Sunday, August 17, 2014

Love Life

One of my favorite things to do is walk the Loop at Wrightsville Beach. There is usually a wonderful breeze that takes away some of the oppression of the summer's heat.
Walking alone allows me the opportunity to spend uninterrupted time thinking and sorting through the thoughts that fill my mind. I walk with no music in my ears--just me, lost in thought.

As I walked recently I realized the busyness of the week had made me unaware of the sadness that I keep hidden inside me. With each step I took that sadness seeped back into my thoughts. Soon it was pushing my other thoughts out of the way, and I found myself wanting to run so fast I would leave my diseased body behind. Perhaps some weird unexplainable event would allow me to run right into a new me.

Not too many weeks ago I remember feeling uncomfortable, almost angry at the phrase "love your body".  Today, I thought, "Honestly, why would I even consider loving my body? Especially now. It is literally trying to kill me."
As each foot moved me along I entertained the idea of leaving my body for another. I looked around at the people walking the same concrete path that I was. "What about that one?" I thought. "No. Maybe that one . . . ?" I wondered, if given the opportunity to take another body, would I?

As I traveled the 2 1/2 miles of path, I continued to think about the "love yourself, love your body" idea. It seems all of us are constantly reminded to love who you are. Embrace the nuances that make you YOU. I considered why our society finds this so important? So many people seem to have such fragile self-esteems. Perhaps that is how this all began. Or, is it used to promote healthy living hoping people will treat their body with kindness? Maybe it is some kind of good-will gesture to make us feel better when we do not meet some societal standard of beauty? Is it an excuse for those that cannot find the will-power to change something they don't like about themselves? Could "love yourself, love your body" really just be a societal mantra created for consumerism? I stopped when I thought of that one. Is this the reason behind this movement--consumerism?

There is nothing like material-goods to either make us feel like we love ourselves, or it is a validation for ourselves that we do. Advertisers have figured out that they can sell us just about anything from the food we eat to the bikinis some people shouldn't wear, to cosmetics, gym memberships, salon services, even vacations and of course the cars we drive all because of our obsession with our self. This obsession was created or at least nurtured for consumerism.

We are told not only must we love ourselves, but we must love ourselves FIRST before we can love others or before good things can start happening to us. I never understood the logic behind this way of thinking. It seems backwards to me. Loving yourself should be the end result of a very long process. A process that involves surrounding ourselves with people (friends, family, work relationships) who make us feel loved and appreciated. Those relationships are the key to how we feel about ourselves.

I have spent years becoming comfortable in my own skin. Comfortable does not mean I like everything about myself, because I don't. And it doesn't necessarily equate to self-love. Comfortable implies acceptance of self. This only comes after many years of living with . . . well, me. As life happens and people and experiences come and go, acceptance of self becomes part of the process of living.

The "love yourself, love your body" goal promotes material wealth, self-absorption and satisfies our need to get things quickly. Businesses just can't wait for people to become comfortable with themselves. They need you to love yourself today so they can sell their product to you -- today.

Then I thought . . .

Loving yourself is not the same thing as loving living. That is really what is important.

Instead of “love yourself, love your body” our society’s biggest promotion should be about respecting life. The feeding of the “love yourself, love your body” narcissistic agenda causes too many people to become greedy and willing to hurt or take a human life in order to get what they want. Our society’s values are misguided.

I think people would be happier if society moved away from the expectation that we must love ourselves. If we could focus on the importance of life itself instead of how important each of us ought to feel about ourselves, the world would be a better place. With that, I think we all would have a better appreciation for ourselves and other people in general.

I walked the Loop two more times this week. I emerged at the end of all those miles calmer and less sad. I will never be able to keep hidden at all times the sadness I have for what is happening to me no matter how busy I get. It will always be there waiting to find its way back into my thoughts. I will manage to put it back in its place.

The “love yourself, love your body” movement is of no use to me. I have decided, though, my body is like my home-- warm, comfortable, familiar. It took a long time to get to this point. I don't think I would want to go through that arduous process of learning to accept a new one. Besides, I love the life I have had in this body. I cherish my memories, and the people I have met along the way. It wouldn't be my life if I took another body. So, I think I'll keep it.

Then again, would there be a test drive option?

Thursday, August 7, 2014

It's Complicated - cancer that is.

Have you ever wondered why a cure for breast cancer once it has metastasized has not been found?

No, it is not the big pharmaceutical companies hiding cures from the public because it would affect their profits.

No, it is not some government conspiracy trying to keep population numbers down.

Actually . . .

It only takes a few minutes to read a scientific article about the signaling pathways inside a cancer cell to understand the reason there is no cure yet is . . . it's complicated—very, VERY complicated.

Take a look at the diagram below showing many of the signaling pathways within a cell.

On the outside of the cell are growth factors. These growth factor receptors sometimes are the beginning of a cancerous pathway. Inside the cell you will see PI3K and Akt. One fourth of breast cancers have a defect in the PI3K pathway. This pathway along with others begins with a gene that makes a protein. This protein activates a molecule. Other molecules are soon activated along a set course that when completed carries out a particular cellular function. PI3K is an enzyme (a special kind of protein) involved in the activation of the protein Akt. The Akt then activates mTOR which causes the cell to grow and proliferate. If mTOR mutates or its activation is controlled by other mechanisms within the cell. Then uncontrolled growth can occur. MTOR is very active in many types of cancers.

In normal cells there are PTENs that repair any mutations or damage to a cell that occurs. If the damage cannot be repaired, the cell experiences apoptosis-- cell death. Sometimes the PTENs are missing which of course is bad because damage to the cell cannot be repaired, nor does the cell die as it should. The cell is then able to make duplicates of itself with the defect and, you guessed it, a monster is on the loose.

I read recently that once a cancerous pathway is established, it travels in a continuous loop. There is no end to the pathway and the cellular function that is created unless something intercepts it. In normal cells, pathways have a halting mechanism to stop those cellular functions when no longer needed. But, in cancer cells, mutations in pathways can cause specific cellular functions to occur non-stop creating a very out of control machine that will replicate itself over and over pushing all the normal cells out of the way in a battle for space.

Amazing and terrifying, isn’t it?  

Below are two wonderful illustrations of pathways within a cell. After finding these pictures on the internet, I decided I had to share them, and the result is this post. 

If you look at the above picture you will see the HER 2 receptor on the outside of the cell. In my case, these receptors have become more numerous than normal. HER 2 neu over-expression can occur in the cells of other types of cancers as well.

When a ligand (a molecule, a hormone, drug or antibody) attaches to a receptor, it begins the signaling necessary for the pathway to be activated. My treatment involves Herceptin with a chemo drug attached--DM1. Herceptin attaches to a HER 2 receptor taking the place of a natural ligand. Once it attaches, the chemo drug is released directly to the cancer. TDM1 inhibits cell signaling through the PI3K/AKT pathway and promotes apoptosis (cell death). Super cool, right?

Because of cancer’s complexity, no two people have exactly the same cancer. There are differences in the genes that have mutated and differences in the pathways that a cancer uses for survival, growth and proliferation. That is why one type of cancer does not respond the same way a seemingly similar cancer does to a particular drug.

To complicated matters further, within one tumor there can be cells that have different mutations than their neighbor. Read this Medical News Today.

Yup, it’s complicated.

Cancer is also very good at surviving. When a pathway is interrupted by a drug, cancer cells find new branches in their pathways in order to continue their survival. It is believed that the cancer cells can even make their surrounding environment conducive to their survival and spread.

Today, a lot of cancer treatment is a guessing game.  A person is given a drug based on their cancer type and the results of clinical trials. Many drugs are given with little knowledge as to whether it will work or not. Currently, many of the chemotherapy drugs are not targeted to a specific protein. Instead, the drugs target fast dividing cells – healthy and cancerous. Since healthy cells are affected some very nasty side-effects can occur. Very often these drugs only affect a cell in a particular phase in its life. Those phases are growth, copying of the genes in the creation of a new cell (replication), and division. Depending on the phase a cell is in upon the arrival of a drug determines how effective it will be. Some cells may be in a resting phase and are not affected by many drugs. There are some drugs that can affect all phases, thankfully. Many times, several chemotherapy drugs are given together to try to affect more cells going through the different phases at any given moment.  

In the future, as more targeted therapies are developed, treatment should become more personalized. It will be wonderful when scientists can take a person’s cancer cells and determine which proteins in a particular pathway need to be targeted. Then a drug can be selected/developed and delivered to a particular receptor and halt one of the proteins in the pathway. Being able to target only the cancer cell and knowing which pathways to intercept will stop so much of the suffering associated with giving drugs that affect healthy cells too. Targeted therapies – like the one I am being treated with -- will allow people to have a better quality of life, and hopefully live longer.

The complicated cellular machine that makes up all of us is slowly being unraveled. My very brief and simplistic attempt at explaining why cancer is so difficult to cure I hope has left you with the realization that the cure for breast cancer will not happen in the near future. Just Google “Breast Cancer Pathways” and the enormity of what scientists are trying to uncover will be revealed.

I am not a cellular biologist, just a person who finds biology fascinating, so if any of my information is incorrect, please let me know by commenting below.

For more information on types of targeted therapies, see Understanding Targeted Therapies: An Overview at