Tag Archives: HDAC Inhibitors

20%

My neck lumps are growing.  Or at least the one on the side is.  There are two, one deep in the neck right around the scar where they biopsied the original lump, and another one poking out at the side. They used to be lymph nodes and are now tumours, and frankly they scare the hell out of me so I touch them all the time to see what they’re up to.  Evidently they’re up to no good.

 

Problem is, yesterday I found out that if my tumours grow by more than 20% I’m off the clinical trial. Finis. Apparently 20% growth means that my body is not responding to the study drug and in a clinical trial if your body isn’t responding, it’s sayonara study subject, next please.

 

When I found out about the 20% growth cap, the internal panic-valve immediately opened and the inner freak-out commenced.  Off the study?  No more tumour-targeted miracle drugs to precipitate cellular suicide? No more sci-fi magic potion??  It would be too overwhelming a disappointment to contemplate, or even to be able to call a “disappointment” without grossly understating what it would do to me psychologically.

 

I know there are other options, like chemo, radiation and possibly even surgery –  all of which I have previously had, and in spite of which my cancer metastasized.  The bottom line is that I’ve put so much faith in this study and been so excited to be a test subject for this new generation of cancer drugs, that going back to more conventional treatments might feel a little like trading smart bombs for mustard gas.  Whether that’s a warped perception (wouldn’t be my first) borne of mistrust and frustration that the cancer metastasized is a question for another day.  Today I’m about 20% more concerned with just staying on this study because, whatever the treatment is, I just don’t want to be declared “unresponsive” again.  It terrifies me.

 

So these bumps have got to stop growing — or, preferably, start shrinking. They just have to. Any suggestions?  I’ll do anything.  Rub voodoo salves on them, drink yak urine, hold crystals up to my neck, whatever, I’m all ears.  And neck bumps.

 

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Apoptosis

My curiosity about HDAC inhibitors (the class of drug to which Panobinostat belongs) has overtaken my better judgment.  Meaning I went a-Googling, even though I knew beforehand that any explanations I found would be in science-speak and therefore way over my decidedly unscientific head.  However, I did find the following almost plain-language description, featuring actual adjectives:

 

“Histone deacetylase (HDAC) inhibitors are emerging as an exciting new class of potential anticancer agents for the treatment of solid and hematological malignancies. In recent years, an increasing number of structurally diverse HDAC inhibitors have been identified that inhibit proliferation and induce differentiation and/or apoptosis of tumor cells in culture and in animal models.”

 

Never mind the wishy-washy “potential anti-cancer agents” or the “in culture and in animal models” qualifier. HDAC inhibitors are cancer agents, alright.  And they mean business.  As my extremely scientific cousin Donald wrote me, “Basically I’m glad I’m not a tumour cell on the receiving end of it since the stuff will kick their tiny butts in several different and lethal ways!”

 

And if that’s not encouraging enough, may I direct your attention to the word “apoptosis.”  It is my new favourite word.  Apparently, in addition to being strangely enjoyable to say, it actually means “cellular suicide” also known as “programmed cell death.”

 

Awfully sinister isn’t it?  I picture the cancer cells drinking up Panobinostat like so much poisoned kool-aid, and my little heart gleefully cries, “Apoptosize yourselves, evil tumour cells! Die, die, die!”

 

What’s not to love?

 

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Jive Talkin’

I titled this blog post Jive Talkin’ mostly because, yes, I am actually listening to the Bee Gees right now (these days anything that enhances my mood without damaging my heart is ok by me) — and also because today I had my second dose of Panobinostat, and I’ve noticed that this absurdly named drug is but the latest word in the cancer lexicon to fly off my tongue like a spitball in a schoolroom. 

 

I like words.  I’m a word geek. So I don’t scare easily around big, multisyllabic, fancy-schmancy words.  But for some reason known only to pharmaceutical companies, most drugs have massively difficult and unpronounceable names. It’s really only after thinking about, talking about, obsessing about and generally Googling the crap out of them that they come to be easily uttered. 

 

For me, Herceptin was one of the first and easiest to learn, but even this is cheating since its real name is the much more laborious Trastuzumab (and I admit that I just had to Google that). 

 

I remember struggling in particular with the names of my chemo drugs, perhaps because there were so many of them right off the top of my cancer treatment when my head was still having a hard time wrapping itself around the word “cancer.”  A year later, Epirubicin is the only one of that first trio that I can remember (because it was ruby red and could burn the epidermis.) The worst of my chemo drugs was oddly one of the easiest to pronounce: Taxotere. So taxing was it, and the cause of so many tears, that Taxotere is forever imprinted, possibly embossed, in the cancer dictionary in my brain. 

 

And here we are today with Panobinostat, a word I now throw around almost casually, even though when I originally heard it several weeks ago I thought the drug-namers had reached a new level of desperation in their quest for alienating and unapproachable words.  But in the spirit of the tireless researchers who discovered this new drug, I would not be deterred.  I have now mastered saying “Panobinostat” and in doing so, in some small way, I feel I’m giving it a kind of substantiation; making it real; willing it to work.

 

As for the category of drugs to which Panobinostat belongs, let’s all be grateful for acronyms like HDAC. Imagine if I actually had to learn to say “histone deacetylase inhibitors” in order to believe they might work? 

 

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