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New Way of Thinking About Cancer

New Way of Thinking About Cancer
August 10
18:53 2016
Kim Liao went to school to become a “professional storyteller.” With a Master of Fine Arts in Creative Writing, she never imagined she’d be translating complicated medical research for an immigration law firm.

“As my job drafting referee letters for the visa applications of foreign medical graduates progressed, the human body came to life in away it never had while I passed notes and daydreamed through my high school science classes,” writes Kim.

Kim documents the medical experiences of patients by speaking with all types of medical professionals about everything from complex surgeries to the activities within a single cell. “The most common shared topic across the work of my clients is cancer. It is omnipresent, all-pervasive – cancer is everywhere, and so is cancer research.”

d5db8e92_shutterstock_239338216.xxxlarge_2xAs Kim continued to write in the “mysterious sci-fi galaxy” that is the human body, she began to view cancer as “Darth Vader.” She pictures doctors as “powerful but flawed Jedi knights” and compares the body’s immune system to “the Force.”

Despite the serious topic of her work, Kim remained emotionally untouched. After all, she wasn’t dying from cancer. To Kim, her stories were just that – stories.

All of that changed when her father was diagnosed with Stage 4 kidney cancer.

“My dad and stepmom told me about his case of renal carcinoma over brunch…and ordered me not to cry in public,” writes Kim. “When we went back to their apartment across the street, he gave me his set of house keys – he was moving up to their condo in Connecticut full-time to get treated at the Yale Cancer Center.”

Kim had tears in her eyes as she carried her father’s guitar downstairs for him. Her dad was surprisingly calm, assuring her that cancer was just one of those things that happens to people.

Kim felt like her father’s decision to move to Connecticut was akin to digging a grave and climbing in.

Kim immediately went to work researching her father’s case – “as if I were preparing a case for work.” By Kim’s reckoning, her father’s chances of surviving for one year were less than 50%; his chances of surviving for five years were less than 10%.

Kim looked through every clinical trial she could find to learn which treatments were most recommended for his case. “If I were discussing my dad’s illness at work, I would have used phrases like ‘renal cell carcinoma, while easily treatable in its earliest stages, paints a grim prognosis by Stage 4 – with inoperable cases having a dismal survival rate of less than a year.’”

Except for the cancer, Kim’s father was relatively healthy. His doctors agreed the best treatment option was high-intensity chemotherapy; what Kim calls “the nuclear bombs of cancer treatment.”

Kim kept quiet about the situation at work, determined not to collapse into an “ineffectual puddle of desperation” in the office. “The hardest writing I’ve ever had to do for money was writing the case for the renal carcinoma pathologist during the two months after I first learned of my father’s diagnosis,” writes Kim.

Everything that made writing exciting and interesting for her was now a reminder of her father’s unexpected battle with cancer.

As she studied the renal carcinoma pathologist’s work, Kim was struck by the way he studied the tumor’s “microenvironment” to learn more about the behavior of renal cell carcinoma.

Brain-coral-fan-worm2In her mind’s eye, she saw her father’s kidney as a coral reef inhabited with all sorts of different cells – each with its own job. The tumor was an ugly lump of coral that didn’t fit in with its vibrant surroundings. “In the microenvironment, immune cells identify, latch onto and disable tumor cells…while tumor cells hijack other cells and use them for their own nefarious devices,” writes Kim.

Meanwhile, Kim’s father received Interleukin-2 (IL-2), a new type of biologic drug aimed to boost the immune system. IL-2 is typically administered in the ICU due to its horrible side effects. “In this case, my partial knowledge of the science, at a molecular level, didn’t help me feel better – it only made the experience worse. It was all far too immediate.”

After two rounds of IL-2 that ravaged every system in Kim’s father’s body, his oncologist was able to enroll him in an immunotherapy trial in which he could participate as an outpatient.

Kim’s father now receives a serum infusion once every three weeks. The personalized concoction is created from his own blood “in which certain antibodies are activated in order to be able to recognize his body’s tumor cells and are re-injected back into his body for about an hour or two.”

There are virtually no side effects. Kim’s father has 97% of his hair, is able to drive to and from the infusion sessions, and eats on a normal schedule.

Almost a year has passed since his original diagnosis, and he looks healthier than ever.

While Kim’s father’s doctors advised against surgical removal of the two cancerous tumors in his body, the treatment has been successful in shrinking both tumors. “They are not gone, nor will they necessarily ever be. But he has reached a tentative status quo.”

Kim never told her father or her stepmom what she had reach about the survival rates of patients with renal carcinoma, and she doesn’t plan to. Every case is different, and Kim has high hopes for her father.

“Disappointed hopes are far worse than worst-case scenarios not quite fulfilled. So I’ve mainly stopped reading about renal carcinoma. I am mainly just grateful that he doesn’t have to suffer from the excruciating side effects of traditional chemotherapy.”

Through her work, Kim has learned to “animate” all of mankind’s biological functions. But now, all she wants is to surrender her humanity to the process – viewing the “tumor microenvironment as a shifting battle of cells signaling through viscous liquid, quietly watching the cells resolve their conflicts without further explanation.”

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April Kuhlman

April Kuhlman

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