Thought you’d enjoy these pictures of the nurses geared up for protection from the stuff they’re just PUTTING INTO MY BODY!  

I’ve had a great stream of visitors and phone-callers today – not a dull moment in the executive suite!  Thanks to all for helping the hours pass more quickly.

A number of you have asked me how do these chemicals (full regimen here), in particular the “vesicants” (scary pictures of what they do to fleshif they escape here) manage to go through my blood vessels and attack the “bad cells” (along with a few good ones 😦 ) without ravaging my vessels and the rest of my body?

What is a vesicant?  A vesicant is a chemical that causes extensive tissue damage and blistering if it escapes from the vein.  The nurse or doctor who gives the vesicant must be carefully trained. If the vesicant escapes the blood vessel it is being dripped into, it can cause extreme damage to the exposed tissue.

So, again, how can they just drip it into my bloodstream? So far, the Interweb, nurses and doctors haven’t really been able to answer this question!  Below is a decent explanation of how these type of chemicals (which are actually special types of antibiotics) work…but we’d have to guess that blood vessels themselves are not dividing much and so are not subject to their mode of action.

From http://www.chemocare.com/bio/doxorubicin.asp

How Doxorubicin Works:

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   “Normal” cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normalchecks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division.  Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division.  If the cells are unable to divide, they die.  The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink.  They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific.  Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific.  The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective.  This is why chemotherapy is typically given in cycles.

Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells.  Chemotherapy will kill all cells that are rapidly dividing.  The “normal” cells will grow back and be healthy but in the meantime, side effects occur.  The “normal” cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss.  Different drugs may affect different parts of the body.

Doxorubicin is classified as an antitumor antibiotic.  Antitumor antibiotics are made from natural products produced by species of the soil fungus Streptomyces.  These drugs act during multiple phases of the cell cycle and are considered cell-cycle specific. There are several types of antitumor antibiotics: