Chemotherapy Ward: Facing My Worst Fears

Shafts of light from rows of windows illuminate the sterile room. A sallow-faced woman hooked up to an intravenous drip slouches in a oversized lounge chair.  Her bald head, cloaked by a crocheted hat, droops on her chest.  A toxic cocktail of drugs surges through her body as she naps.

A tube winds from a plastic bag to a port, a small disk inserted under the skin in her chest.  The drugs sap her strength and drain her energy.  From her looks, she appears to be in her 70's.  It's only a guess because cancer and chemotherapy sabotage the body, affecting your physical appearance.

As I approach the petite woman, I observe the hushed conversations swirling around patients seated in adjoining chairs.  Some patients read to pass the time.  Others watch television or listen to music.  The fortune ones have family sitting in comfortable chairs next to them, chatting quietly.

When I reach the woman, I see a blanket hugs her tiny frame.  She is experiencing chills. However, there are worst side effects.  Vomiting and nausea are the most common.  But the list of reactions is long: fatigue, infection, anemia, loss of appetite, digestive distress, anxiety and hair loss.  And more.

The anonymous woman is in the Infusion Center at the Mays Cancer Center in San Antonio, a facility affiliated with the UT Health Center and MD Anderson. I am present as a volunteer, offering snacks to patients.  It isn't my first visit to a chemotherapy ward.  But I still feel awkward and nervous.

The woman opens her sleepy eyes as I roll the squeaky snack car near her chair.  I tick off a list of snacks and surprisingly she opts for the ice cream.  With seemingly great effort, she stretches out her withered hand to receive the plastic cup.  She offers her thanks and a smile that warms the room.

As I move from patient to patient, I am amazed by their spunk, their grit.  They are determined to battle this cruel disease on their own terms.  One patient is dressed as if she is attending a fancy charity ball.  I remark on her colorful outfit.  "I won't let cancer define who I am," she says.

Some family and friends faithfully accompany patients to each treatment.  These angels of mercy kibitz with their loved ones, providing a welcome distraction. But it is the patients who are fighting alone who tug at my heartstrings.  Who consoles these souls?  I pray they will be comforted.

These patients are hidden from most of society who will never view the inside of a cancer treatment facility.  Their sufferings go unnoticed and unrecorded except by the doctors, nurses and families who care for them.  Perhaps, if more people witnessed, the war on cancer would be our nation's priority.

According to the American Cancer Society, the latest figures show there were an estimated 1,688,780 new cases of cancer reported in the United States in 2017.  That same year cancer claimed 600,920 lives.  It is our nation's second leading cause of death, eclipsed only by heart disease.

Older Americans, like the fragile patient snuggled in the blanket, are especially prone to the disease as they age. Seventy-five percent of all newly diagnosed cancers occur in people aged 60 and over, according to research by the World Health Organization (WHO).

For many patients, chemotherapy is the regimen of treatment.  A powerful legion of drugs is administered to patients to target cancer cells.  Unfortunately, these drugs also affect healthy cells, weakening the immune system.  In the best outcomes, chemo wipes out cancer cells forever.

Those are the lucky ones.  For others, the chemotherapy cannot cure or arrest the spread of cancer. Potent drugs may temporarily shrink tumors, but they often return with a vengeance.  However, if the cancer is detected early enough, chemo saves lives, even as it ravages the body, mind and soul.

I focus on good outcomes as I greet each patient in the Infusion Center. I find hope in this place that once depressed me. Suffering exists but so does healing. I cringe when I contemplate I may end up here one day.  Good health is no guarantee. Cancer is an insidious evil always hunting new victims.

There are even occasions of joy in this antiseptic place.  When patients complete their last course of treatment, they ring a Victory Bell as they exit the Infusion Center.  Often family and friends are there to celebrate.  A loved one usually videos the ceremony to preserve this triumph of life.

Now that I have been roaming the cancer treatment facilities at the Mays center for several years, I have a new perspective.  I see the patients as part of our community, not diseased, anonymous individuals. They are fathers, mothers, sons and daughters.  Their sole purpose is to beat cancer.

Their lifespan is measured not in years or months or even days.  Each hour is a blessing to be cherished.  My brief encounters with these courageous patients are inspirational.  I forget whatever troubles have squeezed into my life.  They are trivial compared to fighting for another day of life.

When I reflect on the beginning of this volunteer journey, I am embarrassed I was reluctant to venture into the unknown realm of a cancer ward.  However, with introspection and time, now I look forward to seeing these warriors.  I realize I am among heroes and heroines.  That is my reward.

