Author Beware: Ransom’s (TV Show) Cancer Problems

Author Beware: Ransom’s (TV Show) Cancer Problems 

There’s a new show airing called Ransom on CBS that centers around a high priced, privately paid negotiation firm. However, they might want to shell out some dollars and hire a medical consultant.

ransomIn the second episode, the show centers around a young man who has just received a lucrative major league baseball contract when he’s diagnosed with cancer, specifically AML, which is a form of leukemia. People kidnap his bone marrow donor and hold her for ransom.

What follows is a major spoiler alert for this episode so read no further is you haven’t seen the show.

The main medical problem centers around this patient’s choice for treatment. In the episode, he decides he doesn’t want chemotherapy and wants to go directly to a bone marrow transplant because “chemo will ruin my lungs and I won’t be able to play baseball.” Of course, the donor is found in time, the baseball player has “surgery”, and quickly recovers in a few days.

Issue One: A patient cannot go directly to bone marrow transplant. Conventional therapy must always be tried first. Bone marrow transplant is never first line therapy for this type of cancer.

Issue Two: A patient will get chemo and/or radiation to wipe out their own immune system in order to receive the bone marrow transplant. A patient cannot have any of their own immune system when they receive their “graft”. It also takes days to accomplish this and the patient is in strict isolation during this process because they have on immune system to fight off disease.

Issue Three: A patient receiving a bone marrow transplant does not go to surgery. The donor does get the cells, but it is simply via a transfusion (as in the same fashion as receiving a blood transfusion). They don’t even leave their hospital room. The person who actually goes to surgery is the donor to harvest their bone marrow.

Issue Four: Can anyone say isolation? Both before and after a bone marrow transplant, the patient is in strict isolation. This means ALL visitors must be gowned, masked, and gloved. The mother cannot be having a conversation with her son without any of these in place.

Showing the patient sicker would have made for a more intense episode. Even better would have been if his own immune system had been wiped out and the actual cells were taken for ransom— that would have truly been a life or death scenario.

I’ve never seen a situation where portraying the real medical scenario makes stories more boring. Writers everywhere— real life is always better than made up implausibilities.

How to Help a Loved One with Cancer

I was asked to post about this topic by my good friend, Dale– what do you do when a loved one is diagnosed with cancer.

This is a situation where it’s easy to feel helpless. Right now, two of my relatives and a good friend are dealing with cancer diagnosis– all of them pretty serious.

My maternal grandmother also died of kidney cancer so I’ve dealt with this from both ends– both as a family member and as a healthcare provider even though it’s not my primary area of focus. I’ve been there when families receive the news that their child has cancer.

So, if I could offer any helpful tips, this is where I would start.

1. Realize when a family member first gets a cancer diagnosis— they will likely not hear anything past those three words. “You have cancer.” While your family member’s mind is reeling, your job will be to remember (and I would even take notes) about what the doctor says next because the person receiving the diagnosis is in shock.

2. It is really helpful to have a family member go to the doctor’s appointments to take notes. Keep a notebook and journal with everything the doctor gives you. Write down questions that you want to ask at your next appointment. It’s easy for things to slip from your mind when your face to face with the doctor.

3. Get a second opinion. I do encourage second opinions for all major diagnosis and surgeries. Your provider should not be threatened by the fact that you want a second opinion. In fact, they should encourage it. You may not want to delay treatment, particularly if you’ve been diagnosed with an aggressive form of cancer, but that also doesn’t mean you can’t get one. It’s not a betrayal of your doctor and it also doesn’t mean you’re going to leave them.

The purpose of a second opinion is to make sure the treatments are relatively aligned and you don’t have a doctor coming out of left field.

4. Do things without asking. I know this may seem rude but what happens when people ask you for help? “No, I’m okay. I’ll let you know if I need anything.” And then, they never call. There are lots of ways to do this and with on-line sign up sheets so pervasive– it’s easy to set up. Set up a sign-up sheet for providing meals, cleaning the house, or giving caregivers respite breaks. If that seems overwhelming, show up at the door and say, “I’m here to clean your house. Where is the vacuum?”

5. Do fun things. A cancer patient doesn’t always want to talk or think about cancer and they still want to live life. Don’t stop calling or inviting them to do activities because you think they’ll be too sick and/or tired.

6. Do cancer things with them. At the same time, don’t be afraid to do “cancer” things with them. Go with them when they get their head shaved. Offer to go wig shopping with them.

7. Pray. This might seems trite but it has been proven through scientific study that patients that are being prayed over medically do better.

