Category Archives: Cancer Information

These articles are filled with information about general cancer topics such as prevention and resources.


There’s a word that’s unique to the cancer experience. Scanxiety.

Most people are familiar with anxiety. There are many types of anxiety, including (but not limited to): generalized anxiety disorder, social anxiety, phobias, and PTSD (post-traumatic stress syndrome).

Scanxiety is a form of situational anxiety or acute stress reaction disorder.

Because of the nature of cancer, patients are already experiencing chronic stress, or the stress of demands that seem endless, with little hope in sight for long stretches of time. When you add an additional stressor to this, it can feel overwhelming, leading to physical symptoms of stress and anxiety for the patient, and his or her family members.

The first time you experience scanxiety is when you suspect you have cancer and are in the process of having it diagnosed—or ruled out as a concern.

Stage IV lung Cancer

Our Story

When Dan felt hard, enlarged lymph nodes, just above his left collarbone, we knew something was wrong. The soonest the doctor could see him was three days later. During that time, we looked at all the possibilities, and the most likely cause of his symptoms was cancer.

Upon examining him, the doctor said, “I can’t tell you exactly what it is, but I can tell you that it’s serious.”

It’s cancer. How bad is it? I didn’t dare say what I was thinking, out loud, in that office.

“Do you have any plans this afternoon? Can you stay for more tests?”

Of course, we stayed. Dan was shuffled from one place to the next. The lab, the room where they performed an ultrasound, the x-ray department. Then, we waited. That was our first dose of scanxiety. Within the next two weeks, we would experience scanxiety as we awaited results from CT scans, MRI’s, and a PET scan.  Each test would add a little more information to Dan’s medical chart. Combined, we would learn the full scope of what we were looking at.

What scanxiety feels like:

When scanxiety hits, you experience many of the symptoms of acute stress (1):

  • Emotional distress — some combination of anger or irritability, anxiety and depression, the three stress emotions.
  • Muscular problems including a tension headache, back pain, jaw pain and the muscular tensions that lead to pulled muscles and tendon and ligament problems.
  • Stomach, gut and bowel problems such as heartburn, acid stomach, flatulence, diarrhea, constipation, and irritable bowel syndrome.
  • Transient over-arousal leads to an elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath and chest pain.
lung cancer awareness
Image courtesy of stockdevil at FreeDigitalPhotos.net

These symptoms are focused on one thing:

…the pending results of a scan.

Those results will affect your life to a degree that is difficult for most people to comprehend. Scans can trigger a lot of emotions. If the cancer has been growing and you’ve started a new treatment, you might feel hope and anticipation. “Is the treatment working?”

Ironically, if things have been stable, fear and anxiety can rear their ugly heads. The thought of recurrence is lurking in the back of your mind. “What if the cancer is back? I had a cough last week.”

Oh, yeah. That’s right. I’m on a limited timetable here.

Once diagnosed, many people experience scanxiety again each time they have a CT scan, x-ray, MRI, bone scan, or any other imaging test that will shed some light on whether the cancer is being effectively treated or whether it is progressing. You can’t help but focus on the things that you’ve pushed to the back of your mind. Every scan is a step back into reality.

How long do I have, Doc?

From the results, you learn what your prognosis is. The doctor tells you what your treatment options are. You make decisions. You decide on your treatment plan and wonder how you’ll proceed with the rest of your life.

  • Do you continue to work—can you continue to work?
  • Do you put down the deposit on your annual family vacation?
  • What minor or major life changes will happen as a result of what we learn from the next scan?
  • Will the next scan be the beginning of the end?
  • Will I be able to continue to live as I have been?
  • Is cancer in a new place? What can I expect?

The feeling of a good scan is amazing.

You have a 3-month extension on life. It feels like you’ve been strapped into the electric chair and the governor called.

I’m writing about scanxiety today because this Monday, my husband, Dan will be having two different kinds of scans: a brain MRI, an upper body/chest CT scan. So, we are experiencing scanxiety. If you are a person who prays, it would mean a lot to me if you would keep Dan and our family in your prayers, not only for his health but for our peace of mind, as well. He will find out the results of those scans a few days later when he meets with his oncologist. The days leading up to the scans and following, while we await the results, are difficult ones.

There are ways to manage scanxiety.

The National Institute of Mental Health gives the following suggestions for dealing with stress (2). These can be applied to scanxiety as well.

The effects of stress tend to build up over time. Taking practical steps to manage your stress can reduce or prevent these effects. The following are some tips that may help you to cope with stress:

  • Recognize the Signs of your body’s response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
  • Talk to Your Doctor or Health Care Provider. Get proper health care for existing or new health problems.
  • Get Regular Exercise. Just 30 minutes per day of walking can help boost your mood and reduce stress.
  • Try a Relaxing Activity. Explore stress coping programs, which may incorporate meditation, yoga, tai chi, or other gentle exercises. For some stress-related conditions, these approaches are used in addition to other forms of treatment. Schedule regular times for these and other healthy and relaxing activities. Learn more about these techniques on the National Center for Complementary and Integrative Health (NCCIH) website at (www.nccih.nih.gov/health/stress ).
  • Set Goals and Priorities. Decide what must get done and what can wait, and learn to say no to new tasks if they are putting you into overload. Note what you have accomplished at the end of the day, not what you have been unable to do.
  • Stay Connected with people who can provide emotional and other support. To reduce stress, ask for help from friends, family, and community or religious organizations.

