Tuesday, October 31, 2006

An Unwanted Journey: Day 0342 - Colondar

Scarred. Yes, having undergone surgery for an low anterior resection, I am scarred. Or, as I often say when asked, "I have one huge, wonkin' scar in my abdomen." It's really long and makes me feel quite self-conscious when even the thought of wearing a bathing suit comes to mind.

But there are other, probably smarter, people than me who have also undergone resections who realize that the scar is a badge of honour and a symbol of survival from the second leading cause of cancer death in North America. The Colon Club, at http://www.colondar.com/, publish an annual calendar with photographs which actually celebrate their abdominal scars and tell stories of survivors (not all the photographs are of scars!).

I never would have thought of something like this, but after getting used to the idea for a little while, I think it's a great idea. The stories are especially inspiring. There are tales from people with Stage 1, 2, 3 and 4 diagnoses.

The web site is designed to educate people about colorectal cancer. It includes crazy projects like the calendar, a 40-foot colon, and a Rolling to Recovery inline skating marathon by Molly McMaster, a colon cancer survivor diagnosed at age 23. There are even online copies of colondars from previous years.

A great idea and a fabulous educational resource.

Sunday, October 29, 2006

An Unwanted Journey: Day 0341 - Not Knowing

On one of the email groups to which I subscribe, there has recently been some discussion about tolerance for ambiguity, especially in regards to questions about the existence of God, life after death, the meaning of life, etc. To summarize, it seems that fundamentalists and atheists are both strident in their affirmations and their certainty about such ultimate concerns (as Paul Tillich put it, "faith is the state of being ultimately concerned."). One cannot be agnostic without jeopardizing one's moral position - this is a truism for both groups. The only alternative appears to be development of a comfort level with ambiguity, for tolerating a state of not knowing.

For cancer patients and cancer survivors, not knowing is the normal state of affairs. We don't know why we got cancer. We don't know why we survived and why others don't survive. We don't know whether treatment will be effective. We simply don't know about most of the issues surrounding our experiences with cancer.

Asking why isn't just about survivor guilt, although that is certainly one aspect of what is happening with me. It's also about delving into one's spiritual roots. One reason we do so is to regain a sense of control. That sense of control may be the key ingredient in why fundamentalists and atheists share common ground. But with cancer, the sense of control and certainty is shattered.

Tolerance for ambiguity or not knowing is an acquired skill. It is definitely not about submitting to an external authority. Instead, it is about asking the tough questions, about putting established authorities on the hot seat without necessarily expecting a resolution, about relishing the journey of question-and-answer, about holding on lightly, about what Edward de Bono calls prototruth - the best we can do after our latest deconstruction. To do this requires a minimal level of maturity that is often missing among the young and certainly absent among those who demand unequivocal answers to questions like "Was Jesus the Son of God?" or "Did I bring cancer on myself?"

In my personal journey, tolerance for ambiguity has been a hallmark of the development of my spiritual understanding. But it was with the advent of a diagnosis of cancer that I had to face the life-threatening reality of not knowing. In fact, even now, during my recovery phase, I find I have to continue with an exercise routine to strengthen my tolerance for ambiguity. Just because I have survived thus far is no guarantee that I will survive in the future, nor is it a guarantee that I won't fall back into a fundamentalist desire for certainty. I have to exercise not knowing or what the great English mystic called The Cloud of Unknowing in order to remain psychologically healthy.

Saturday, October 28, 2006

An Unwanted Journey: Day 0340 - Survivor Guilt

For the first time in many, many years, I will not be at home with my family on Remembrance Day. Sure, I'll have my poppy and I'll be remembering the sacrifices of those who gave their lives in the cause of freedom and democracy, but I won't be home with my loved ones. It is the faces of my wife and children that are most poignant when I reflect on what soldiers sacrificed.

The phrase that comes from the Tom Hanks character, Captain John Miller, to Private James Ryan in Saving Private Ryan near the end of the movie, comes to mind: "Earn this."