8. Be okay if they want to stop treatment. Hopefully, you won’t face this point and your loved one with cancer will have successful treatment and go on to lead a full life. However, this isn’t the case for everyone. Some patients make the decision to forgo treatment. They haven’t come to this decision lightly. Be supportive and make the most of the time you have left. Let them know what they’ve meant to you.

What are your suggestions in how to help a loved one during a cancer diagnosis and treatment?

Using Polio to Kill Brain Cancer

Rarely, am I super impressed with medical discoveries.

I can’t say that for this piece I just saw on the news magazine 60 Minutes.

Cancer treatment has gone through various stages. First surgery. Then came the advent of radiation therapy followed by chemotherapy.

But now, the newest frontier in the fight against cancer is your body’s own immune system which makes the most sense, right? If we could train the immune system to seek and destroy cancer cells like it does bacteria and viruses then whole hosts of people wouldn’t have to face death related to this, often times, devastating diagnosis.

I’ve blogged here about the use of the measles virus in treatment of cancer.

Now, researchers at Duke University are using a genetically modified polio virus to kill brain cancer . . . and it’s working.

Glioblastoma is a particularly aggressive, nasty brain tumor. As stated in the piece, it’s usual for this cancer to double its size in 2-4 weeks.

What I learned about cancer cells in this piece that I didn’t know before is that they are smart. I remember learning in my pathophysiology class in college that cancer cells were merely your own cells running amok– dividing uncontrollably and invading normal functioning tissue. Perhaps this is why our own immune systems don’t attack it as the potential killer that it is– because it is our own cells.

The doctors at Duke University are attempting to change this. They took a small group of patients who had glioblastoma for the second time. These patients had already been through standard therapy at it failed.

They surgically implanted a catheter into the center of the tumor and then gave the patient an infusion of modified polio virus directly into the tumor.

What happens is two things. One, the body recognizes the polio and begins to attack it. Second, the virus seems to also strip the protective coating of the cancer cells so the body recognizes it and begins to attack it as well. The body amounts an impressive immune response and MRI’s initially show massive inflammation around the tumor, but then, over a period of 4-8 months, the body’s immune system begins breaking down the tumor.

Two patients who received this treatment first are now cancer free for nearly three years. That is unheard of with this kind of brain tumor. I mean– it is miraculous.

After the researchers had success with the first several patients, they attempted to double the dose to see if they could get a better immune response. In fact, they did get a massive immune response but it proved to be too much for the patients and several of them died.

Now, they are using smaller doses and it remains to be seen if this is a cure but it’s so promising that in a year, the FDA may cut their red tape to make it available to lots more patients.

Truly, truly impressive. I mean for us medical nerds– it is jaw dropping.

Now, of course, there is always worry that modifying viruses could lead to potential breakouts of untreatable illness. That’s definitely fodder for any medical thriller.

But today, let’s bask in the glory of this amazing discovery and what it could mean for patients who receive this deadly diagnosis.

For more information on this study you can view the piece here.

Perspecitve…

I loved this short, sweet post by Dan Greene where he shares his thoughts on a cancer diagnosis. I love hearing what people have learned in a moment of crisis. Dan has offerred to let me share this blog piece here at Redwood’s. You can find Dan at his blog a Writer’s Room.

Welcome, Dan.

I’m a survivor….
In March of 2001, I thought my world was coming to an end. I was diagnosed with lung cancer. I had hurt my neck at work and had to get an x-ray. It just so happened part of my right lung was in this x-ray. There was a spot the size of a quarter on my right lung.
I smoked for almost 30 years. The thought of not being here for my family was the hardest part. When my son hugged me and said, “Dad, I don’t want you to die.” I was so scared I didn’t know what to do. After several tests it was determined that the type of lung cancer I had was a large cell cancer that is not as aggressive as small cell. It was caught in the earliest stage and it cost me half of my right lung.
I believe that God was looking after me when I hurt my neck. You take life for granted when everything is okay, but when faced with death you realize how important life and time here on earth can be.
I try to live life now to the fullest and try to enjoy everything I do. Sometimes, it’s hard not to be mad but mad to me is wasted time. 
I am in great health now. I don’t smoke. I still drink beer on weekends. Shed about 30 pounds. But the most important thing is that it’s 2013 . . . I am still here with my family and was able to write this note. I never had to have chemo or anything.
I was truly blessed with learning how precious life can really be even though it cost me half a lung.
So the next time you look in the mirror—make sure that the person who is looking back at you is who you truly want to be for the rest of your life!
And please . . . don’t smoke. It was cool in 1975 but deadly in 2001. 
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Dan loves to write stories and poems. Expressing himself in the written word. He loves taking pictures. God helps him see who he needs to be.