Footnotes:

https://www.nimh.nih.gov/health/publications/stress/index.shtml

What are YOUR thoughts?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since doctors diagnosed my husband, Dan with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, Photo by Everbranch Photography

 


X-Ray

Image courtesy of stockimages at FreeDigitalPhotos.net

An X-ray is the most commonly used imaging scan for most people since it is simple, safe, and low cost. Doctors use x-ray to diagnose injury and lung issues, from bronchitis to lung cancer.

An x-ray uses radiation in small quantities. The radiation (or x-ray) passes through the body, capturing an image. The rays are blocked by dense tissue, bone, and objects in the body. Radiologists look at the x-ray picture and send a report of their findings to the doctor.

CT Scans

CT stands for Computed Tomography. It’s a painless scan that combines the power of x-ray with computers to make images. The images are 360-degreecross-sectionall views of your body.

Doctors often use CT scans when they want to see bone, soft tissue and blood vessels at the same time. It’s also okay for a patient who has metal in their body to have a CT. Because of this capability, it is a common scan for a cancer patient to have.

CT scans often involve oral and/or intravenous contrast. This clear, tasteless liquid helps radiologists see certain things in the scan, such as lymph nodes, better. During the scan, you lay on a scanner table. The table will move you through the scanner, while the technologist will take the images from outside of the room. Depending on what your doctor needs from the scan, it takes from 10 to 30 minutes.

MRI

Your doctor may order an MRI if he or she wants a good picture of soft tissues such as your organs, your brain, or other internal structures. Unlike x-ray and CT scans, MRI doesn’t use radiation. Instead, it uses powerful magnets to take cross-section images, or “slices.” This scan takes from 30 minutes to an hour.

Because a patient must lay on a table in a small tube for a long time, it’s not an ideal scan for people who are claustrophobic.

A Helpful Comment from MRI Test Prep:

“While external metal, such as keys, cellphones, hairpins, etc. are strictly forbidden from entering the MRI exam room most metal implants, including nearly all orthopedic and dental implants are MRI Safe. There is a spectrum of safety with metal implants which includes safe, conditional, and unsafe. Even many implants which were previously deemed “unsafe” for instance cardiac pacemakers, are now being built with MRI Conditional varieties, allowing these patients to undergo MRI. As a patient be sure to inform both your physician and technologist of all metal implants prior to your exam, and if you have any implant info cards be sure to fax them to the MRI center before your exam, and have them on hand the day of your MRI. (I know this may be too much information but I don’t want people with metal implants to feel like they are disqualified from MRI when they otherwise would be a fine MRI candidate.)”

Whether it’s an x-ray, a CT, or MRI, your doctor will know the best imaging scan for your needs. They’re very careful about safety. If your doctor orders a scan, it is because they believe the risk of letting a suspected problem go undiagnosed outweighs any potential risk the scan may have.  Thanks to low dose radiation, and careful precautions, imaging technology has become quite safe.

Our Story

The first scan Dan had was an x-ray. Doctors saw something suspicious but needed to know more in order to make a diagnosis. They performed many more scans and tests to confirm their suspicions. Throughout Dan’s treatment, he has had scans at least once every 3 months. Often they have been 6 weeks apart. At one point, they needed more up to date information, so they gave him an x-ray every 2 weeks for 2 months. All of these images have given us a picture of what was happening in his body. With that knowledge, we could make informed medical decisions.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

Undifferentiated, A Definition (1)

A term used to describe cells or tissues that do not have specialized (“mature”) structures or functions. Undifferentiated cancer cells often grow and spread quickly.

This is a somewhat scientific post. Keep reading because it’s very interesting.

Tumor grade is different than cancer stage.

After the doctor biopsies, suspicious tissue, he or she sends it to a pathologist. The pathologist then determines whether the tissue is malignant. Furthermore, they can tell what kind of cancer it is, as well as what the tumor’s stage is. Your doctor may also ask the pathologist to also check for specific mutations which can be treated using targeted treatments.

When a pathologist looks at the cancerous tissue under a microscope, they assign a tumor grade. This is based on how similar the tumor cells and the tissue are to normal, healthy cells. They call tumor cells that are more like healthy cells, “well differentiated.” They call more abnormal the cells, “undifferentiated.” This is important because, in undifferentiated cancer, the cells are immature. In addition, undifferentiated tumors are likely to grow and spread quickly.

Making the Grade

There are several ways to grade tumors, This is a popular method. Pathologists give tumors a grade of 1, 2, 3, or 4. The lower the number is, the more normal the cells and the organization of the tumor appears. Grade 3 and 4 tumors grow rapidly, dividing and spreading faster than tumors in grades 1 and 2. (2)

  • GX: Grade cannot be assessed (undetermined grade)
  • G1: Well differentiated (low grade)
  • G2: Moderately differentiated (intermediate grade)
  • G3: Poorly differentiated (high grade)
  • G4: Undifferentiated (high grade)

It’s important for doctors to know a patient’s health history, the stage of their cancer, and the tumor grade to determine a patient’s prognosis and put together a treatment plan.

Sinonasal undifferentiated carcinoma – high magnification By Nephron – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=21382293

To Know or Not to Know

Patients sometimes get upset that their doctor has given them a poor prognosis based on the cancer being advanced and their tumor(s) being undifferentiated. You can tell your doctor at the outset, how much information you are comfortable hearing about your cancer. Tell your doctor if you don’t wish to be given certain details about your cancer. They will usually take care to honor that. Doctors base these predictions on statistics as well as their years of experience. Still, they are statistics. A patient is not a statistic. At the same time, a prognosis can be extremely valuable in making treatment decisions as well as end of life planning.

