Once You Have a Serious Chronic Disease, You are Never the Same
Chemo and Radiation Produce Senescent Cells
Let’s just start with this. I am one of the luckiest men in the country. I had cancer when I was 43. They told me I would be cured or dead in six months. I am 77. Because I was cured, I have seen my sons graduate from college, marry wonderful women, develop outstanding careers, and I have spent time with my seven grandsons. Of course, they are the smartest and the best looking. What a gift! I think that gift is the reason I have such empathy for patients with serious chronic illness and determination to see that they understand how to get better. I have often said, cancer was both the worst and best thing that ever happened to me.
That said, I have never been the same. I had diffuse, large cell lymphoma which is a rapidly fatal cancer if you don’t get the right treatment. The eight affected lymph nodes were around the aorta, kidney arteries, and the spine. I received a six-drug chemotherapy regimen and radiation to the area. The whole process took about five months, and when they were done with me, there was not much left. It was still hot in our area, and just standing in the yard for ten minutes was all I could handle. I bought a treadmill, and I started walking. I gained strength rapidly, and within a year, I was close to what I had been, but there were major residual effects even then.
I had very significant nerve damage from the chemotherapy. My hands and feet were numb. I told my oncologist, and she just laughed “let me know when you can’t button your shirt.” They told me it would go away in a year or two, but it never did. It stayed with me and later it slowly progressed with a severe impact on my balance. I also had spinal damage from the radiation. I can tell because I have fasciculations which is a visible, involuntary twitching of an individual muscle. That is a sign of spinal cord injury. I can feel it and see it. That means I am weaker from the bottom of the rib cage on down. By doing squats and other leg exercises every day, I keep going but I need an upright walker to go any distance.
Chemotherapy also had significant effects on the heart. Adriamycin was part of my treatment, and it can cause congestive heart failure. I was alone in a remote area planting pine tree seedlings about 5 years later when my heart suddenly went out of rhythm. It was irregular with a rate of about 150. That causes a feeling of weakness, and I had no cell coverage. I just laid down and waited for it to pass. I have continued to have brief episodes of atrial fibrillation (irregular rapid beating) ever since.
As part of the cancer treatment, I had major abdominal surgery with an incision from the sternum to the pubic bone. They removed my spleen and some of my lymph nodes. Abdominal surgery frequently causes scar formation that involves the bowel. Radiation damages the bowel and can cause narrowing also. The result is a tendency to partial bowel obstruction which limits what I can eat. It is very painful when it occurs. It is like any blockage of a hollow organ. It is like having gallstones or kidney stones. The pain builds and lessens. It waxes and wanes. I can’t eat most uncooked vegetables and fruits. Until I figured that out, I had severe episodes twice a year.
The muscles that orient my spine were damaged by the radiation and I have lost about 4 inches of height. My rib cage sits on my pelvis. Just in the last month, I have learned more about why I have struggled.
Chemotherapy changes cells. It makes them senescent (senile, old). They stop dividing. In cancer, cells divide in a wild, uncontrolled fashion. If you shut down division in enough of them, that cures the cancer. It is a double-edged sword though, because these senescent cells that don’t divide produce growth factors and inflammatory mediators that can change the tumor cell gene expression and make them more highly malignant, invasive, and resistant to chemotherapy. When that happens, the patient is not cured and the cancer is fatal. Similarly, radiation also causes senescence. “Although cellular senescence is a normal consequence of aging, there is increasing evidence showing that the radiation-induced senescence in both tumor and adjacent normal tissues contributes to tumor recurrence, metastasis, and resistance to therapy, while chronic senescent cells in the normal tissue and organ are a source of many late damaging effects.” And there it is. That is why I have never been the same and that is why you can’t really reverse cancer or other chronic illnesses like type 2 diabetes.
My own experience is the reason I have so much empathy for patients who struggle with chronic illness, and I am so passionate about helping other people stay healthy. Those who believe you can reverse chronic disease just don’t understand. They haven’t walked the walk. You can never be entirely the same. I am convinced that the reason I developed lymphoma was my weight. At the time, low fat diets and low-calorie diets were the answer. They aren’t. They don’t work. It was not until I learned that you could lose weight permanently by eating real food that I lost 60 pounds. Now we know that eating real food, resistance and aerobic exercise, and certain medications can slow aging and delay the development of chronic disease. They are also the path to a return to the best recovery you can manage. The best path is keeping your health. Once you have lost it, everything is different.
There is one more lesson to be learned. The old science of medical treatments is like a blunt instrument. Treatments can injure normal tissue while killing cancer. Now we have a much better understanding of the genetics, epigenetics, and molecular biology of aging and chronic diseases. We can prevent and treat disease much more precisely. More on that in the next post.
Hi, Thank you for sharing your incredible and encouraging story. To me it is proof that a person with a chronic disease can age well with proper knowledge and care.
Thank you for telling your own story in clear detail. I appreciate the many lessons to be learned from your experience. I wish you ever-improving health.