Soldiers who have survived when many of their comrades died are often immediately grateful that they are able to continue with their normal lives. But as time progresses, they often experience survivor guilt, the sense of disentitlement to life. Sometimes, that translates into a sense that their survival must now be earned, sometimes, sadly, nothing they do seems to compare with the gift they have been given.

This happens to cancer survivors as well. In fact, if my experience is indicative, the longer I survive the less entitlement I feel for my survival. Just yesterday, for example, our family learned of the death of a high school teacher at age 33 from cancer. Both my sons had studied Spanish with her. She leaves a husband, three small children, and a host of students whose lives she enriched.

"Earn this."

I have been wondering lately why I am almost always on the verge of crying. I'll watch a movie or television show or hear a newscast or read a story and my eyes will well up. I can't control this. But maybe it has something to do with survivor guilt. Why me? Why am I seemingly beating back an advanced colorectal cancer while so many others succumb? What makes me so special?

Nothing, really. I just hope I can earn the fortune given to me.

Friday, October 27, 2006

An Unwanted Journey: Day 0339 - Red, Red Wine

The American College of Gastroenterology will be meeting in Las Vegas this coming Monday. I'll be in Vegas a week from this coming Tuesday. Kwinky dink? I think not. Many of those gastroenterologists gathering in Vegas will be toasting a new study with glasses of red wine. I'll drink to that! In fact, when I'm in Vegas, I think I might have a glass of red wine every day, sometimes even while contemplating the same study celebrated by gastroenterologists.

What is it about this study? Well, the study tells us that three glasses of red wine or more per week reduce the incidence of abnormal growths and cancers of the intestinal tract. Dr. Joseph Anderson, an assistant professor from the State University of New York at Stony Brook, discovered that 9.9% of wine abstainers, 8.8% of white wine drinkers, and only 3.4% of more-than-three-glasses-of-red wine-per-week drinkers had colorectal neoplasia - cancers or polyps that become cancerous.

The key ingredient is apparently resveratrol, a component of the skins of grapes and a polyphenol found in red wine.

Dr. Anderson will likely try to spoil the fun - you know, totally ignoring "what happens in Vegas stays in Vegas". He will likely suggest that people not start drinking red wine. They should exercise instead. Hmmm...maybe if I have a glass or two of red wine while walking on the rebounder while watching movies on the DVD player...yes, that would do the trick!

Thursday, October 26, 2006

An Unwanted Journey: Day 0338 - Choosing Your Poison

I continue to read Leroy Siever's My Cancer blog every day. He is an amazing individual who has suffered far more than I have endured during my treatment for rectal cancer. Right now he has to decide whether to continue his current chemotherapy regime or give his body a rest for a couple weeks before embarking on another cycle. Avastin is a major part of his treatment protocol. Unfortunately, that alone tells you a little bit about what he faces. Avastin is primarily used in treating metastatic colorectal cancer, something I hope never to experience.

It seems that a lot of the current research in colorectal cancer studies has to do with metastatic cancer, especially in chemotherapy. One report I read today is an excellent example. It's about Vectibix, a monoclonal antibody that lengthens the time to disease progression or death from 60 days to 96 days. When viewed in terms of percentages, it seems remarkable - a survival time approximately 50% greater than with standard treatments. But when viewed in terms of overall efficacy, it hardly seems worth the effort - 36 more days, days that are probably marked by nausea, fatigue, and the whole host of chemotherapy side effects. But, I suppose when faced by death, having an extra month isn't such a bad proposition.

Cancer patients dealing with chemotherapy are often faced with decisions that cast a twist on that common phrase "choosing your poison". Very often, especially in the case of metastatic disease, the medical oncologists cannot state unequivocally whether one or another treatment regime will produce beneficial results for the individual patient. There are simply too many variables to be sure about the outcome. That means that the decision to participate in a regime becomes a guessing game, one in which the patient has to assume even weightier decisions.

Another recent study from Denmark casts a light on how patients make these kinds of decisions. Normally, when faced with a choice of taking a drug orally or submitting oneself to intravenous therapy, patients will choose the oral medication. But the Danish study indicates that many patients chose to take 5-FU (fluourouracil) and leucovorin intravenously rather than Xeloda orally, primarly because they experienced less toxicity from the standard 5l-FU treatment.