Our Story

Early on, we saw the word, “undifferentiated” on countless reports over the past four and a half years. What did it mean? Undifferentiated almost sounds okay. It sounds like it’s not clear, so maybe it’s not that serious. We found out how wrong we were in November of 2015 when Dan began to have a hard time breathing. He coughed whenever he tried to talk or take a deep breath, due to undifferentiated cancer filling his lungs. Radiologists call this “ground glass,” because it looks like ground glass on scans.

I have a picture of one CT scan that shows the comparison. His cancer was so aggressive that when we wanted a couple of weeks to try one treatment and then change if it wasn’t working, the doctor said, “You don’t have two weeks.” Therefore, we treated aggressively. It saved his life.  Read more HERE.

Undifferentiated cancer
The x-ray on the right shows the rapid increase in cancer in Dan’s lungs.

Everyone has their own way of coping with their cancer. Ours has been to learn as much as possible, trust Dan’s medical team, and pray, pray, pray.

Footnotes:

  1. National Cancer Institute, NCI Dictionary of Terms, Undifferentiated
  2. National Cancer Institute, Diagnosis and Staging, Prognosis, Tumor Grade

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. My husband, Dan has battled stage IV lung cancer since 2012. I help cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com.

The Erickson Family, August 2016. Photo By Jim Bovin

 


Not that long ago, cancer treatments were synonymous with losing your hair and suffering from nausea and vomiting. Now with the advancements in cancer research, it’s not uncommon for patients to go complete a treatment regimen without either of these issues.  One of these advancements is targeted therapy, also called targeted treatments. Targeted treatments “target” specific genes or proteins found in cancer cells These genes and proteins are related to cancer growth.

Many different types of cells make up the tissues in your body, from your bones to your skin. Cancer cells are created when specific genes in healthy cells mutate or change. To learn more about how cancer cells are made, check out my post, C is for Cancer Cells.

What is a Targeted Treatment?Drug Resistant

Your genes tell your cells how to make the proteins that keep your cells working. What happens if your genes change, or mutate? The proteins will change, too. This is when you get cancer cells growing and spreading out of control. Like zombies, they don’t know when to die.

Targeted treatments “target” the mutations like a zombie killer. They try to normalize the cell growth by turning off signals that tell the cancer cell to grow or divide. This keeps the cells from living longer than normal and soon, they die the death they were meant to.

Traditional Chemotherapy Vs. Targeted Treatments

Traditional chemotherapy takes the carpet bomber approach. It blasts all the rapidly dividing cells in a patient. While it’s effective at killing cancer cells (since they are rapid dividers), it also kills healthy, rapidly dividing cells like hair, nails, skin, and mucous membranes. This leads to the classic chemotherapy side effects like nausea and hair loss. Targeted treatments attempt to treat cancer while sparing healthy cells.

Chemotherapy resistance

Small-Molecule Drugs

One type of targeted treatment is small-molecule drugs. These treatments are typically taken orally in the form of a pill. One example of a small molecule drug is angiogenesis inhibitors. This type of treatment prevents the formation of blood vessels around a tumor. This cuts off the supply line of nutrients to the cancer cells, essentially starving them.

Finding a Match

Different types of tumors have their own unique genetic mutations. It’s important to have the biopsy tissue sent to a lab for molecular testing to find out if you are a match for one of the known mutations. Not all cancers have a known match, suitable for targeted treatments. This is still cutting-edge medicine. Researchers continue to isolate new mutations and develop drugs to treat them.

Cancer.Net has a comprehensive guide that you can use to see some of the latest information about a specific cancer and known targeted treatments. Look up the specific cancer, and then click on the link for “Treatment Options.”

changes in cancer treatments

Monoclonal Antibodies

Another type of targeted therapy, called monoclonal antibody therapy, is a form of immunotherapy. It binds to certain cells or proteins outside of the cancer cell. Often the idea is to get the immune system to see the cancer cells that so often elude it. These drugs are usually given intravenously as an infusion. They are also often used in conjunction with traditional chemotherapy or radiation. It has been used in a variety of diseases including rheumatoid arthritis. You can spot this kind of therapy by the “mab” at the end of its name.  For example, nivolumab, also known by the brand name, Opdivo. Researchers are still learning why these therapies work well for some diseases and not for others and why they work well in some patients while having no effect on others.

 

Side Effects

Some people assume that immunotherapy is natural or that targeted treatments don’t have side effects. These treatments are still drugs and they do still have side effects, sometimes even serious ones. If you are a good match for one of these treatments, they can be a valuable weapon in your arsenal against cancer.

Our Story

When Dan’s oncologist first diagnosed him, she sent his biopsy sample to a special lab in California where they checked it for the most likely mutation, EGFR (epidermal growth factor receptor). The results said he was positive for this mutation. He was on and EGFR inhibitor called Tarceva for 18 months before it stopped working. After a time, the mutated cells that the Tarceva was fighting would mutate again in order to avoid getting eradicated. Think of it like the zombies in the video games that keep coming back with new strengths. While it had its own side effects, it greatly improved his quality of life and extended it.

He tried various more traditional treatments with different degrees of success. Each time we learned a treatment wasn’t working, we would try another one. Then he was put on Nivolumab. That treatment wasn’t right for Dan at all.

