Sobbering Events - The Mexican Flu Gains a Foothold

I'm watching in morbid fascination as the potential of a global pandemic, with resulting illness and death, spreads from the Third World to the First across a porous border.

As I write this, Mexican Flu cases have appeared in California, Texas, Kansas, and New York. So far, no deaths linked to the flu have been reported. It will likely not be long before we learn of the first death of an American to the Mexican Flu.

For CLL patients, and others with serious, life-threatening conditions, this comes as frightening news. The Mexican Flu is eerily similar to the Spanish Flu pandemic of 1918, killing healthy young adults (20-40) rather than the usual children and elderly populations.

The specter of bioterrorism has already been raised, but it doesn't take a terrorist attack to bring the potential of such a calamity to our world, already battered by a severe economic downturn. You'd think someone had it in for us. Maybe they do.

The misery of the Great Depression was worsened by a long drought resulting in the Dust Bowl. We now have a potential pandemic in the midst of another serious money panic. Do these things go together.

The President of Mexico has now exercised emergency powers. This comes as Mexico failed to respond with the first inklings that something out of the ordinary was going on. Only when the First World (The US and Canada) were able to analyze the genetics of the victims in Mexico did everyone realize there was a flu that seems to meet all of the requirements of a pandemic: human-to-human transmission, humans can become infected with it, and the populace has no immunity to it. In my opinion, these conditions have already been met.

I will be interested to see what happens to the stock markets of the world on Monday. If the news continues to get worse, a nascent recovery will die a quick and early death.

The government claims they are ready to stem a pandemic quickly. We'll see how this pans out.

Meanwhile, keep doing what you should have been doing all along; wash your hands frequently, avoid crowds, avoid sick people, cover your nose and mouth while sneezing or coughing.

A bit more on fasting before chemo

I neglected to put a citation in on the post about fasting before chemo. I can't seem to find the reference at the Proceedings of the National Academy of Sciences website, though.

Here's a news blurb on the subject if you want to read a bit more on it. The technique may protect healthy cells more than kill cancerous ones.

http://health.usnews.com/usnews/health/healthday/080401/fasting-before-chemo-protects-healthy-cells.htm

The article quotes a researcher at the University of California, San Diego who cautions that not enough is known in the human population to predict if this technique would be effective. There are some cancers, he notes, that some cancers have already altered metabolic functions in normal tissue already, and fasting might not add anything to the current treatment regime.

Interesting to note, though. I wonder if any CLL researchers have an opinion on this now, or if they will take refuge in the all-purpose answer, "it's too soon to know yet."

For Americans Only

It's a few hours before April 15, a date heavy with meaning for Americans. It's the day federal and state income taxes are due. Despite suffering from cancer, or going through chemotherapy, the IRS wants its money, and it wants it NOW!

I have somewhat of a complicated return, so I've in my third week of working to get this monster done. It's nip and tuck whether I can finish on time.

On the other hand, I've never failed to get at least the federal return in on time. I hope I stay healthy enough for one more day...

Should you fast before chemo?

There is evidence that you might be doing yourself a favor it you do.

Me? I'm so addicted to food that when I fast, all I think about is food. I could fast one day. Two days? I've had to do it before a colonoscopy that I had late in the day one time. All I could think about was food.

I think it would be worth a try!

I'm through with FCR, so this advice comes a bit late for me.

When it's your life, this might be something to at least run by your onc doc.

Feeding the Beast

If I dropped dead tomorrow, my cancer would be cured. Sounds kind of a stupid thing to say, but let's consider it a bit.

Once my heart stops beating, the CLL cells are going to soon be feeling the pinch. Nutrients are going to stop coming along, the blood flow bringing oxygen and taking away carbon dioxide simply won't be there. The protective vitamins such as vitamin C the cancer cells use to fend off death are going to be used up, and no longer serving a purpose. The CLL cells begin to die.

Obviously, this is a drastic (but 100% effective) CLL cure. Can we use this impractical information to our advantage? I think so.

We can perhaps slow the growth of the CLL clone by denying them the stuff of life. With our limited knowledge (we don't know, for example, what drives the CLL cells to merrily proliferate until it kills us, and it), we can't cure CLL by 'gentle means', but perhaps we can slow its growth.

And since CLL is an indolent (slow growing) cancer, with a potential lifespan of more than a few years, slowing the growth may mean months or even years more of good quality of life. This means, perhaps, more of us will be around when truly effective treatments are finally available.

I'm going to discuss one of those vital constituents as I see them, that the CLL cells require to madly and indiscriminately split and split and split. That's cholesterol.

Several papers have been published that point out that the standard cholesterol tests are not a valid indication of the cardiovascular health of the CLL patient (http://tinyurl.com/dha4hc). It seems that both high-density lipoprotein, HDL (the 'good' cholesterol) and low-density lipoprotein (LDL, the 'bad' cholesterol) is decreased in the CLL patient as the disease progresses.

Consider this paper in PubMed: http://tinyurl.com/dmegog. It asserts that cholesterol levels are reduced in progressive blood cancers including CLL, and that cholesterol levels rise when there is a response to chemotherpeutic intervention.

