Light at the end of the tunnel

We brought Peekaboo home from the clinic almost a week ago, last Saturday evening to be exact. I thought that she’d slowly return to her usual self once she got home, but it has taken longer than expected. Reason: we ran into a few problems…

Problem number 1. Like most (all?) cats, Peekaboo was REALLY bothered by the Elizabethan collar, a cone-shaped torture device that prevents cats and dogs from licking or scratching or biting their wounds (Note: these three photos of Peekaboo are “post-Elizabethan-collar” photos. The white and red stuff around her neck is just a temporary bandage that doesn’t impede her movements and will come off next week).

Problem number 2. On Friday and Saturday, while she was still in the hospital, the vets had slowly weaned her off her pain medication. Too soon, evidently. By Sunday evening I knew she was in pain. She wasn’t purring or licking food off my finger anymore, so we had to feed her, and administer her meds (antibiotics, etc.), using the esophagostomy tube, which is a feeding tube that connects the esophagus directly to the stomach.

Furthermore, she was very lethargic and wasn’t moving at all, really. And she hadn’t used the litter box at all (even though we put one right on the bed).

I called the weekend vet who told me to give her more of the anti-inflammatory drug, which contains a painkiller, too. There wasn’t much else we could do on a Sunday evening, but first thing on Monday morning I took her back to the vet hospital, where they ran some tests and immediately gave her a shot containing a stronger painkiller. I gave her painkiller shots twice a day until Wednesday (at home). That at least got rid of the pain issue!

She peed inside the cat carrier in the car…so, er, that problem was solved, too! And in fact, as long as she wore the blasted cone, she peed only when we drove to the vet hospital. 🙄 

On Wednesday afternoon the surgeon removed her feeding tube. Consequently, off came the cone!

Life was good again. Peekaboo was back to her old self–happy, relaxed, hungry, and curious. Since then, it’s been all uphill. JOY!!!

Without the awful collar, in fact, she began eating and drinking on her own…she started peeing (etc.) in the litter box, not in the car (!)…she’s grooming herself (as you can see in photo no. 3), and she purrs and talks a lot…

So she’s doing really well. One of my MAIN concerns, in fact, before agreeing to the surgery, was HOW she’d be able to eat without half a jaw…But she is indeed eating–wet food only, right now–and it is such a joy to behold…Cats are such amazing creatures…

More good news: we have some partial biopsy results (from her jaw, which of course was sent off to the lab for testing):

  • the cells aren’t dividing madly, as aggressive cancer cells do.
  • there are indications that this type of melanoma is NOT aggressive.

This means that, IF the surgeon was able to remove every bit of the tumor, and IF no cancer cells have migrated to another part of her body (the lungs, usually), from now on she will lead a normal, healthy life.

Of course, these are big “IFs,” and Peekaboo will have to be monitored for some time…with periodic X-rays of her lungs, for example.

But for now, at least, Stefano and I can sit back and relax…

Quick update on Peekaboo

I took our cat, Peekaboo, to the vet two days ago, around lunchtime. When her new CAT scan results came in, my vet told me that, even though the melanoma had spread a bit in the past two weeks, the cancer hadn’t gone into the jawbone yet. She recommended that we do the surgery.

After asking a few obvious but almost-impossible-to-answer questions (will the surgery PROLONG HER LIFE without impacting her QUALITY OF LIFE, blablabla), I called Stefano, and we both agreed it was our only choice at this point, even though there really aren’t any guarantees: this sort of cancer is very aggressive, so it may come back at some point…

But if we’d waited until, say, September, it would have been too late to do anything. And by then she would been suffering a lot…bleeding from her mouth, etc. I’ve seen the photos online…It’s nasty.

We had to try removing the blasted thing…

In a nutshell: the surgery went well. No complications. Now we just have to wait until she’s well enough to come home. That will happen once she begins eating on her own, which is going to take a few more days…

Yesterday Stefano and I went to see her twice, at lunchtime and just before dinner. I braced myself, expecting her to look like a little Frankenstein, but no, she actually looks the same (see photo). Not that we care what she looks like, of course! As long as she’s okay…

She’s not a happy camper, as perhaps you can tell from the photo. She’s NOT in any pain, of course, but I think the Elizabethan collar is driving her bonkers. Plus, the painkiller/sedative is making her live in a world of her own. I don’t know how much she even knew that we were there…

My job is to get her to eat on her own again. So at one point I put some mushy food on my finger and offered it to her. She turned her head, growling (growling? My Peekaboo???), got up and moved away. Who can blame her? Poor sweetie. I didn’t insist. I’ll try again today. As soon as she begins eating on her own, we can bring her home, where she will be happier and recover more quickly, for sure.

