Day 62, Cancer Hurts

My pain has returned in the last several days.  While generally I’m able to move around okay, if I move the wrong way or sit in the wrong position, I get a pain in my hip or back.  Unfortunately, sitting in the wrong position includes sitting in a car seat and holding my foot on the gas pedal.

This pain could be cancer dying a slow and torturous death at the hands of chemotherapy.  It brings me some amount of consolation to think of my anthropomorphic cancer cells writhing in agony.  Die bastards die.

To get a bit sciency, one of the hostile things cancer cells can do is produce prostaglandins for no reason.  Prostaglandins are normally only produced when tissue is injured and produce the inflammation and pain associated with the injury.  It helps bring in blood and an immune response to heal the tissue.  Many pain relievers work by blocking the production of prostaglandins, which relieves pain but can also slow down the healing process.

Prostaglandin production is one of the ways cancer can cause pain. When the cancer cell is killed, all the prostaglandins in it are dumped out at once. Kill a lot of cells at the same time and inflammation and pain is the result, or so the theory goes.  In the long run this is a huge benefit but in the short term it kinda sucks.

In addition to the pain, I fear my hair is starting to fall out.  Detangling my ponytail has produced much more hair in my comb than I’m accustomed to.  So the transformation form long haired hippy to skinhead has probably started.  I’m not taking it well, my long hair has been part of my identity for longer than a decade now.

I worry that by Christmas day I’ll be a half-bald, half long haired freaky looking person.  To make matters worse, I’m convinced that the hair which started growing out of my ears a few years ago will continue to be as healthy as ever.  I didn’t want to worry about hair loss until it started happening and now it looks like it will happen at what is supposed to be that most wonderful time of the year.  NOT!  Oh well, it’s not like there are large social gatherings during the holidays while I’m trying to adjust to sudden hair loss and not feel awkward about it.

In spite of all this, my blood test numbers continue to improve.  While I don’t have an updated PSA number, my liver enzymes are back to normal and my alkaline phosphatase (a marker of turnover in bone tissue, and excessive amounts can result in liver damage) is down to only double what is considered normal.  This implies the bone damage is being repaired.

So I find myself in the paradoxical position where treatment appears to be working, but I feel worse.  At some level, this is expected as my body has been through a lot in the past couple months, and chemotherapy is yet another insult to every system in my body.  However, at an emotional level I respond to how I feel, not blood test numbers on a computer screen.

At the moment I find myself unmotivated, in a bit of pain, and mourning the impending loss of my hair.  Even more distressing is that this is happening at the point in the chemo cycle when I expected to be feeling my best, as the body has a chance to recover ahead of the next cycle.  This too shall pass, hopefully before the start of the next cycle but at worst sometime after all the cycles are completed about 16 weeks from now.