Cancer is Not Simple

I don’t blog about my sister’s illness much, but it’s a big factor in my life right now. I’ve been trying to help her make decisions about treatment. I’ve learned a few facts that might help other cancer patients. The doctors didn’t explain all this to us, and yours probably won’t explain it to you, either. It must be difficult to treat patients efficiently while simultaneously educating them.

Four things (that I know of) can affect your mental abilities when you have cancer:

1. Chemotherapy
2. Cranial radiation
3. Paraneoplastic problems
4. Brain tumors

Depending on the breaks, you can get memory loss, difficulty moving, hallucinations, mood problems, headaches, blindness, and a lot of other stuff.

Chemotherapy-induced cognitive problems have a label: “chemo brain.” That’s what they call it. It may increase with the dosages you receive. You may forget things and have difficulty concentrating. The effects may last six months, or they may last ten years. You need to prepare for this, and you need to develop ways to compensate. Buy a calendar and so on. I read about a treatment for it, but I believe it involved antioxidants, and if you’re getting radiation, your doctor may tell you not to use antioxidants, because they diminish the effect of the therapy.

Prophylactic irradiation of the cranium (PCI) is an option for small-cell lung cancer patients who go into complete remission as a result of chest radiation and chemotherapy. “Complete remission” isn’t a cure; it means the cancer is too small to be found. If you reach this stage, cranial irradiation will make you much less likely to get brain tumors if the cancer relapses. It will also improve your odds of making it to various time milestones. The improvement is significant but not great. Some people who receive cranial irradiation have memory and other cognitive problems. You have to weigh this against the small likelihood that it will lead to a complete cure, and you have to consider the suffering you will endure if your cancer goes to your brain.

If you combine PCI with chemotherapy, it raises the odds that the radiation will damage your brain. On the other hand, it’s very important to do PCI early in order to maximize the benefit. So once again, you have to balance the risks and make a decision.

Paraneoplastic ailments are problems that arise in conjunction with cancer. Some involve the brain. One is encephalomyopathy. If I understand it correctly, it’s caused by your body’s efforts to attack the cancer. Healthy tissue suffers as well. You may have memory problems, loss of sensation, seizures, paralysis, and a wide variety of other symptoms. It’s somewhat like multiple sclerosis.

In some people, encephalomyopathy clears up once the cancer is gone, but there is no treatment, and it’s usually permanent.

Encephalomyopathy can be detected with a blood test. Most patients aren’t diagnosed until after they find out they have cancer. The mental symptoms are likely to predate the cancer diagnosis.

Brain tumors are a problem for cancer patients, because chemotherapy doesn’t get into the brain the way it gets into other tissues. You can imagine the problems they cause. Any part of your brain, no matter what it does, can be damaged or destroyed. So you may end up blind, deaf, unable to move, insane, or demented. If you get brain cancer, you are likely to end up hospitalized and completely dependent on others during the last months of your life.

I can’t promise you all of this is correct. It’s what I remember after reading up.

If you smoke cigarettes or use smokeless tobacco, you need to know about these possible consequences. You may think cancer is simple, like a wart, and that it’s just a matter of killing it or dying peacefully after months on morphine. It’s not always that easy. I remember walking into the room of a patient who had cancer in his brain. He was playing with his own feces, and he had smeared them on his head, and when he tried to communicate with the nurses, he just made inarticulate sounds. You might beat the cancer relatively easily, or you might succumb without too much suffering, but you might end up like the guy I saw. I know addictions are hard to beat, but God really does deliver people.

I have to call her and tell her what I learned. Pray we’ll work well together and choose the best course.