He was ready for hospice when a drug called Tagrisso was released by the FDA early. Tagrisso was a new generation of targeted treatment that went after the Tarceva resistant mutation. It was amazing how well it worked. Dan has been taking this drug for 15 months, now. It’s been effective, with very little side effects.

Initially, Dan was given a prognosis of 6 months to live. Thankfully, with both traditional and targeted treatments, and a lot of answered prayer, he will reach 5-year survival in October 1017. That’s a miracle for a stage IV lung cancer patient.

About Heather Erickson

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

Doctors stage a patient’s cancer at the time of diagnosis. Doctors determine the extent of your cancer, such as how large the tumor is, and if it has spread, using x-rays, lab tests, and other tests or procedures .  This is called the “stage” of your cancer. By staging the cancer, your doctor can determine among other things, how aggressive the cancer is and how aggressive the treatment will have to be.

Most staging systems include information about (1):Staging Systems

  • Where the tumor is located in the body
  • The cell type (such as adenocarcinoma or squamous cell carcinoma)
  • The size of the tumor
  • Whether cancer has spread to nearby lymph nodes
  • Whether cancer has spread to a different part of the body
  • Tumor grade, which refers to how abnormal the cancer cells look and how likely the tumor is to grow and spread

The most commonly used system of staging is the TNM System.

The most common place to see this is on a pathology report.

What is the TNM System?

T stands for tumor.

Numbers (and sometimes the letter X) accompany the T.

X means the main tumor can’t be measured. O means that it can’t be found. Numbers 1-4 indicate the size and extent of the primary tumor. The higher the number, the larger the tumor, and the more it is invading nearby tissue. These numbers are sometimes broken down further, to give a more precise picture of how extensive the cancer is. For example, T2a and T2b. A would be closer to T2 and b would be closer to T3.

N stands for regional lymph nodes.

The number (or the letter X) accompanying the N indicates the number of nearby nodes that are cancerous.

X means that cancer in nearby nodes can’t be measured. 0 means there is no cancer in the nearby lymph nodes. Numbers 1-3 indicate the number of cancerous lymph nodes, and where they are. The higher the number, the more lymph nodes there are that contain cancer. Localized cancer is limited to the location where it started, with no indication that it has spread. Regional cancer has spread to nearby lymph nodes, tissues, or organs.

M stands for metastasis.

There are three possible letters/numbers that can accompany the M. X indicates that metastasis can’t be measured. 0 means that cancer hasn’t spread to other parts of the body. 1 means that it has spread to other parts of the body. When cancer is described as distant, it has spread to distant parts of the body.

From this TNM staging system, doctors derive the more commonly known, stages I to IV.

  • Stage 0 means that abnormal cells are present but haven’t spread. Doctors call this, “in situ,” or CIS. CIS isn’t cancer but could become cancer.
  • Stage I, II, and III mean that cancer is present. The higher the number, the greater the concern. Doctors asess the size of the cancer and how invasively it has spread into nearby tissue.
  • Stage IV is cancer that has spread to distant parts of the body.

The doctor said Dan’s cancer was at least stage IIIb. This was based on his tumor and lymph nodes. But was he stage IV? To find that out, doctors ordered a PET scan. It showed that cancer had crossed his thoracic region and was, therefore, distant. That made it stage IV.

Lymphoma

Doctors stage lymphoma using a different system. They look at which lymph node regions are affected, and how many are affected. Again, as the number of the stage increases so does the extent of the cancer’s effect on the patient. Progressive or refractory lymphoma is when cancer continues to grow or spread despite treatment. When doctors treat lymphoma successfully and then it returns, they call it recurrent or relapsed lymphoma. (2)

Leukemia

Leukemia uses a completely different staging system known as the Rai staging system. The Rai system takes several things into consideration, including whether there are high levels of lymphocytes in the blood, also known as lymphocytosis. Does the patient have enlarged lymph nodes or lymphadenopathy? Is the patient’s spleen enlarged? This is called splenomegaly. Does the patient have anemia or low red blood cell counts? Are the patient’s platelets low, also known as thrombocytopenia? Is the patient’s liver enlarged? This is called hepatomegaly.

All stages of the Rai symptom include lymphocytosis (high levels of lymphocytes).

  • Stage 0 means that there is lymphocytosis, but no other staging conditions present.
  • Stage I is when lymphadenopathy accompanies lymphocytosis.
  • Stage II adds an enlarged spleen and/or liver, and possibly lymphadenopathy, as well.
  • Stage III includes anemia, and possibly lymphadenopathy and/or enlarged spleen and/or liver.
  • Stage IV includes thrombocytopenia (low levels of platelets) and possibly the other symptoms.

To make things even more complicated, European doctors use a completely different system known as Binet classification. Since I am writing in the United States, I won’t go into that system. (3)

Brain and Spinal Cord Tumors

Cancers of the brain and spinal cord tumors do not have a formal staging system. That’s because these kinds of tumors rarely spread to other parts of the body. This risk with these cancers is their effect on the brain and central nervous system. (4)

The Stage Stays the Same

The stage doesn’t change, even though the cancer might. Doctors refer to cancer by the stage it was given at diagnosis. It doesn’t matter if your cancer has improved due to successful treatment, or if it gets worse and spreads. If it was stage III, in the beginning, it’s still stage III after it has metastasized. Doctors add new information to the original stage over time as the cancer changes.

