We all have an idea in our head that the stories we hear others tell is never going to happen to us. That, even though we are there for that person in their time of need, we think to ourselves “I can’t imagine going through something like that” and “I’m lucky this isn’t happening to me.” A couple of weeks ago, my dad was diagnosed with a Grade 4 Glioblastoma of the frontal lobe of his brain.
The still invincible man that is my dad always worries about clean drinking water and having a balanced diet. He is always active, takes time to reflect and meditate, and wouldn’t even take panadol. The only few things that have been able to ever slow down my dad is my mum, a bottle of red the night before or a rusty bit of metal that he stepped on at 80 Mile Beach in Western Australia when I was younger. I say still because, even with the curveball that life has thrown, mum continues to send through Snapchat pictures of him smiling; something that I don’t think I would have the strength for if it was me. It’s ironic and unfair that the man who wouldn’t use a cell phone because of his scepticisms would be diagnosed with a brain tumour. This is part of my process of dealing; I research, I read, and I learn as much as I can. Most importantly, I get it out of my head.
Cancer is when a normal cell goes out of control and is usually a result of errors in the coding that maintain normal cell growth and division within its DNA. Cancer is actually an umbrella term for more than 200 diseases as cancer can stem from almost every cell in the human body. If the cancerous cells are isolated, they are benign, but if they do start to grow into the surrounding tissue and/or different parts of the body then they are malignant. A glioblastoma is a type of cancer that stems from out of control astrocytes which are cells that structurally support brain tissue almost like glue.
The grade 4 is a ranking with 4 being the highest and means that it is aggressive because of the large network of surrounding blood vessels feeding it and highly malignant so growing is imminent. Symptoms include headaches and drowsiness and, because of the edema (swelling resulting in pressure) in my dad’s brain, changes in personality and mental function. This was apparent the next morning when I had flown up to Brisbane to be with my family when, my once modest father, was dancing around showing some extra leg in his purple hospital gown, in his ward.
Surgery is definitely the initial step when it comes to the treatment of cancer but there can be issues with the location that can make some cancers inoperable or difficult to remove significant portions of the tissue. For my dad, some cancer had made its way into the Corpus Callosum which is the area of the brain that connects the left and right hemispheres together allowing communication between the two. Going into surgery, we knew that not all of the tumour was going to be attempted to be removed for fear of physical or mental impairment but, lucky, 95-97% of the cancerous tissue was successfully removed from his frontal lobe.
This is what the tumour originally looked like before its removal. It was a mass that was 20 x 40 x 50 mm and, pointed out by my aunt, once turned upside down resembled a flaccid penis (use your imagination). Over the 6 days that I was up, a plethora of jokes followed this realisation which resulted in some concerning and odd looks from fellow patients and hospital staff.
As I write this article, my dad is currently getting fitted for a face mask during his treatment planning appointment. It’s known as an immobilisation mask and it is used to ensure minimal movement during radiation therapy to increase accuracy. The therapy uses painless, precise x-ray beams to kill or damage the cancerous cells while reducing the risk of damaging surrounding, healthy tissue. Treatment duration and frequency is to be determined but usually occurs daily, Monday to Friday for 7 weeks. Though radiation therapy aims to cure, control and/or relieve symptoms, it is coupled with its own list of symptoms like fatigue, loss of appetite, hair loss and shortness of breath. As someone who is constantly reminded of the fate of my hairline when seeing my dad, I’m not too concerned with the hair loss aspect personally.
Chemotherapy is a cocktail of drugs that aims to destroy rapidly dividing cells while leaving normal functioning cells behind. It is this targeting that results in other fast dividing cells, like hair follicles, to be damaged too. Unfortunately, chemotherapy, though coupled with other treatments has shown some benefits, has a limited effect on brain tumours due to the blood-brain barrier. This is a physical, tight, cellular barrier around the brain and spinal cord that aims at separating your central nervous system from the rest of the body. This is to protect it from harmful substances that can circulate in the blood like pathogens (disease-causing things) and chemicals. Only specific types of drugs have been designed that are effective at crossing this barrier, and, in recent years, modified viruses have been used to deliver treatments across the blood-brain barrier.
Administration of chemo varies as well as the symptoms that one can experience. It is these symptoms that, depending on a person’s own life experiences, can either drive them towards or away from chemo. If there is a good chance of beating it, are the symptoms of chemo worth it in the short term? Or, do you not want to spend the rest of your little time experiencing the symptoms of chemo? Regardless of my perspective, the choice ultimately falls to my father and I will support him and that choice.
Experimental trials of immunotherapy are currently taking place around the world to see if a person’s own immune system can beat brain cancer. This is where modified viruses come in as mentioned previously. Viruses are modified to only infect cancerous cells while leaving the rest of the bodies healthy cells unaffected. The body’s own immune system then identifies that the cells are infected with the virus and attack them. Not only viruses but other studies have also shown that engineered human stem cells have also been effective at ‘labelling’ cancerous cells for targeted medications and for the immune system to attack. One of the issues from this treatment is that activation of the immune system is relatively easy (we’ve been doing it for decades with vaccinations) but ‘turning it off’ can be difficult. Risks are escalated for individuals with higher grades of cancers as their body is already weakened. There are mixed results currently for its effectiveness but trials using children and the polio virus are underway to try and demonstrate that this type of therapy can be used for multiple cases. This is something that my dad and mum are looking at exploring further.
That’s where we currently stand; at the edge of a ravine with no immediate idea has to how we’re going to get to the other side. I wrote this as part of my process. Getting this all down on electronic paper is a way for me to remove some of the thoughts from my head and contextualise it. I know it’s different for all sorts of people but I felt like this is something that I had to do. And for my dad, you are and forever will be an amazing man that I have had the fortune of calling my father. I wouldn’t be who I am today if it wasn’t for everything you taught me. You taught me how to work hard, to appreciate what I have, to appreciate where I have come from and to never give up. I love you, dad. Here’s to making some awesome memories and never giving up. Plus, I don’t think mum will allow you too.