I just hope the vet surgeon was able to get all of that blasted thing, that no cells escaped, and that there will be no recurrences…

One day at a time.

It’s not just malignant. It’s very aggressive.

All of Peekaboo’s test results are in (see my July 4 post; Peekaboo is one of our cats…11 years old…I took the above photo of her in 2015).

The biopsy confirmed the diagnosis of an aggressive malignant oral melanoma.

I won’t go on and on about all the discussions Stefano and I (and friends and family) have had in the past couple of weeks, especially this past weekend…all the going back and forth (surgery…or no surgery???), all the online research we’ve done, reading horrible stories on various cat forums, the heartbreak, the anxiety…”what should we DO???”…

You can imagine all that…

We haven’t been sitting around…doing nothing but talk, I mean. In addition to speaking with the oncologist and the vet surgeon at our own vet hospital, last week we sent her test results to a well-known oncology specialist vet( outside of Florence) who called us on Saturday, recommending we go ahead with the surgery.

Even with that second opinion, I still didn’t want to put her through all that misery…the pain…the risks of doing this surgery…etc. During the weekend, talking things over with Stefano’s aunt (also a cat lover) and his cousins, I decided to let Nature take its course: palliative care…curcumin…pain killers…But no surgery. Definitely absolutely NO SURGERY. How do you explain to a kitty that she’ll have to undergo such a painful procedure blablabla? You can’t. It’s not fair, I decided. She might never recover…never be able to eat properly again…and then she will die anyway, eventually…So WHY do it? Those were all the things rushing through my mind this past weekend.

But what happened today changed my mind. This morning I took Peekaboo to see another vet surgeon, highly recommended, at a clinic here in Florence. He went through her tests very carefully and calmly and told me that, if this were HIS cat, he’d go ahead with the surgery. I still wasn’t completely on board, though…

Until we looked into her mouth…

I’d seen the melanoma almost two weeks ago, when it was just a tiny oval on the side of her gum. Well, it’s not an oval now, and it’s not tiny, either. In just two weeks it has spread quite a bit. Now you can see the blasted thing clearly. It’s growing.

It freaked me out, I have to admit.

I took Peekaboo home and decided I needed to discuss this new bit of information with our vet and the main vet surgeon over at the vet hospital. I was there within a half hour. I told them both what I’d seen this morning in her mouth, and here’s what we agreed to do (we = all of us, Stefano included, of course…Oh my poor sweetheart, getting all this awful news while at work!):

I’ll take Peekaboo to the hospital day after tomorrow (which happens to be my birthday…I hope it brings her luck!). The vets will do another CAT scan to see how much the tumor has spread. Then we will decide what should be done.

  1. If the blasted thing has spread TOO much, meaning that a manibulectomy would impair her QOL, then I’ll just take her home, and we’ll go with the palliative care option. Right now the tumor isn’t bothering her: she’s eating (even dry food), playing, purring, etc.
  2. If, as we hope, something can be done to give her a good QOL for quite some time, we’ll go ahead with the surgery.

Whatever the choice, it’s going to be hard on all of us…first and foremost, on Peekaboo, of course, but also on Stefano and me. And I can’t help but still ask myself: are we doing the right thing? Or rather, are we doing the right thing FOR HER?

To be honest, right now I don’t have an answer…

Incidentally, I’d really appreciate hearing from anyone who might have had this sort of experience with their cat. Thank youuuuuuu!

A case report: the antibiotic roxithromycin induces PR in a patient with smoldering myeloma

Well…Well…WELL!!! I’ve got a very interesting item for you today…

Many many many thanks to my blog reader Charlotte for this gem: goo.gl/hMsWov

The link will lead you to a case report about a 86-year-old patient (with IgA lambda smoldering myeloma) who went into partial remission after taking roxithromycin, an antibiotic, for just ONE MONTH. This happened last year in New Zealand.

The patient’s paraprotein, which had been increasing since he was diagnosed in 2008, dropped from 46 g/L to 20 g/L.

That’s a 57% decrease! Wowsie.

And another thing: in addition to his other markers remaining stable (calcium and creatinine, e.g.) in the four months after taking roxithromycin, his hemoglobin increased to 132…from 97. Another wowsie.

I also discovered something else: the antibiotic clarithromycin has been found to have anti-myeloma activity BUT only in association with other drugs (dexamethasone, etc.). That’s the difference between the two antibiotics, since roxithromycin appears to have “significant single-agent anti-myeloma activity.” That is, it goes after myeloma all by itself…

I’m not a big fan of antibiotics, that’s for sure (although when you need ’em, you need ’em!!!), but this case report has certainly given me food for thought…

A lot of food for thought…

 

“Crystal structure reveals how curcumin impairs cancer”

Wow, VERY EXCITING BIT OF NEWS that popped up in my Google Alerts yesterday.