Footnotes:

  1. National Cancer Institute, Diagnosis, and Staging. Staging.
  2. Cancer.Net Non-Hodgkin‘s Lymphoma Stages
  3. Cancer.Net Leukemia Stages
  4. Baylor Scott and White Health, The Stages of Brain and Spinal Cord Cancer

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com.

The Erickson Family, August 2016. Photo By Jim Bovin

 


The Lymphatic System

Lymphatic System
Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work

Your lymphatic system is part of your circulatory system AND your immune system. It’s a network of vessels and lymph nodes that make up your body’s drainage system.

These vessels move excess fluid that’s been collected from all over the body back into your blood stream. Once the fluid enters the lymphatic vessels, it is known as “lymph.”

The word Lymph comes from the Latin word lympha, meaning, water.

As these fluids move through the tiny lymph nodes, Harmful organisms and cancer cells are trapped and destroyed by the lymphocytes. Those lymphocytes are then added to the lymph which flows from the nodes, back into the bloodstream.

Unfortunately, the lymphatic system is also notorious for transporting cancer cells around the body, also known as metastasis.

Doctors call it called lymphoma when cancer begins in the lymphatic tissue. Leukemia is related cancer in the bone marrow and blood.

What’s a lymph node?

A lymph node is a small, kidney bean-shaped organs. They contain B and T cells (lymphocytes) which are part of your adaptive immune system. (see Immune System)

Lymph Node
Diagram of a Lymph Node By Cancer Research UK – Original email from CRUK, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34332684

Lymphadenopathy

It’s called lymphadenopathy when one, or more, of your lymph nodes, become enlarged. This usually happens when you have an infection, or in response to inflammation. When many the enlarged lymph nodes are in different areas of the body, it can be a symptom of a systemic infection like mononucleosis, or inflammation like rheumatoid arthritis. It can also be a sign of or cancer.

Lymph nodes can trap cancer cells, but if they don’t destroy all of them, the nodes can become secondary tumor sites.

Our Story

My husband felt a string of hardened enlarged lymph nodes along his left clavicle. These are supraclavicular lymph nodes. He usually avoided doctors, always thinking whatever ailed him would go away on its own. This time, though, he called and made an appointment immediately. He had stage IV lung cancer. Because doctors diagnosed and treated him as quickly as possible, Dan is still alive today.

If you discover hard, enlarged lymph nodes, get them checked out.

Lymphedema

Sometimes lymph accumulates in a patient’s face or limbs. This is called lymphedema. This is a common problem for cancer patients who have had their lymph nodes removed. Treatment is usually massage and compression sleeves. Thankfully, it’s usually temporary.

The Spleen

Your spleen is basically a giant lymph node. It filters your blood. As it does, it removes old red blood cells, recycles iron, and plays a big role in your immune system, to the point that if you don’t have a spleen, you are far more likely to get certain infections.

The Thymus

Your thymus is also part of the lymphatic system. This is where the T-cells mature.

By the way, if you’ve ever heard the term, “sweetbread,” referring to a culinary delight, they are specifically talking about a calf’s thymus. I’ve never eaten them, but have heard they are delicious.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com.

 

Speaker


What is your immune system?

The immune system is your first line of defense against infections, both viral and bacterial, as well as other diseases. The immune system, which is made up of special cells, proteins, tissues, and organs.

How does it work?

Your immune system works through a series of actions known as the immune response. This response attacks invaders including organisms and substances that attack and your body’s systems and cause illness and disease.

Three Types of Immunity

Blood Cells
One can see red blood cells, several white blood cells including lymphocytes, a monocyte, a neutrophil, and many small disc-shaped platelets. By Bruce Wetzel (photographer). Harry Schaefer (photographer) (Image and description: National Cancer Institute) , via Wikimedia Commons

Adaptive Immunity

This type of immunity is very active, developing throughout our lives as we are exposed to various germs and diseases, as well as when we are vaccinated. Adaptive immunity involved the parts of our immune system that are in our blood.

Most people know that their blood is made of white and red cells. The white blood cells are part of your immune system. They are also known as leukocytes.

There are two basic types of leukocytes:

Phagocytes

Phagocytes are cells that destroy invading organisms. The most common type of phagocyte is the neutrophil. Neutrophils fight bacterial invaders.

Lymphocytes

Lymphocytes are created in the bone marrow. If they stay in the bone marrow to mature, they become B lymphocytes (think B for bone marrow). B lymphocytes produce antibodies.  Antibodies are special proteins that lock onto specific antigens. Antigens are foreign invaders in the body. These antibodies stay in your body, preventing you from getting sick with the same disease in the future. An example of this is the chickenpox. Once you get chickenpox, you usually won’t get it again.

Immunizations utilize this function to prevent certain diseases. Most immunizations are an inactive virus or disease which doesn’t make you sick but still causes your body to produce antibodies, protecting you from getting sick with that disease/illness in the future.

B lymphocytes are great at finding invaders, but they can’t destroy them on their own. They need the help of another type of lymphocyte.

While the B lymphocytes are maturing in the bone marrow, there is another type of lymphocyte that leaves the bone marrow early and head for the thymus gland, where they mature into T lymphocytes (think T for thymus). T lymphocytes destroy the invaders the B lymphocytes have identified. Sometimes, people call T lymphocytes, “killer cells.” Another thing that T lymphocytes do is signal other cells in the immune system, such as phagocytes, to do their job.

Antibodies can neutralize toxins. They can also activate a group of proteins called a complement, which assists in killing viruses, bacteria, and infected cells.

