Week the Second

So Week Two begins auspiciously. My blood counts were good; I felt (relatively) healthy and well going into my appointment yesterday; my port was hardly painful at all during the blood draws and chemo; and best of all, I'm feeling none of the nausea today that so flattened me last week. (Partly due, I am sure, to the different regimen of drugs I received this week.) I've been able, so far, to avoid many of the "optional" supportive drugs, which I like to believe is helping my body launch a more vigorous response to slaying the cancer cells and getting back in fighting shape.

I'm starting to lay the groundwork, ever so gently, for post-treatment life: plans for collecting my car from Alabama, for various short- and long-term work projects, for vacation travel and other small indulgences.

This week, I received vincristine and bleomycin; but I'll backtrack for a moment and talk about two of last week's drugs, mechlorethamine and vinblastine (since I already explained doxorubicin, the third).

Mechlorethamine, C₅H₁₁Cl₂N, is a type of mustard gas. Its anticancer properties were discovered (or, confirmed) as an unexpected "side effect" of a terrible accident in Bari, Italy, during WWII, where a stockpile of secret mustard gas exploded and thousands of civilians and soldiers died. While the incident was classified until 1959, and covered up for years after that, autopsies of those killed during the tragic event showed that the exposed experienced lowered white blood cell counts, demonstrating mustargen's potential anticancer effects.

Mechlorethamine simulates the effect of radiation on cancer cells, making the double-helix strands in DNA unable to uncoil and separate - and thus unable to divide and replicate. It is, as might be imagined by its chemical warfare uses, very damaging to the skin if it escapes the veins, causing extensive tissue damage and blistering.

Side effects include nausea, vomiting, hair loss, mouth sores, darkening of veins used for infusion, fever, poor appetite, metallic taste, ringing in the ears, loss of fertility, and low blood counts.

Vinblastine, C₄₆H₅₈N₄O₉, is a vinca alkaloid. For the gardeners among you, yes, that means it is derived from a periwinkle plant. Its anticancer properties were discovered when scientists realized that people drinking this periwinkle tea lowered their white blood cell counts.

Vinblastine works by halting mitosis, the process by which a cell separates and replicates its chromosomes for division into two daughter cells. The protein tubulin is needed to fuel this process; vinblastine binds the tubulin and thus starves the cell of the food it needs to produce mitosis. Like mechlorethamine, vinblastine is a vesicant and will cause extensive blistering and tissue damage if it escapes the vein.

Side effects include low blood counts, fatigue, nausea, vomiting, poor appetite, constipation or diarrhea, hair loss, mouth sores, metallic taste, headaches, jaw pain, high blood pressure, muscle and joint pains, depression, shortness of breath, and peripheral neuropathy (the aforementioned and dreaded numbness and cramping in fingers and toes).

Out of the laundry list of symptoms for mechlorethamine, vinblastine, and doxorubicin, I probably experienced just about every one over the course of the previous week, at one point or another. Luckily, the side effects seem to have faded prior to this week's treatment.

Thus begins Week Two.