My Husband and Cholangiocarcinoma – Part 2

Pam: The tattoo is a pair of Eagle wings, with a green ribbon (liver cancer color) between the wings. Tom written on the left side of the ribbon and Margie on the other. Then “On Eagles Wings” written above the wings.

Hope you all like the tat! Tom started back on Chemo this past thursday (Yesterday). Not for the spot on the lung however, his doc is not too concerned about that right now. What she is concerned about is in the liver. Where there were two distinct spot close together have now grown into one spot kind of like a snowman without a head…that means that one of the tumors is growing. Where there used to be a space between them now it looks like one large tumor.

Initially the plan was to put him on a continous type chemo with a fanny pack, however now they want him to come into the chemo center. First he gets an anti-nausea drug, then they hang a large bag of medication to protect his kidneys and that takes 2 hours. 1/2 way into that back they administer a large syringe of 5-FU (Fluorouracil also known as Adrucil or 5-Flurouraicl) in what they call a IV push over a period of 10 minutes, then the remainder of the medication for the kidneys. He will have this every friday for 6 weeks, then 2 weeks off. After that 8 weeks we will discuss again.

The 5-FU is an anti-cancer (antineoplastic or cytotoxic) chemotherapy drug. This medication is classified as an “antimetabolite”.

How 5-FU works: Cancerous tumors are characteried by cell division, which is no longer controlled as it is in normal tissue. “Normal” cells stop deividing 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 normal checks and balances in lace that control and limit cell division. The process of cell divison, 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 mitosid (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.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. 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 teh 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.

5-FU belongs to the category of chemotherapy called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporated these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. antmetabolites are classified according to the substances with which ther interfer.

Folic acid antagonist: Methotrexate
Pyrimidine antagonist: 5-Fluorouracil Foxuridine, Cyarabine, Capecitabine and Gemcitabine
Purine antagonist: 6-Mercaptopurine and 6-Thioguanine
Adenosine deaminase inhibitor: Cladribine, Fuldarabine and Pentostatin

I will also repost this information in the section of the site so that it does not get lost!

Love and HUGS to everyone. Go with God and KEEP KICKIN’ THAT cancer!

Margaret and Tom