Innate Immunity

Everyone is born with natural immunity. This is known as innate immunity. This type of immunity protects one species from getting illnesses of another. For example, humans don’t get heartworm and Dogs don’t get HIV.

Some of our innate immunity comes from parts of our immune system that form a barrier between us and potential invaders.

One of these barriers is our skin. If you get a cut, the defensive barrier is broken. As the cut heals, you are vulnerable to infection. Thankfully, immune cells on the skin attack invading germs, protecting us.

Mucous membranes are also part of our innate immune system. These gooey barriers to germs and other invaders line our nose, throat and gastrointestinal tract. As you breathe, the mucus membranes that line your nose trap air pollutants. It’s your first line of defense.

Passive Immunity

In the early years of life, we are most vulnerable to infections and viruses because we haven’t yet developed a strong immune system that recognizes and destroys invaders. Thankfully, babies can get antibodies in their mother’s breast milk. These antibodies protect them against many early childhood illnesses and infection.

What if it doesn’t your immune system doesn’t work right?

There are 4 main things that can go wrong with the immune system:

  • Immunodeficiency is when part of the immune system isn’t working properly.

Primary Immunodeficiency is when you are born with the problem.

Acquired (or secondary) immunodeficiency develops later. They can be the result of malnutrition, disease, or medication such as chemotherapy or steroids.

  • Auto immune disorders are when the body’s own immune system attacks its own tissue as if it were a foreign invader. Examples of autoimmune disorders are rheumatoid arthritis and lupus.
  • Allergies happen when the immune system over-reacts to antigens (allergens), producing excess histamine, causing a variety of symptoms ranging from mild itching to life-threatening anaphylaxis. Associated disorders include eczema, allergies to food, environmental allergies, and asthma.
  • Cancers of the immune system include lymphoma and leukemia. Both are common childhood cancers. Thankfully, most cases of these cancers in kids are curable with current treatments. Leukemia involves out of control growth of leukocytes. Lymphoma involves lymphoid tissues. Both cancers weaken the immune system making it harder for the patient’s body to fight off infection.

How does cancer treatment affect your immune system?

Medications like chemotherapy and radiation destroy cancer cells. Unfortunately, they also destroy healthy cells like those found in bone marrow and other parts of the immune system. Patients lose neutrophils, which fight infection-causing bacteria. Doctors call this “neutropenia.”

Immune System
By Volker Brinkmann – (November 2005). “Neutrophil engulfing Bacillus anthracis”. PLoS Pathogens 1 (3): Cover page. DOI:10.1371. Retrieved on 2009-01-04., CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=2107792

Boosting your Immune system

Doctors sometimes give patients non-specific immunotherapies alongside traditional cancer treatments such as chemotherapy and radiation. This improves their overall immune system function.

An example of this is the Neulasta shot which prevents/treats neutropenia. This is a colony-stimulation factor, a man-made form of a protein which stimulates the growth of white blood cells. There are no common side effects of Neulasta. My husband, Dan, experienced one side effect that occurs in less than 30% of patients. The side effect was bone pain. This is caused by the rapid production of white cells in the bone marrow.  It feels like growing pains, only much worse. Dan was in the worst pain of his life.

When someone is in active cancer treatment, they must be more careful about coming into contact with bacteria and viruses. One person’s minor cold can put a cancer patient in the hospital since they are immunocompromised and can’t fight the illness. Cancer patients often decline to shake hands or attend social functions when their immune system is compromised.

Can your immune system fight cancer?

Immunotherapy is one of the most recent developments in cancer treatment. The goal is to stimulate a patient’s immune system, causing it to be more effective in fighting cancer.

Cancer cells grow and spread because the immune system doesn’t recognize them as foreign, Immunotherapies are inactivated forms of cancer cells or proteins that are unique to cancer cells. These are introduced to the patient’s immune system to try to “teach” it to recognize cancer cells and attack them. These therapies aren’t without side effects, and they only work for certain patients with certain cancers. For those patients, immunotherapy can be a powerful; weapon in their cancer battle.

Immunotherapy is opening doors to new ways of fighting cancer. With every new discovery, researchers gain a greater understanding of the enemy we are up against, and the possibilities for eliminating that enemy.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

Most people experience fatigue at some point in their lives, and we all know what it’s like to feel tired, but it usually doesn’t last long. Once you sleep or even just quietly rest for a while, the fatigue goes away and you feel refreshed.

Cancer takes fatigue to a whole other level

The first cancer treatment that doctors prescribed for Dan was a targeted treatment called, Tarceva. It’s considered an easier treatment than traditional chemotherapies. Yet, within a week, Dan felt completely drained.  “It’s like you’re a car that isn’t running on all cylinders,” he says. “It always feels like bedtime. You fool yourself into thinking, ‘I’ll just go to bed and rest up and then I’ll get up and do it.’” Dan chuckled. “Sure you will.”

Traditional Chemotherapy

Two years into his cancer journey, Dan’s doctor put him on a traditional chemotherapy, and things went from bad to worse. Taking a shower, using the bathroom, even eating, were exhausting. After a chemotherapy appointment, he would spend days in bed, only getting up when he absolutely needed to.

It became a cycle.Dan's Fatigue

He had no strength and no endurance.

It only got worse with time because he didn’t exercise much.

His muscles atrophied.

He had no strength and no endurance.

It only got worse with time because he didn’t exercise much.

His muscles atrophied.

