Delayed Side Effects

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As I have talked about (a LOT) during my treatment for FBC (f-bomb breast cancer), cancer therapy (especially chemo) can have side effects and that surface long after treatment for the original disease is gone. Some such side effects include liver damage, heart disease and even cancer itself. Yes, chemo can in fact cause other types of cancer.

And, yes, cancer brings out the f-bombs in me. Ahhhh, FBC.

On Good Morning America this morning, Robin Roberts told viewers (quite bravely, I might add) that her treatment for breast cancer triggered another serious disease called Myelodysplastic Syndrome, a/k/a MDS.

WTF is it, you ask? Myelodysplastic syndrome (formerly known as prelukemia) is a rare, malignant (i.e., cancerous) blood and bone marrow disorder.

WTF is bone marrow, you ask? Well, as you may recall from my FBC days, I like to explain things. So, to better understand what happens to your blood when a person has myelodysplastic syndrome, it helps to know the fundamentals about normal blood cells and where they come from.

So, let’s start from the beginning: there are three major types of blood cells:

  1. Red blood cells (RBCs) are the major part of your blood. They carry oxygen and carbon dioxide throughout your body.
  2. White blood cells (WBCs) include several different types. Each has its own role in protecting the body from germs. WBCs play a major role in fighting infection. Infections are more likely to occur when there are too few normal WBCs in the body. The three major types of WBCs are neutrophils, monocytes and lymphocytes.
    1. Neutrophils destroy most bacteria.
    2. Monocytes destroy germs such as tuberculosis.
    3. Lymphocytes are responsible for destroying viruses and for overall management of the immune system. When lymphocytes see foreign material, they increase the body’s resistance to infection.
  3. Platelets are the cells that help control bleeding by helping blood to clot normally. When you cut yourself, the platelets collect at the site of the injury and form a plug to stop the bleeding.

Bone Marrow is the soft, spongy material within the bones where blood cells are made. All blood cells begin in the bone marrow as stem cells. Stem cells are very immature cells. When there is a need, the stem cells are signaled to develop into mature RBCs, WBCs or platelets. Make sense?

Ok, so MDS is when things go haywire with the bone marrow, i.e., when the blood-forming cells in the bone marrow are damaged. This damage leads to low numbers of one or more type of blood cells. And because we need our RBCs, WBCs and Platelets to fundamentally fuel and protect us, this is not good.

Many people have no symptoms of MDS. However, when symptoms do present they tend to be

  • Anemia (low RBCs)
  • Fatigue (from the anemia)
  • Easy bruising or bleeding (due to low platelets), and/or
  • Frequent fevers or infections as a result of low numbers of infection-fighting cells.

The primary approach to treating MDS is a bone marrow transplant.

The goal is to take bone marrow from a healthy donor who has similar immune markers on their blood cells (in Roberts’ case, the donor will be her sister who is considered a perfect match – Silver Lining) and use it to replace and repair the abnormal bone marrow in the MDS patient. Before the transplant, Oncologists use chemotherapy to eliminate all of the cells in the patient’s bone marrow and then infuse the new bone marrow. Basically, the chemo wipes out the nonfunctioning bone marrow to make room for the new, donated bone marrow.

Who is at risk for MDS? Prior treatment with chemotherapy is the most important risk factor for MDS. Patients who have been treated with certain chemotherapy drugs for cancer are more likely to develop MDS. Other risk factors include: familial MDS, smoking (who on earth smokes anymore? I mean, really.), age, genetic syndromes, and being a man.

Robin Roberts is so cool.  She is turning her own scare with a rare bone marrow disorder into a call for organ donation (Silver Lining).

Her coolness is further highlighted in her blog post today when she referenced the highs and lows that happened simultaneously in her life:

I received my MDS diagnosis on the very day that Good Morning America finally beat the Today Show for the first time in 16 years. Talk about your highs and lows! Then a few weeks ago, during a rather unpleasant procedure to extract bone marrow for testing, I received word that I would interview President Obama the next day. The combination of landing the biggest interview of my career and having a drill in my back reminds me that God only gives us what we can handle and that it helps to have a good sense of humor when we run smack into the absurdity of life.

See what I mean about cool?  Sounds to me like she has found a whole lot of Silver Linings amidst her very trying circumstances.

I know that I’m not alone when I wish her all the very best (Silver Lining).

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Comments

  1. says

    I think about this sort of thing all the time as a breast cancer survivor. I have had one too many friends get even more sick from side effects than they were with cancer. It's insane. Robin Roberts sets such a good example of pressing through it all.

  2. florence takacs says

    i have to say the one thing that scares me is that this can happen, or that the cancer will return else where . while i dont dwell on it it is kind of always there!

    • says

      It is something that we all learn to live with, isn't it Florence? Just knowing that the other shoe "can" drop…but hoping that it doesn't!
      Thank you for your comment!

      • says

        Thanks, Hollye, for your honesty. Yes, the other shoe can always drop. When I read your BLOG, and did the math, I realized it's been 11 yrs since my stage 2 diagnosis (lobular – double mast.). Wow!

        Wish I could forget about the other shoe (the ultimate FBC thing). Sometimes I forget – more and more as time goes by –then a "Robin" story scares me — but, maybe only for a day.

        What has worked best for me is deeply, happily feeling involved in writing and (like you, I think) being active in the great outdoors. I need to hike and backpack – even to the point where my grandson will kindly help me up Mt. Whitney! :-)

        • says

          Thank you so much for your note, Patricia! Wow, 11 years. Amazing. I'm so glad to hear that you are cancer-free. Wonderful! I am also so happy to hear that you enjoy writing and being outside. They are definitely two of my favorite things! Thanks again for your note. Best wishes!

  3. Maili says

    Tears reading this. Robin's comments made tears come to my eyes. Both you and she are an inspiration and an example of how our lives are a mixture of the good and the bad. Sending prayers and strength to all.

  4. Camila S. Mata says

    Robins is really a (brave) warrior…God knows where we stand/if we can handle the ordeals in our life…last week supposedly my 3rd cycle of chemo but it was postponed since my neutrophil count (300) is very low…i'm scheduled again on thursday (june 14) and i hope n pray the count goes up…

    • says

      Indeed, Camila. Best wishes on Thursday. I always found it such a strange feeling to "hope" to be able to take chemo. Please stay in touch!

  5. Kim C says

    I saw her on the news last night and couldn't stop thinking about her and what she must go through now. Yes, she sounds like such a strong and positive person who looks for silver linings. It was good to hear her sister is a perfect match… but what a shock it must have been to learn what was happening and that it was caused by chemo. Sometimes I feel so angry at the disease – not the chemo as it helps many of us. In saying that, hopefully there will be a better way to fight cancer in the future!! I'm sure she's in the best possible hands and I'm with you in wishing her all the best.
    Thank you for this information, Hollye.

  6. Bonnie Likover says

    Hollye,

    Thank you for taking the time to explain the importance of all those bloody initials…WBC, RBC, BM…it helps so much to have a visual picture of what someone is going thru and now I can visualize the toxic blood cells needing to be eliminated. Must be all of those initials after your name that help you sort out all the gritty details. I appreciate your thorough explanation.

    Have a blessed day. I know this is another scary step in someone's journey who has survived cancer.

    Bonnie