This rings true with me. When faced with a choice between two types of drugs, most cancer patients will choose the one that is less toxic, even if the administration of the drug is less appealing. But when faced with a choice about taking a treatment or doing nothing, most will choose the treatment, no matter how toxic the results. I hope never to have to make choices like that, but my thoughts and prayers are with those like Leroy Sievers who is faced with such decisions regularly.

Wednesday, October 25, 2006

An Unwanted Journey: Day 0337 - 5 Year Recurrence Rates

Fear of recurrence is one of the most powerful emotions experienced during recovery. Because I was warned about such emotions prior to entering this transitional period, I think the impact is less severe than would otherwise be the case. I do worry occasionally about recurrence, but for the most part I think I have a relatively healthy and realistic attitude about the future.

Next month I will have another colonoscopy conducted by my surgical oncologist, the person most familiar with the anatomy of my colon and rectum. I am actually looking forward to this, primarily because I anticipate that no polyps will be found and that everything on the "inside" is clean. Then I will wait another 2 years for the next colonoscopy, followed by a 5 year wait.

Fortunately, a recent study from Indiana University has found that the chances of having colorectal cancer 5 years after a colorectal screening with no precancerous growths or polyps found is very low. Followup screening is a somewhat contentious issue among gastroenterologists, the American College of Gastroenterology recommending a 10-year interval rather than the standards used in Ontario and British Columbia. Those two jurisdictions have moved in the opposite direction and have studies supporting the change.

From my personal perspective, the more frequently I have colonoscopies, the better. It is the gold standard; nothing compares to what some term "optical" colonscopies, even the more recently favoured "virtual" colonoscopies. Patients who fear recurrence, and especially those like myself who have endured radiation, surgery, and chemotherapy, are quite willing to undergo the indignity of a colonoscopy just to assure themselves that their worries are without foundation.

Wednesday, October 18, 2006

An Unwanted Journey: Day 0330 - The Bottom Line

I tried completely eliminating Imodium from my daily pill popping diet. Bad idea.

This past week, I have been dismayed to find myself in the washroom at least a dozen times each day at a bare minimum, mostly in the evenings. Part of that experience may be due in part to attention -clearly, I have more time to devote to how my body feels in the evenings after I've come home from work. But that's only part of the story. Another major reason for the frequent visits I've come to associate with the effect of Imodium on gastrointestinal peristalsis; in other words, the bowels become more active without the depressing effect of the medication. That alone is enough reason to continue some pill-popping.

Frequency also has a direct correlation to soreness of the bottom. Another good reason to continue with the medication.

What all of this means, I suppose, is that I am discovering that I don't really know what a normal life will be yet. To some extent, I am dismayed by the thought that my life is irrevocably changed. If my current bowel habits, for example, are indicative of the future, I will have to adapt my lifestyle dramatically.

I strongly suspect that some aspects of what I am experiencing are not due to continuing side effects, but are related to the surgery itself. Having lost most of my rectum and all of the mesorectum, as well as part of the sigmoid colon, the experience of defecation has changed and will never be the same. For instance, the sense of urgency that everyone experiences is far more urgent for me than it ever was before surgery. I literally have far less time to make that visit to the washroom than ever before. This means that meetings can become a problem, long telephone conversations, seminars, air transport, etc. I suspect it also means that I will have to be extremely careful about diet.

I can adapt and I will adapt. I only hope that I will know soon what is temporary and what is permanent in my recent recovery.

An Unwanted Journey: Day 0330 - Shame on Canada

CBC has reported recently on Canada's leading role in opposing a proposal to restrict international sales of asbestos, a known carcinogen and almost always the direct cause of mesothelioma.

Canadians, and especially the Canadian federal government and the Quebec provincial government, should hang their heads in shame.

It's not as if the link between cancer and asbestos is news. We've known unequivocally of the carcinogenic properties of crocidolite asbestos (so-called "blue asbestos") since at least 1960.