It's tempting, then, to conclude that the rapidly proliferating CLL cells 'sop up' large amounts of cholesterol to support their indiscriminate breeding. It may follow, then, that limiting the amount of cholesterol available for these cells to grow might slow the proliferation down.

I'm not aware of any studies that have tested this idea in CLL, but the idea has been floating around for some time. It's been known for years that high cholesterol is a risk factor in the development of cancers, but as far as lowering the levels as a means of slowing cancer's growth, much less is known.

There is one interesting paper, though, that concludes that the use of one type of statin drug (which is designed to reduce cholesterol levels), simvastatin, seemed to cause a slowing of the growth of the clone (http://tinyurl.com/cbzaac). Ironically, it was noted in the paper that some 40% of this very small sample of patients, went on to require treatment the following year. It is unclear from the abstract whether these four patients were the same ones who had noticable effects on their CLL clones. The apparent conclusion these researchers reached was that the use of statins may actually increase the need for treatment. The very small sample size makes reaching that conclusion difficult.

It seems reasonable to consider moderating the amount of cholesterol coming through the diet. The body is perfectly capable of manufacturing enough of the substance to meet the needs of the brain and body without necessarily consuming it.

This means going on a low cholesterol diet, exactly the same as one would adopt if one was concerned about heart disease. Low saturated fats, avoiding all sources of cholesterol in the diet, lean proteins, use of good fats in lieu of 'bad' fats, and so on. There are plenty of these diets and advice elsewhere on the web.

Another way of lowering cholesterol is to eat a higher-fiber diet. This includes both soluble and insoluble fiber. By increasing the bulk of the stool, the amount of bile acids excreated is increased. And since we know that these substances contain cholesterol, this effort can decrease cholesterol further.

We can't go too far, because a certain amount of cholesterol is necessary in the body, so I'd talk it over with your doc, and track your over-all cholesterol level.

Maybe it would have a slight, but real, effect.

Waiting for BMB Results

I had another bone marrow biopsy last Wednesday, March 25. I can't count how many I've had, perhaps nine? For some reason, they've gotten increasingly painful. When I had one at MD Anderson, they told me I needed some sort of pain-killer, so that's what I asked for this time at UC San Diego. I got a prescription the day before from Dr. Kipps. It worked pretty well, I had percocet. They told me to take it when I got to the clinic, but I worked out that the maximum pain-killing aspect of the drug was at about one hour. That will be useful information if I ever have a BMB again.

I don't have results. Dr. Kipps has held off with any thoughts of other treatment until we get the results. I would have thought I would have heard about the results by now; perhaps he just doesn't want to give bad news?

I've had somewhat of a hard time dealing with my failure on FCR. My blood numbers are OK, a little low, but OK. However, the percentage of the white blood count that are lymphocytes are going up, and the percentage that are neutrophils are going down, obviously a poor sign.

He mentioned getting a Neulasta shot on Wednesday, but I forgot about it and the physician's assistant also apparently forgot about it. I have a call into Sheila Hoff, but have not heard back from her. I would I guess (now) get the shot in Sacramento, since it would be ludicrous to fly back down there for a shot.

I wish I had remembered, not that they shouldn't have arranged it themselves. Failure all around.

Cruelty to Animals - Snail Bait

Sorry to depart from the usual topic, but I just witnessed one of the most horrible things I've ever seen.

We have our dog in the vet, recovering from a splenectomy (yes dogs get them as well).

There was a beautiful, young, chocolate-colored dog in another pen. He was restless when I first walked by him, but despite being on anti-seizure medicine, he was getting more and more restless. As I was visiting my dog, and could more clearly see him, I noticed he was basically having full, constant, convulsions. His eyes were staring straight ahead, and his limbs where flailing around as if his whole body was in relentless, terrible motion. It was one of the most horrific things I've had to witness.

I overheard the vet techs talking that they had given the maximum dose of the anti-convulsive drug that they could. He was getting worse and worse, they said. The dog could not swallow even a drop of water.

I asked the vet tech standing nearby what had happened. She said that the dog had eaten snail bait.

I've since found out that snail bait contains metaldehyde, a toxin that is poisonous to animals, wildlife, and children(!). It is flavored with molassas to be attractive to snails. You can imagine what a young puppy would do when there was tasty 'meals' spread around the back yard.

Why this product is permitted to be sold is beyond me. Obviously, the poor dog's owners cared about their animal, because they took him to the emergency vet. Yet they apparently didn't read the small warning label on the back that warned against putting the product where dogs and small children could find and eat it (yes, children have died from eating this crap).

There are other snail control products available that don't contain metaldehyde. And there are of course other control methods that don't subject animals to a slow, painful death.

Seeing that poor animal suffer such a heart-breaking event was enough to be seared in my mind as long as I live. If others could see that dog, I wouldn't believe that metaldehyde wouldn't be banned immediately for at least residential use.

PLEASE PLEASE PLEASE don't use this product where pets, wild animals, and even children could encounter it. This is not a painless death. It is torturing an animal to death.