Facing Chemotherapy I: This Stuff Could Kill You

When I was diagnosed with acute myeloid leukemia, I received an initial round of “induction” chemotherapy to get my disease into temporary remission and buy time to consider my long-term treatment options.

I had no prior experience with cancer or chemotherapy. My first lesson about this treatment was when my nurse Jane approached me wearing the hospital equivalent of a hazmat suit, face shield, gloves, and mask. She then placed a thick mat over my torso to protect me from any accidental spillage of the drug. All this vividly symbolized the toxicity of the medication I was about to receive. I realized that while it was intended to cure me, this could only happen by first poisoning me.

It was some time later that I came across an arresting footnote in Susan Sontag’s Illness as Metaphor. She describes an incident in World War II when an American ship carrying mustard gas was bombed, releasing the deadly chemical. Some soldiers died from burns and drowning, but most succumbed to bone marrow poisoning from the mustard gas.

When some creative doctors realized that this lethal agent might also kill cancer cells, they fashioned a closely related chemical compound known as nitrogen mustard to treat blood cancers like leukemia and lymphoma. As I proceeded to my stem cell transplant, I received a chemotherapy drug called Cytoxan that is derived from this lineage of chemical weapons. The goal was to kill off both cancer cells and my diseased immune system and it worked. Unlike those unfortunate sailors, however, I received a carefully calibrated dose followed by a cord blood transplant of healthy stem cells that jump started a new immune system.

One of my oncologists captured the role of chemotherapy in transplants succinctly by saying “first we bring you to the brink of death, and then we try to bring you back again.” Needless to say, I’m happy the second part worked as well as the first. More on chemotherapy in my next post.