Immunotherapy: New Hope For Treating Cancer

He has been dubbed "The Texas T Cell Mechanic."  For the last 30 years, he has relentlessly studied this particular cell from every angle.  His dogged pursuit of knowledge has produced breakthroughs in the treatment of cancer.  This researcher's name is Dr. Jim Allison, a pioneer in immunotherapy.

The innovator was recognized in December with the Nobel Prize in Physiology and Medicine for his discovery of a cancer treatment that frees a patient's immune system to attack cancerous tumors.  The Nobel committee lauded his research efforts as a "landmark in our fight against cancer."

Editor's Note: Dr. Allison shared the award with Tasuku Honjo, M.D., Ph.D., of Kyoto University in Japan.

Dr. Allison's journey from the South Texas town of Alice to the Nobel ceremony in Stockholm, Sweden, began 70 years ago.  He acquired his interest in medicine observing his father, who was the country doctor in Alice, population 19,100.  His mother died of cancer when he was 10-years old.

Those experiences shaped his passion for medicine, which began at the University of Texas, where he earned a degree in microbiology and then a doctorate in biological sciences.  After college, he pursued his fervor for research in the cancer field, eventually concentrating on T-Cells.

T-Cells, a type of white blood cell, play a key role in the body's immune system.  The cells act as soldiers, patrolling the body, attacking old cells that have reached their expiration date.  But the cells also stalk intruders, such as bacteria, fungi, parasites and viruses, destroying these hostile invaders.

The T-Cell warriors face a formidable task policing an estimated 30 trillion cells in the average human body. And T-Cells are just one of 200 cells living in our body.  Isolating and studying T-Cells was once viewed by experts as nearly an impossible mission.  But Dr. Allison persevered.

Through years of painstaking research, Dr. Allison discovered that T-Cells do not kill every bad guy.  In fact, he found T-Cells have a braking mechanism that restricts it from attacking every cell in the body, the fit ones as well as the diseased cells.  But the brakes allow cancer cells to flourish.

A determined man, Dr. Allison wanted to learn how to ease off the brakes on T-Cells to allow the cells to demolish cancer cells.  The researcher uncovered a protein CTLA-4, found on the surface of T-Cells, which act as the cell's brakes.  Then he zeroed in on how to manipulate the brakes.

Toiling late hours in the lab, he developed an antibody to block CTLA-4, thus removing the brakes and unleashing the T-Cells to attack the marauding cancer cells.  His work paid off with the development of the drug Ipilimumab, the first in a category of drugs known as checkpoint inhibitors.

Dr. Allison, who published a paper on his ingenious finding in 1995, points out that it took "way too long" for the Federal Food and Drug Administration to finally approve the drug in 2011 to treat late-stage melanoma.  There results were unprecedented.

Twenty percent of the patients who took the drug lived for at least three years and many patients survived 10 years and beyond. He remains humble about his achievements, calling it an "emotional privilege to meet cancer patients" who have been successfully treated with the inhibitors.

His pioneering research sparked fellow scientists to study other immune system brakes, which paved the way to the development of drugs to treat other cancers, such as lung, kidney, bladder, gastric, liver, cervical, colorectal, head and neck as well as Hodgkin's lymphoma.

These discoveries have opened a whole new field of immunotherapy, using the body's immune system to battle cancers. Until now, there were basically three ways for doctors to tackle cancer: surgery, chemotherapy and radiation.  Now doctors have a fourth option with fewer side effects.

Even more promising, Dr. Allison believes the T-Cells will continue working long after the treatment has ended.  "The immune cells remain in the body.  If the cancer comes back, the immune cells will attack it," he was quoted on the MD Anderson website.

Dr. Allison's success led to his appointment as director at the Parker Institute for Cancer Immunotherapy at the University of Texas-MD Anderson Cancer Center in Houston.  He captains a team dedicated to expanding the uses of immunotherapy to not only treat but one day cure cancer.

By disabling the T-Cell brakes, Dr. Allison has toppled one more barrier in the war on cancer. As his career illustrates, breakthroughs often take decades.  But with an estimated 609,000 cancer deaths last year alone in the U.S., time is not an ally for those suffering with the disease.

More research and experimentation urgently needs to be done.  But the FDA also must dispense with regulatory red tape to speed up approval of drugs.  Allowing potential life saving drugs to languish in research laboratories robs cancer victims of an opportunity to extend their lives.