One Brave Cookie: Alice J. Wisler

Often times, I will read biographies as research to delve into what it might have been like to live in the shoes of the person I’m trying to portray fictionally. Some experiences are beyond our imagination and first hand accounts help us to draw these characters more realistically.

I’m pleased to have Alice here at Redwood’s Medical Edge today discussing her son’s battle with cancer. She’s so brave to share her story with us and I’m very thankful she chose to give us insight into some of the emotions that surrounded her during that time of her life.

Welcome, Alice.

In 1996 we had tickets for a three-week trip to Japan. As I packed for our trip, excitement filled me.  I couldn’t wait to experience the reactions of my three kids as we flew to Japan where I grew up as a missionary kid. My picnic-plaid journal would record their words and their vacation memories.

My husband and I hoped three-year-old Daniel would be fully recovered from his surgery and back to his energetic self by the date of our June departure.  It sure looked promising because the night of his surgery he did cartwheels in our grassy lawn, laughing with friends who stopped by to check in on him.
Right before Memorial Day when people were getting their coolers stocked for picnics, the pediatrician called with news.  The lump on Daniel’s neck was not Cat Scratch Fever or TB as earlier presumed. The surgery from the previous day showed that my son had a mass that consisted of small round blue cells.
That weekend I became familiar with a childhood cancer called Neuroblastoma.  At UNC Hospitals in Chapel Hill, NC, Daniel had another surgery, a Broviac catheter inserted through his body—into the right side of his neck and out his back— and the start of his first round of chemotherapy.  The catheter was the line used to dispense his chemo.  Nurses taught us how to flush the line, clean the area of skin it was near, and tape the catheter to his back for safety purposes.  We also learned the names of chemo drugs and found out that the narrow cot placed alongside Daniel’s bed was not as comfortable as it looked. It didn’t really matter; hospitals are not known for places of rest, regardless of the type of bed provided.
Daniel’s prognosis looked good—for a kid with cancer.  Over the months of week-long hospital stays, the tumor responded to the harsh medications.  He lost his hair, he hated being bald.  He made friends with the oncologists and nurses, teasing and laughing with them.  He threw up and felt weak and tried to be brave.  I recorded each day in my picnic-plaid journal.
In the hospital chapel he asked God to heal him.  “Please God, take away my boo-boo.” He liked to hear how people around the world were praying for his health.
But on a balmy day in January after his chemo and radiation treatments ended, he felt weak.  I took him to a scheduled check-up at the oncology clinic.  At nine his blood pressure was fine, but there was some concern about his blood counts.  His hematocrit was dangerously low.  The nurse was ready to take another blood sample to test again when Daniel complained of not being able to breathe. “I just wanna go home,” he told me. The doctor was called in; no pulse could be found.  Daniel was wheeled to the ER.  He coded once he arrived, was resuscitated, and coded again.  A staph infection was discovered to be the culprit.
Daniel lived on the ventilator in the PICU for five days.  When the EEG showed he had no brain activity except for voluntary, I asked for another.  But the second results matched the first, so we removed him from the ventilator, saying our good-byes. Yet Daniel’s heart and lungs continued to function. Since the staff in the PICU could do nothing more for him, his oncologist asked that we consider moving him to a room on the cancer ward.  “We want to take care of him and of you,” he said.  “Daniel is our patient.  We remember when he walked down the corridors swinging off his infusion pole.” I looked at my son, a calm figure with his eyes shut, morphine pumping into him. Surely, God would provide a miracle and Daniel would wake from his comatose state and jump on the bed as he had before.
When Daniel breathed his last in my arms on a cold night at the beginning of February, I was six months pregnant.  My baby within kicked with life as my bloated and compromised child ceased to move. 
I felt abandoned by God. I didn’t care to live.  During the next days, I didn’t want another casserole or vase of flowers brought to my front door. I wanted my son back in my arms—a chance for him to live life outside hospital walls with a new crop of hair as he played with his siblings.

Instead, I would have to learn to survive his death.  It would mold me, push me, shape me, and change me.  I would feel God’s presence again.  In time, I would walk with a new faith, one harbored within a broken heart.

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Alice J. Wisler is the author of RAIN SONG (Christy Finalist 2009), HOW SWEET IT IS (Christy Finalist 2010), HATTERAS GIRL and A WEDDING INVITATION—-all by Bethany House Publishers. In memory of her son, she teaches online grief-writing courses and at conferences across the country.  Visit her website: http://www.alicewisler.com/.