What may be news to readers (it certainly was news to me) is that Canada is the only western nation that exports asbestos, something which associates our nation with Russia, China, and Kazakhstan. This past week, at a convention in Geneva for parties to the Rotterdam Convention, a treaty for restricting trade in toxic substances, Canada led opposition to adding chrysotile asbestos to the list of toxic substances. Even though asbestos and asbestos products are banned in Canada and the Canadian Environmental Protection Act of 1999 lists asbestos as a toxic substance, we still export more than 90% of the asbestos mined in Quebec to places like India and the Philippines, places where adequate laws and regulations limiting the use of asbestos either don't exist or aren't enforced. This is shameful behavior!

The World Trade Organization has already ruled against a challenge put forward by Canada against a ban on all asbestos products in France. The WTO ruled that "no minimum threshold of level of exposure or duration of exposure has been identified with regard to the risk of pathologies associated with chrysotile." But despite this, Canadian tax dollars - to the tune of $20 million - are used to support the industry lobby group called the Chrysotile Institute.

As someone just recently discharged from a regional cancer centre and having received treatment worth in the hundreds of thousands of dollars, I am ashamed of our country's hypocrisy in the promotion and sale of a know carcinogen to developing countries.


The Canadian federal government and Quebec provincial government position is supposedly based on claims from the Chrysotile Institute that the chrysotile form of asbestos must be distinguished from amphibole asbestos, the latter supposedly being the only demonstrated culprit in mesothelioma. But other studies dispute that claim. See, for example, a major 25-year longitudinal study conducted in China linking chrysotile asbestos exposure with mesothelioma: "As the results indicate, we found no evidence in support of the amphibole contaminant hypothesis. To the contrary, a strong potential for chrysotile asbestos alone to cause lung cancer and mesothelioma was suggested."

See aslo Chrysotile Peritoneal Mesothelioma.

For more information about chrysotile asbestos, see Mesothelioma Information.

Sunday, October 15, 2006

An Unwanted Journey: Day 0327 - Flashbacks

It's Sunday morning. Everyone in the family is taking the opportunity to sleep in...except me. I have been working on a presentation for work for tomorrow morning.

This is progress! Working on the weekends is not something I would normally do, but my place of employment has been very generous with me during my illness and it only makes sense to pay back when I can. Not only that, but being able to do so is itself an indicator of progress back to health.

There are other indicators too. Yesterday, my youngest son and I went next door to take our neighbours' greyhound for a walk around the block (they were away for the day). The animal is a magnificent specimen of a greyhound, white body, lean, muscular, gentle, and yet made to run. It's always fun to see her bounding down the sidewalk, knowing full well that if we released her to run that she would fly like the wind.

Being able to walk the dog is an indication that my stamina is returning. Being able to work on both days of the weekend is another indication. Reading both business and personal books over the weekend is another indication.

But there are flashbacks to tougher days. Yesterday I went in for an unusual Saturday office opening for an allergist. I still have some skin rash from the antibiotics I stopped taking 16 days ago. As I walk, the neuropathy in the feet is evident with every step I take, the bottoms of my feet feeling like they were sponges. And then, of course, there is the omnipresent possiblity of diarrhea. Last night, for example, I made at least 15 trips to the bathrooms of our house, progressively becoming sorer and weaker with each trip.

Still, I am reducing medication, trying to gradually eliminate the pill-popping that has been par for the course during my illness. This, too, is an indicator of progress.

I have relaxed some this weekend too, and will do some more today. My preference for relaxing is watching episodes from the first season of Lost. The flashbacks used so frequently as a device for that series are something entirely different from the symptom flashbacks I continue to experience daily.

Wednesday, October 11, 2006

An Unwanted Journey: Day 0323 - Discharged!

I have just come from my appointment with the medical oncologist at the Grand River Regional Cancer Centre. Effective immediately, I am discharged from active assessment and treatment at the GRRCC. My family physician will manage the followup recommended by Cancer Care Ontario (CCO), the British Columbia Cancer Agency (BCCA), and the American Society of Clinical Oncology (ASCO).