With fatigue comes a lack of drive and desire to do anything

“You have stuff to do, but you don’t want to do anything,” he says. “If you try to push through anyway, you pay for it and end up in bed for a few days, so you live within the boundaries of the fatigue.”

This can lead to frustration, irritability, and depression. It can be hard at times to know whether what you’re experiencing is fatigue or depression since they share many of the same symptoms. This is one of the reasons it’s so important to discuss what you’re feeling with your doctor. While fatigue is one of the most common symptoms in cancer patients, it’s also one of the least discussed.

Mental Fatigue

Along with the physical fatigue, Dan also experienced mental fatigue. It was often hard to concentrate for any length of time. He describes it as having a cloudy mind. “It’s like your mind is yawning,” he said.

Talking to people was also difficult. Dan would push himself through a conversation in order to stay engaged, But, by the end of the conversation, he would realize that he was wiped out.

He knows he’s crossed the line when he can no longer think of the words he wants to say. He recalls a visit with a friend. “Twice during that conversation, I was convinced that nothing I said made any sense at all.’’

Over time, the fatigue got worse.

Dan used to enjoy going for walks and biking. After a year of treatment, Dan would walk to the end of the cul-de-sac in our neighborhood and had to rest. He just couldn’t keep going. walking up steps was hard. He was breathless all the time.

There are a lot of possible reasons for breathlessness and fatigue. Doctors were especially concerned because Dan has lung cancer. They needed to know if it was cancer or the treatment that was causing his shortness of breath and fatigue.

Dan’s doctor ordered lab work to make sure Dan didn’t have another underlying problem that needed to be addressed such as low blood counts or anemia. She checked his lung function and ran a CT scan to ensure that his cancer wasn’t progressing. After the doctor ruled out several possible reasons for fatigue, she said that his fatigue was due to his treatment.

Getting Some Pep

Dan asked for the drug, Ritalin. Ritalin is best known as an ADHD drug given to children. Ironically, it can give adults more energy. Ritalin is a controlled substance, and it certainly isn’t the answer for all fatigue. Only you and your doctor can decide on the best way to address you fatigue. For Dan’s fatigue was so debilitating that this was worth trying. And, it worked! It didn’t completely fix the problem, but it made a noticeable difference in his energy levels.

Dan also drinks a caffeinated beverage each evening with dinner. For most of us, this would cause disturbed sleep patterns. But it gave Dan a boost, just long enough to get through until bedtime.

Know your best time of day.

Dan learned that he functioned best an hour after waking up in the morning. By that time, he’s slept night’s sleep and then had a cup of coffee. This is the best time for him to do anything that requires a lot of energy or a clear head.

Dan also listens to what his body is saying. It’s not worth the consequences of ignoring it. When he plans his schedule, he knows that he can only do one thing each day. It might be a visit with a friend, a real estate appointment, or going to church. Dan has learned that if the day will involve expending more energy than normal, it will need to come from somewhere. To prepare, he rests both the day before and the day after.

Every treatment is different

They will all have one thing in common—fatigue. Thankfully, the treatment that Dan is on right now causes less fatigue than treatments he was on in the past. He doesn’t take the renewed energy for granted. And, he still struggles with fatigue. Last week we ran around like crazy, bringing the kids places, taking continuing education classes for Real Estate, and more. It took its toll and he spent most of the weekend in bed, recuperating. Once you have cancer and especially after years of treatment, you are never the same again. Finding ways of coping with cancer-related fatigue will go a long way toward enjoying life a lot more.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

One of the things we learned early on in Dan’s cancer journey was that even if a treatment worked, eventually, it wouldn’t. Cancer cells become drug resistant.

Our Story

When doctors first diagnosed Dan with stage IV lung cancer in 2012, they perscribed a targeted treatment called, Tarceva. The treatment worked well for 18 months before the cancer in his body became drug resistant and again progressed.

After that, he volleyed back and forth between targeted treatments, immunotherapy, and traditional chemotherapies. He would take each treatment until the cancer again became drug resistant.Then, the doctors would put him on a new drug. This is something that’s often difficult for people to understand.

Once a treatment works, why can’t you use it indefinitely?

There are several reasons for this.

Remember in yesterday’s blog on cancer cells, we learned about the ways that cancer cells are different from healthy cells? As these cells mutate, they act more and more abnormal. One of the ways they differ is that the cells can become drug resistant to the chemotherapy treatments that we rely on the kill the cancer cells.

One form of drug resistance in chemotherapy is similar to the way we become drug resistant to antibiotics after taking antibiotics repeatedly, inappropriately, or for long periods of time, The bacteria which aren’t killed become stronger.

In chemotherapy, some cells survive and mutate. They then continue to multiply and soon there are more cells that don’t respond to the treatment than those that do.  This is one theory as to why Dan became resistant to Tarceva. Thankfully, over the years, researchers have been working on this problem. Just in the nick of time, the FDA approved a drug called Tagrisso. This is another targeted treatment that is used when the original EGFR mutation that some lung cancer patients have, becomes drug resistant to the currently targeted treatments that are available such as Tarceva, Iressa, and Afatinib.

Chemotherapy resistance

A Drug Resistant Protein Molecule

Cancer cells use a molecule called “p-glycoprotein” to protect themselves against cancer drugs. Resistant cells often have high levels of this protein, in the cell walls. The protein acts like a pump which removes toxins from cells. This includes pumping chemotherapy out of the cell faster than it can take the treatment in. Because there isn’t enough of the chemotherapy in the cell, it can’t kill the cell.