My post title is the title of a new study revealing a previously unreported biochemical activity of curcumin. This very important study, carried out by three research teams (University of California San Diego School of Medicine, Peking University, and Zhejiang University), shows how curcumin attaches to, and INHIBITS, a gene called DYRK2, which is associated with cellular growth and/or development. This inhibition diminishes the proliferation of cancer cells. It reduces the tumor burden. 

How about THAT?

Here’s the link to the University of California San Diego School of Medicine press release: goo.gl/XPUz6G

Quote: “DYRK2 depletion impairs proteasome activity and exhibits slower cancer proliferation rates and significantly reduced tumor burden in mouse models. In combination with the FDA-approved multiple myeloma drug, carfilzomib, curcumin induced a much higher cancer cell death while normal non-cancerous cells were less affected. This suggest that targeting proteasome regulators (such as DYRK2) in combination with proteasome inhibitors may be a promising approach of anticancer therapy with less side-effects but further work is needed, said Banerjee.

Curcumin plus carfilzomib = HIGHER MM CELL DEATH. Food for thought.

One of the researchers involved in the study states the following: “In general, curcumin is expelled from the body quite fast. […] For curcumin to be an effective drug, it needs to be modified to enter the blood stream and stay in the body long enough to target the cancer. Owing to various chemical drawbacks, curcumin on its own may not be sufficient to completely reverse cancer in human patients.

I agree, of course. I never thought curcumin would (reverse cancer, that is, etc.). But I was also told by an expert that curcumin gets absorbed by our tissues, slurp slurp slurp!!!, within ten minutes or so after we swallow it. Well, whatever the case, curcumin has done me (and many of you, too!!!) a world of good in the past 12 and a half years…

And that is why, while waiting for researchers to come up with a truly effective, modified form of curcumin, I’m going to keep taking my daily eight grams of C3 Complex.  

Well, well. Curcumin never ceases to “wow” me, that’s for sure…

Possible case of feline oral (malignant) melanoma

Because our 11-year-old cat, Peekaboo, has been very aggressive toward the new kittens…stalking them, pushing them into corners and then hitting them until, screeching like hyenas, thus giving us heart attacks, they manage to escape (mind you, she doesn’t hurt them, no blood is shed, e.g., but she really scares them, and that isn’t nice at all!), I finally took her to the vet clinic yesterday morning for a checkup.

When, back in May, I took Pandora and Pixie to the clinic to be spayed, I spoke about this aggressive behavior with the vets who agreed with me that Peekaboo might have some sort of painful physical condition. Pain can make a cat aggressive. Well, come to think of it, pain can make ANYTHING aggressive!!! Made sense to us, since she has never been like this before…

Soon afterwards, though, I came down with bronchitis, so the appointment got postponed. Until yesterday, when my schedule finally coincided with the good vet’s schedule.

As soon as the vet began the checkup, however, Peekaboo started growling ferociously and acting like a wild animal. I’ve never seen her like that…and she has certainly NEVER behaved like that at the vet’s. She’s usually super friendly with human beings, even vets. Not this time. It was so bad that we decided it would be best to have her sedated to have all her tests done. This turned out to be a good thing, as we will see.

To make a very long story short, her blood and urine tests were fine, her abdominal ultrasound was also fine, and her spinal column is in good shape. All very good news.

BUT, and unfortunately there may be a big BUT (!), the vet found a small black spot on her gum (lower, left side) that worried her so much that she used a fine needle to suck up some cells, which she then examined. If Peekaboo hadn’t been sedated, the vet wouldn’t have seen the spot.

Apparently, there were some malignant cells in the sample. The vet thinks it might be oral (malignant) melanoma, which is quite rare in cats, but this diagnosis needs to be confirmed by the oncologist and by a biopsy, which Peekaboo is having done today (I had to leave her at the clinic last night), together with a CAT (hah!) scan. We won’t know the results of the biopsy until next week…

Stefano and I are incredibly worried, of course. If this turns out to be oral melanoma, the prognosis really sucks…

For now, all we can do is wait and hope…

P.S. Does anyone have any experience with feline oral melanoma (just in case that’s what this “thing” turns out to be)? Thanks!

P.P.S.S. Incidentally, the first three photos show Peekaboo as a kitten in 2007; the first two were taken in July, just before and just after we adopted her; the third, in November 2007. The fourth, not-very-great photo, taken with my cellphone, is more recent: June 25 2018. Our beautiful girl!!!

For the first time, the FDA approves a CBD-containing drug

As I have written in previous posts, CBD, or cannabidiol, an active ingredient of marijuana, kills myeloma cells, so the news I came across early this morning is of huge interest to me.

In a nutshell, for the first time ever, the FDA has approved a CBD-containing oral solution (= a strawberry-flavored syrup) for the treatment of rare but severe forms of epilepsy in children.

Note: this syrup does not contain THC, the ingredient in marijuana that makes people “high.”

It may not come without side effects, such as sleepiness and increased liver enzymes (like most anti-seizure drugs, it appears), as you can read in the FDA press release: goo.gl/hS7aQm

Compared to seizures, however, the potential side effects seem tolerable. Here’s a Time magazine story about a 10-year-old girl with Dravet syndrome who participated in the CBD clinical trial in 2016, for example: goo.gl/JT2CAM

Anyway, I think this is very exciting…and promising…!!!

A new commission looks into the adverse effects of blood cancer treatments

This morning I read an IMPORTANT Science Daily article on how the adverse effects, tolerability, and toxicities of conventional treatments for blood cancers (including myeloma, of course) have not been reported/disclosed as well as they should have been, to put it mildly. See: goo.gl/ou9CNg

Well, this may change soon enough: a new commission set up by The Lancet Haematology has been looking into these adverse effects and toxicities, considering in particular the long-term, chronic effects that don’t go away even after the completion of treatment, such as neuropathy, which can be crippling.

Quality of life has always been a big concern of mine, and I always look for adverse effects and toxicities whenever I read studies about patients and conventional treatments. Very rarely, however, are adverse effects mentioned…The first study that comes to mind is the Spanish SMM patient-chemo study, where there was no information on how the early treatment of SMM patients affected their daily lives. And yet their lives must have been affected, at least in some ways…

Excerpt from the SD article: “In particular, the toxicity over time and tolerability to the patient of new chronic or continuously administered therapies are not well defined, and are poorly captured by existing reporting mechanisms.

Well, the important thing is that FINALLY (about time!!!) there is a commission looking into this lesser-disclosed (to say the least) part of conventional treatments. This is very good news.

We, the patients, need to be INFORMED about any and all potential problems, both short-term and long-term…

Or, at least, that is MY opinion! As usual!!! 🙂

Food items we should avoid “like the plague”…

I just read a very interesting interview with/article about a food poisoning lawyer (imagine that…!!!) who shares his knowledge about food, potentially contaminated food. And some of it isn’t so obvious.

That is why I’m posting the link to the article, as a warning/reminder to those of us who have weakened immune systems: goo.gl/NG3oty

I never buy prepackaged (washed? Hah!) salad, e.g., or anything that has been cut and washed by others. I never go near salad bars, no matter how clean the restaurant looks. Bacteria bacteria bacteria! Better be safe than sorry…

After my SMM diagnosis, I began growing my own sprouts, which contain lots of vitamins and minerals (even protein and so on). Until…one day I read about the risk of Salmonella and E.coli contamination, and that completely killed my sprout-growing enthusiasm. I gave my sprouter away. Just a few days ago, in fact, there was an outbreak of Salmonella in Southern Australia caused by alfalfa sprouts. Yes, okay, these were store-bought, but still…I’m not taking the risk. No sprouts in my sandwich, thank you very much!!!

Anyway, the above interview/article may surprise you. Or not!

Do you have any additions/suggestions? Thanks! Have a great Sunday! Ciao! 🙂

Researchers test curcumin in new bone-building study

After enhancing the bioavailability of curcumin using polymers, a group of Washington State University researchers proved that curcumin can increase bone growth by between 30% and 45%  in a matter of weeks: “The presence of curcumin in TCP results in enhanced bone formation after 6 weeks.” (Quoted from the abstract.)

The researchers are currently testing other natural extracts as well, namely “aloe vera, saffron, Vitamin D, garlic, oregano and ginger [… ] that might help with bone disorders, including those that encourage bone growth or that have anti-inflammatory, infection control, or anti-cancer properties.” (Quoted from Science Daily, see link below.)

The bone-forming qualities of curcumin are nothing new to us (I’ve written a number of posts on this topic), but it’s always good to learn that researchers are looking for, and apparently FINDING, new ways to make curcumin more bioavailable, especially if it has to do with our precious bones!

Note: this study was carried out on 3D-printed, ceramic bone scaffolds, not on human beings. So there is still a long way to go. Still, it is encouraging to have one more study prove the importance of curcumin for bone health and growth…

Curcumin forever!

Here’s the very interesting write-up in Science Daily (easy to read, to boot): goo.gl/MRxtK2 There is a link to the study’s abstract there, for those who want to know more.

Happy reading! 🙂