Every 4 months for the next 2 years, I will have a full physical examination by my general practitioner (GP), including a digital rectal exam (DRE) and blood tests for carcinoembryonic antigen (CEA). The latter will be done for 5 years. After the first 2 years, I will meet for the same tests with my GP every 6 onths for the next 3 years. In addition, for the next 3 years, I will have a CT of the abdomen, pelvis, and chest. A colonoscopy should be performed at the 1 and 3 year mark from diagnosis and then every 5 years after that.

So, unless recurrence happens, I will no longer have to visit the GRRCC.

It feels odd. There was no ceremony to mark the discharge, no graduation, no celebration, just a handshake and goodbye. I guess that's the way it should be. But it still feels like something is missing. I just hope that something is cancer!

An Unwanted Journey: Day 0323 - Remember This Name

Today, a European researcher named Dr. Eduard Batlle will be honoured at the 6th annual ISREC (Swiss Institute for Experimental Cancer Research) cancer research conference in Lausanne, Switzerland.

Dr. Batlle has concentrated on the onset and progression of colorectal cancer, studying intestinal stem cells and their malignant counterparts, identifying molecules that prevent colorectal cancer, and identifying the genetics for metastasis of cancer cells to the liver. His research has been cited over 1,000 times in scholarly journals. He is also a patent holder for products being developed by two separate companies.

The award he will receive today is the Debiopharm Life Sciences Award (worth 100,000 francs or $89,450.67 CAD)). This year the award is slated for cancer research. The intent of the award is to honour European Life Sciences researchers under the age of 40. The research rewarded by this prize must demonstrate high potential for therapeutic and commercial applications. Debiopharm is currently known for Eloxatin, a treatment for colorectal cancer based on oxaliplatin administered by injection.

Oxaliplatin was one of the cocktail ingredients in my own chemotherapy. It is delivered as an intravenous infusion given over 1-6 hours. The dosage is measured according to the body surface area, calculated by body weight and height. Usually, that means 85 mg/m2 every two weeks. In almost all cases, eloxatin is given with fluorouracil (FU) and folinic acid.

Tuesday, October 10, 2006

An Unwanted Journey: Day 0322 - Continuing Side Effects

No matter how much you hear about it, no matter how prepared you think you are, no matter how much you have researched the topic, the continuity of chemotherapy side effects after chemotherapy has stopped is still a surprise.

I mentioned in an earlier post how I was counting backwards from the time of my last chemotherapy treatment in order to provide myself with some perspective on side effects. Yeah, I'm doing that. But still, Monday night's diarrhea and sore bottom, which continued into Tuesday, thoroughly pissed me off. Here I was visiting the washroom every 50 minutes or so, swearing at myself and angry that I would have to miss yet another day at work. What made it worse was that it was happening almost exactly as if I had a chemotherapy treatment last Friday. But I hadn't. I enjoyed a fairly decent Thanksgiving weekend with my family, with a sore butt and tentative though I might have been in our excursions, but then Monday evening comes along and I am apparently betrayed yet again by my body.

Perhaps my attitude sucks. Perhaps I need to be thinking more about the benefits of being through chemotherapy. I recognize the wisdom in that advice, but I still have to recognize the feelings of frustration and write it out of my system. So, I guess this blog entry is pretty much self-indulgent. Thanks for listening...

Monday, October 09, 2006

An Unwanted Journey: Day 0321 - Completely Preventable

It's a pain-free procedure. But only 5% of the population will develop colorectal cancer. Unless, of course, you happen to have a member of your family who has had colorectal cancer; then your chances of developing cancer are dramatically increased.

So why don't more people follow their doctor's suggestion to have a colonoscopy? Or why don't people request a referral for a colonoscopy from their family physicians?

Physicians are reluctant to prescribe the procedure because it's relatively expensive (until you consider the treatment alternatives after you're diagnosed). From the patient perspective, it is a potentially risky procedure, but complications are so rare that most physicians will never encounter anyone whose has suffered a complication brought on by a colonoscopy. Finally, doctors simply aren't doing a good enough job of recommending and prescribing the procedure.