An Inactive Gene

In a study done on colon cancer cells, researchers discovered that cells which were initially sensitive to the drug oxaliplatin and later became drug resistant, had inactivated a gene in their DNA. This caused the cells to repair these breaks and they are back in business, growing and spreading. This is known as acquired resistance. Researchers are also studying how the loss of this gene function causes tumors to be drug resistant from the outset, otherwise known as primary resistance.

Lack of Transportation

Cancer cells can become drug resistant because the protein that transports the drug across the cell wall stops working.

Gene Amplification

Sometimes, a cancer cell can produce hundreds of copies of a particular gene, which triggers an overproduction of protein rendering the treatment ineffective. This is known as gene amplification.

Multidrug Resistance

If cancer becomes drug resistant to one drug, it’s more likely that it will be resistant to others. For example, once Dan’s cancer became resistant to Tagrisso, and EGFR targeted treatment, his cancer was resistant to all of the other EGFR targeted treatments.  This is known as multidrug resistance. This is why it’s so important to choose the best possible treatment first. Sometimes, doctors give patients multiple drugs in combination, to reduce the chances of becoming drug resistant to any one drug.

Drug Resistant

We need to adjust our expectations.

Often, our expectations of cancer treatment are too high. The human body is complex on every level and when it breaks down, there is no easy fix. Sometimes the systems which protect us under normal circumstances can be the very problem we encounter when things are no longer working as they were designed to. Thankfully, researchers are continuing to look at ways of preventing drug resistance.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, despite their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

The Erickson Family, August 2016. Photo By Jim Bovin

 


Cancer is a complex disease. In fact, it is really many diseases with one thing in common— cancer cells have a communication problem.

To understand cancer cells, you need to first understand healthy cells and how they function. A cell is the basic, structural unit of all known living organisms. It’s the smallest unit of life that can replicate independently. Each cell contains DNA, a blueprint for how proteins are produced or suppressed in the body.

Mutations, inherited or caused by carcinogens (cancer causing things in the environment such as tobacco or ultraviolet rays), can result in the abnormal production of proteins.

 

Healthy Cells

Healthy cells stop growing when there are enough cells present. In the “cell cycle” damaged cells are repaired and old cells die and are replaced if appropriate. Your skin is a good example of this. New skin cells are produced in the bottom layers of your epidermis. Over time, they move to the top layers as old skin cells from the top-most layers of your epidermis, die and slough off. In fact, 30,000 to 40,000 old cells die and slough off each day! The skin you see now will be gone in about a month. This is the reason some people exfoliate their skin to get that “healthy glow.”

Epidermis
Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine

Cancer Cells

Cancer cells ignore growth inhibitors. They also don’t listen to the surrounding cells that “tell them” to stop growing. They not only grow when they shouldn’t but they also go where they shouldn’t. This includes spreading to the blood stream, other organs, and the lymphatic system. This happens because cancer cells don’t have the adhesion molecules in them that makes them “stay put.”

What kind of cancer is it?

Often when cancer metastasizes, people think that the location the cancer is found in is the type of cancer the patient has. For example, if a breast cancer patient has a metastasis to her liver, someone might think she has breast cancer and now, liver cancer, too. Or if it spreads to the lungs, they might say she has breast and lung cancer. In fact, it is all breast cancer. The cells found in the liver or the lung are distinct breast cancer cells.

The origin of the cancer is unique, so pathologists can determine what type of cancer a patient has by looking at the cancer cells. When my husband Dan discovered he had lung cancer it was because lung cancer cells had metastasized to his lymphatic system and beyond. The biopsy found lung cancer cells in his lymph nodes.

Cancer cells look different than healthy cells.

While healthy cells are consistent in shape and color, cancer cells have a lot of variety in size and shape. Their nucleus is also larger and darker than that of a healthy cell, because of excess DNA.

Cancer Cells vs. Normal Cells
4.0.4

Your body, the night club.

Cancer cells grow too quickly and divide before they fully mature. Doctors call these immature cells “undifferentiated.” If these cells would wait until they grew up and became mature to divide they could specialize into adult cells. By looking at how quickly or “early” these cells divide, doctors can tell how aggressive the cancer is.

Imagine your body is a night club. Lymphocytes are the bouncers, keeping out the riff-raff. They kick out damaged cells, keeping the place hopping. Cancer cells (immature things that they are) sneak past the bouncers by secreting a chemical that shuts the immune cells or lymphocytes (the bouncers) down as they come to remove the cancer cells from the party. Another tactic cancer cells use is hiding long enough to grow into a tumor.

Malfunctioning Cells

Cancer cells don’t act the way they should. They don’t die when they should. They go wherever they please, despite the danger they present to the patient. Each type of cancer is unique. I describe them as a juvenile delinquent zombies. By understanding what we are up against, we can better fight cancer when it presents itself.

Rapidly dividing cells

One thing to note is that because cancer cells divide rapidly, many of the traditional cancer treatments go after rapidly dividing cells, in general. Unfortunately, that includes killing off the healthy rapidly deciding cells which include those that form hair, skin, and nails. This is why with traditional chemotherapy patients often lose their hair.

Newer targeted treatments attempt to go after only those cells which have specific cancer mutations in them. This spares the healthy cells. They aren’t without side effects, but they are a far more effective and tolerable treatment option for patients.

ABOUT HEATHER ERICKSON

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com

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