Research preliminaries

Tuesday, July 12, 2011

Research preliminaries

I remember walking down the hallway of my first unit’s battalion headquarters it was 2^nd Battalion/34^th Infantry Regiment, 24^th Infantry Division (Rapid Deployment Force). It was your standard cinder block Army building with dark wood paneling on the walls to cover up the austerity of the construction.

The obligatory poorly lit trophy case, the hallway, which didn’t seem to cast much but shadows, and the omnipresent posters about keeping secrets, set the ambience for a stroll down the headquarters hallway. The hallway was lined with doors leading to several “shops” such as personnel (S-1), Intelligence (S-2), Operations (S-3), and Logistics (S-4). Each shop had its own flavor and identity with its own set of irreverent posters meant to drive home specific points.

On the door of the S-3 shop was a picture of John Wayne from one his WWII USMC movies. He is standing with his hands on his hips saying, “Life is tough. It’s tougher if you’re stupid.”

Truer words have never been spoken; especially it seems when you are digging around trying to figure out how to access cancer information, for a small population such as Burkitt’s patients. Jeepers!!

I spent a several hours yesterday trying to track down how decisions are made about chemotherapy dosages and midcourse corrections if needed. The thing is there really is not – as far as I can tell – any place that advises a patient or doctor what to expect or adjust in the way treatment based on a specific set of criteria encountered as they move through a cycle. For example, should dosages be changed based on success or failure of current regimen? How does a chemo regimen exploit success and not reinforce failure?

The thing I am coming to realize is Cancer is Complicated and there is more we don’t know, than do. Slowing growing cancers can have more treatment options than highly aggressive ones because well … there’s more time to adjust. But for cancer like mine, which is highly aggressive, there is little time to adjust and experiment during the treatment phase because every day has a specific task that must be accomplished based on research done at clinical trials. This pushes both doctor and patient to accept risk and at times, hope that results at the end of treatment will mirror the results at clinical trials.

I am discovering that for my cancer there is very little wiggle room as far treatment goes. There is a 95%+ cure rate when adult males go through the entire course of eight blocks of treatment, but there seems to be no available data if the course is abandoned a block or two early. The point is, regardless of how well a patient may do in the middle rounds there is no way to determine whether that success will carry over to a successful end state – That upsets me.

I was hoping that good early results would mean an earlier finish, but the cause and effect I want may not exist. Oh well!