The most important message I wish to convey from my Unwanted Journey entries is to have a colonoscopy. If you wait until you've had symptoms, then your chances of surviving are reduced to about 50% (I'm certainly optimisitic that I'm in the 50% who will survive). Far too many people, including members of my own family, are playing the odds. And why? Mainly because they don't like the idea of bowel preparation. Granted, not a fun time, but it is pain free, just like the procedure itself.

In a few weeks' time I'll be in Las Vegas. I might even play a few slot machines or gamble at some card games while there. I'll be thinking about odds, to be sure. But when it comes to whether or not to have a colonoscopy, the odds are decidely in favour of having the procedure.

Sunday, October 08, 2006

An Unwanted Journey: Day 0320 - Canadian Thanksgiving

I've started counting backwards from the end of treatment in order to provide myself with some perspective on the continuing side effects. That way, I will train myself to expect some discomfort, some neuropathy, some diarrhea, and some fatigue. I hope to then be less surprised when my body seems to betray me as it did yesterday when visiting the apple orchard with my family. A simple reaching for apples high in a tree, left me in some pain and feeling less confident about how well I was recovering.

Still, that was a minor episode in an otherwise refreshing and genuinely memorable experience with my wife and youngest son. The skies were extraordinary both yesterday and today. Bright blue skies, almost painfully bright sunlight, warm temperatures for this time of autumn, the crunch of biting into an apple only moments before having been plucked from the tree and polished on my sweatshirt to remove the remnants of pesticide, the wash of colours on the trees, especially the sumac by the roadside hills, the slow moving and blue mirror of the Grand River meandering through both the cities and the countryside, the casual, thankful conversations in the car about family traditions, Oktoberfest sausage, Cambridge's Reid's chocolates, and Kitchener's Nougat's speciality foods.

I am so grateful the eighth and final chemotherapy treatment was canceled. Otherwise, this weekend for me would be all about visits to the bathroom, sleeping the days away, and hoping for better times. Instead, my family and I are doing precisely what we want to do on the Canadian Thanksgiving weekend - enjoying each other's company, remembering past Thanksgivings, giving quiet, unmentioned thanks that I am recovering from cancer, eating all the traditional foods and treats, watching some TV, taking drives in the countryside to see the colours of autumn, walking in orchards and conservation areas, and hoping for even better times in the future.

As one person put it, life is about remembering, forgetting, and then remembering again. This Thanksgiving is special for me. It's all about remembering past Thanksgivings, forgetting, if only for a day, the anxiety of this past year, and remembering too that life is short, but can be beautiful.

Friday, October 06, 2006

An Unwanted Journey: Day 0318 - Getting Used to Recovery

The recovery phase is pretty much what the authors of Picking Up The Pieces: Moving Forward After Surviving Cancer predicted. I no longer have Community Care Access Centre (CCAC) nurses coming to my home regularly to monitor how I'm doing and to change PICC line dressings. I no longer have biweekly visits to the Grand River Regional Cancer Centre (GRRCC) where I can talk to oncologists, nutritionists, pharmacists, and nurses about what's happening in my battle with cancer. In other words, I no longer have a regular structure and support network.

Instead, I have occasional questions from colleagues and neighbours about how I'm feeling. Friends and family members tend to talk to me about celebrating the end of treatment with the expectation that it's all about putting the battle behind me and getting on with life. My immediate family is a little more knowledgeable about what the recovery phase is actually all about, and for that I am indeed grateful.

Still, there is a major shift going on now that will take reflection, time, and practice to handle skillfully. One obvious example is the continuity of side-effects. During the past two days, for instance, I have felt as if I had a low-grade flu, with additional symptoms like diarrhea and neuropathy in the feet. My feet have felt as if I was walking on gravel in very thin sponge flip-flops. Not a natural feeling!

On the other hand, I am back at work full-time and making a difference again in the lives of my colleagues...for the good, I hope! I can look forward to fulfilling projects and contributions to the welfare of our information management systems and the productivity of our staff. I have never felt more excited about my work, perhaps because of the troubles I've gone through in the past year.

I still have to take things easy. A full day at work is more than enough right now. The evenings have to be geared towards rest and relaxation with a snooze or two before going to bed for a good 8-9 hours of sleep. I simply cannot consider anything more ambitious right now. Give me a month or two and things will gradually change as I begin to regain physical fitness and work through the exercises in Picking Up The Pieces.

Tuesday, October 03, 2006

An Unwanted Journey: Day 0315 - PICC-less in Kitchener

On a day when other events eclipsed my personal news, I still have many things to be thankful for. Yes, the Grand River Regional Cancer Centre called to have me come in and remove my PICC line, but the Grand River Hospital emergency department is still in the news. ER doctors are overworked and understaffed, so much so that the entire ER ward was to have been closed this past Sunday. The Cambridge Memorial Hospital's ER is now being managed by a private company in order to solve some of its problems. It seems that there is a province-wide malaise in hospital ER departments. Throughout the Waterloo region emergency medical services are certainly in crisis. But all three hospitals seem to be keeping services alive at least. That's something to be thankful for.

I also received a phone call from my eldest son as he was walking home from our local shopping centre and passing by the Forest Heights Collegiate Institute where my youngest son is in grade twelve. Shortly after 11:00 am, the school was locked down and students either evacuated or kept in safe locations throughout the school for up to 3 hours while up to 40 police officers and 12 tactical officers searched for intruders carrying weapons. Arrests have been made and I'm happy to report that no students, including my son, were injured during the code red lockdown.

On a personal level, the skin rash is starting to abate, the PICC line was removed without any problems, and I'm beginning to feel better in general. Side effects are still quite evident - including neuropathy, sensitivity to cold, fatigue, and diarrhea - but they are starting to diminish slightly. Again, something to be thankful for.

This weekend is when Canadians celebrate thanksgiving, so it seems appropriate that so many good things are happening these days.

Sunday, October 01, 2006

An Unwanted Journey: Day 0313 - Re-Mission

So, do you think a 53-year-old male should qualify as a "young person with cancer"?

That was how the gastroenterologist described me when I was first informed that I had a large tumour in the sigmoid colon and rectum and that it was most likely cancerous. "It is quite a large tumour for such a young man as yourself, " he said.

There are days when I feel anything but young. Still, I think I have many of the personality characteristics of someone far younger than my chronological age. In fact, just today, I borrowed the book I purchased yesterday for my son in order to read all about why video games are so good for young people (Everything Bad Is Good For You). The section on video games outlined how gaming makes you smarter by focusing on decision-making, something I have already outlined for friends and family members wondering why my wife and I allow our two sons to spend so much time playing World of Warcraft on their computers.

Which brings me to the point of today's blog entry - cancer gaming, a kind of why-didn't-I-think-of-that situation.

A non-profiit Cailfornia company founded in 2001, called HopeLab, has created an interactive 3rd-person shooter video game called Re-Mission in which players pilot a nanobat called Roxxi through the body of a fictional cancer patient destroying cancer cells and defending the body against side-effects.

The game manual looks interesting. In the Table of Contents, for example, there are a cast of friendly and enemy characters which reads like a mini-textbook of information about cancer.

Friendly Characters

B cells and dendritic cells, macrophage and T cells, platelets, red blood cells

Enemy Characters

Bacteria, brain tumor cancer cells, fat globule, leukemia cells, lymphoma cells, mouth sores, mucous drops and mucuous sludge, neuronal impulses, osteosarcoma cells, stool jag, Reed-Sternberg cells

A study was conducted by HopeLab to see if there were potential health benefits to those playing the game (for the full outcomes study report see http://www.hopelab.org/docs/Outcomes%20Study.pdf). The results were announced in March 2006 (about 1 week before my surgery) to the Annual Meeting of the Society of Behavioral Medicine in San Francisco. Their conclusion was "that a theory-based, data-driven intervention delivered in an appealing interactive videogame context can produce significant increases in cancer-related knowledge and self-efficacy for young people with cancer."

Sounds good to me. Because I am a cancer patient, I qualify with HopeLab to receive a single free copy of the game (but it will take 2-4 weeks before the DVD arrives). And while waiting for the game, the following cancer-related games are worth a try: