Health and Fitness : Paclitaxel, pizza and a new definition of "exquisite"

After weeks of misery, my aunt recovered enough to visit the military K-9 memorial for the very first time. "Beware of nausea." After a harrowing month which included 21 days in the hospital, two chemo treatments and several days of tolerating an NG tube because of a severe bowel blockage, my aunt improved enough to come home. But the doctors warned her that vomiting was a likely sign of the blockage recurring, which meant going back to the hospital and more days of NG misery. She did very well for a few days, and soon was eating and getting around as close to normally as possible. One morning, however, she woke up very early with that all-too familiar urge to run to the bathroom. "Oh, no," said my aunt. She took some nausea medicine, and kept her feelings, and her fears, to herself for a couple of hours. Finally told me what was happening, and how she was feeling. I listened to her report of nausea, and thought back on the advice the doctor had given her, and about how she had been feeling so good she had begun to eat like a healthy, young person. Occasionally, despite my newness to this cancer journey, I find that I know exactly what to do at a particular moment. I opened a door. I looked into a box. "Aunt Kathy," I said. "This nausea ain'tthe cancer. It's the third big piece of pizza you ate at 10 p.m. last night." She laughed. "I think you may be right," she said. Shortly later, her nausea disappeared. Pizza Story quickly became a favorite; the anecdotal comic relief my aunt shared with all her friends and care providers. It was also a milestone of triumph, a reminder that our patient, who had just a few weeks ago been on a diet of nothing, could resume normal living and eating -- and yes, normal reactions to late night indulgences. While writing this, it occurs to me just how blessed our family is. Not every cancer patient has a Pizza Story. My aunt had been convinced, for a while in that hospital, that she would never eat pizza again, afraid she would only leave the hospital to come home to die. And I have known a few people who died within weeks of receiving a terminal diagnosis. Now, two months after the pizza episode, my aunt is doing as well as possible for a person with her diagnosis. With the help of a huge team of people, which included doctors, nurses, friends, and countless people she has never met who have helped research cures for cancer, my aunt can now expect several more good years of mostly healthy living. "It's because you nursed her back to health," someone suggested. No, not really. While it's true that Valerie and I provided a variety of support for my aunt, and that having that kind of support from friends and family is urgent for any cancer patient, most of the credit belongs to some people we will never meet. The key to my aunt's recovery is a cancer-fighting drug known as paclitaxel. Paclitaxel is available for her because more than 50 years ago, the National Cancer Institute provided funding for the U.S. Department of Agriculture to go hunting for cancer-fighting compounds in nature. While that search was mostly a failure, it did produce one very promising lead: The Pacific Yew tree. Scientists discovered in the bark of that tree a potent substance that could eventually kill cancer cells. Years of research, especially research on how to synthesize paclitaxel in the lab because there simply aren't enough Pacific Yew trees to meet the need, led to paclitaxel's use for a treating a variety of cancers. My aunt's oncologist used a phrase I had not considered part of medical jargon before. She told us that my aunt's cancer responds "exquisitely" to paclitaxel. While most of us think of the definition of "exquisitely" as "in an extremely beautiful and delicate manner," the other definition, which doctors use, means that cancer cells are particularly sensitive to paclitaxel. Both definitions of "exquisite" can apply to a cancer journey. Everyone who has ever seen the disease affect someone close to them has seen the fragile beauty of humanity; anyone who finds themselves suddenly on someone's cancer team becomes highly sensitive to many aspects of the fight against the disease. And that leaves us exquisitely in tune to our patient's needs. It teaches us to respond with indifference to the cruel indignities of disease. It teaches us to pray, to laugh, to cry, or yell, and when each of those responses is most appropriate. It teaches us the courage to encourage our patient to follow the doctor's advice and take another round of the most potent chemotherapy treatment, even though making that recommendation will trouble us for days. And sometimes, it teaches us to know when a situation calls for a doctor, and when what the patient most needs us to do is call the pizza delivery guy.