Quantum Diaries, researchers at CERN run Monte Carlo collision simulations for comparison purposes to the actual data stream. If events occur that are not anticipated by the simulations, then there is cause to examine the particular events. Interesting approach to sorting the data.

Denver ACS Meeting

Leave a reply

Just back from Day 1 at the Denver ACS meeting.  Spent the afternoon at the INORG session celebrating the 50th anniversary of the journal Inorganic Chemistry.  As usual, Harry Gray stole the show with his talk- today it was on oxo complexes. What I like about Gray is that he shows the younger members that being socially constipated is not manditory for success in chemistry.  Maybe it’s his delivery, but after a Gray talk I leave feeling like I have gotten a glimpse of the future.

Attendance is down a bit due to hurricane Irene.  Looks like the Atlantic coast dodged the bullet. Earth quakes, hurricanes … what next? Cane toads?

Afganistan: US Fights While China Mines Copper

Leave a reply

From an article by reporter Alex Rodriquez in the Tuesday, July 12, 2007, LA Times entitled “History succumbing to the allure of ore”.  The article describes efforts by archeologists to dig sites in an area southeast of Kabul soon to be razed by bulldozers in preparation for copper mining.

So, I understand the part about saving the archeology.

What I fail to understand is why the US is fighting in Afganistan, expending national treasure consisting of the lives of soldiers, equipment, and mountains of cash, while the China Metallurgical Group is busily extracting copper.

USA fights for “freedom”, expending vast treasure.  China’s communism overrides freedom yet digs and extracts treasure.  Really now.

Are we congenital fools?  Are the Chinese at least thanking us for making Afganistan safer for them?  The wars in Afganistan, Iraq, and Pakistan are estimated to cost the US 3.7 trillion dollars.  These wars have produced wealth for defense contractors and for China through it’s mining.  At home republicans are busy sheltering corporations and the wealthy from tax liability while trying to apply wingnut libertarian economic theory to justify why we can’t commit resources at home. 

Most republicans are not wealthy. Yet, republican ranks are jam packed with people of modest means who support a doctrine and a silent power base of wealth who will not reciprocate the support.  It’s utterly irrational.

This is too crazy for words.