I hear people puzzle over this question often.  Oh, not so much about why I have cancer, but why cancer exists.  In a world filled with bizarre, pre-enlightenment notions of “knowledge” that competes for our attention, it’s easy to see why so many would be confused.  Luckily, we know exactly why cancer exists.  It’s no mystery, and it certainly doesn’t require mystical explanation (though I’ve been astonished at how many attribute it to non-material forces).

Cancer happens because change is the fundamental property of living things.  That change can happen in populations, or it can happen in individuals.  Somewhere along the way, probably in the early 2000′s, one of my b-cells—that important component of the immune system that generates those amazing chemicals called antibodies . . . well . . . got changed.  The change was random.  I do not use this word—random—in the unfortunate way so many are today, to mean improbable, which is the precise opposite of its actual meaning.  The change certainly was improbable in that single cell, in my body; such changes, however, are highly probably across populations where cells are changing all the time.  But when I say random, I mean that it was just as likely to occur in the cell that it occurred in as it was to occur in any b-cell, and the change’s occurrence was without direction, without intention.

The details of the change in my b-cell are well known, and in my case they were demonstrated genetically in Manhattan at the time of my formal diagnosis with follicular lymphoma.  Most say something went wrong; I don’t see it that way.  Oh, I’m not one of those infuriating bright-siders who say absurd things like they’re glad they got cancer, or whatever other garbage they have to tell themselves so they can grapple with their mortality.  I just know biology, and life is change. Populations of cells change just as populations of wasps change.  One of my cells changed.  That’s it.  Maybe, it could’ve been an advantageous change, but it wasn’t, at least not for the whole of me (but from the reproductive perspective of the b-cell, it certainly was. . . more on that later).

The relevant behavioral change in that singe b-cell allowed it to reproduce without bound, and so it and its daughters have been busy clogging my body with their bodies—with too much of me.

Some might find this view cold.  Perhaps.  But it is the truth.  I happen to be comforted by the knowledge of the true nature of the natural history of cancer.  As a famous biologist once wrote, “there is grandeur in this view of life.”

So, that last post didn’t actually go up until 31 days post-transplant—that is, today.  The first week post infusion seemed to go fairly well, but matters descended shortly after that, and my heart just hasn’t been in the blog.  I think I’ve mustered my gumption again.  Hopefully posts will be steady at this point.

Frankenstein is by far my favorite novel.

When I’m not in the bathroom applying ointments containing sodium hydroxide to various parts of my groin to kill the fungus that won’t stop growing, or taking pills to satiate the nausea that pops up from time to time, or trying to get some work done, or sleeping (=what I mostly do these days), I watch TV.  Frankenstein was on earlier—the good one from 1994 that tells the story as Shelley wrote it—a story of a world on the brink of medical miracles, and of the hubris of such thoughts. Every time I read it, I find it more relevant.  As I’ve matured as a biologist, I see more and more genius in it.

Now with cancer, and having just seven days ago undergone a stem cell transplant to completely replace my native immune system—the one that’s been rebelling against me for at least four years—I see another layer to Frankenstein. On its face, it is a book as much about transplantation as reanimation.  Getting living parts from different people to happily co-exist must have been at least as perplexing to Shelley as getting long-dead tissue to come alive again. The latter is taken up by the book, and I am keenly focused on the former.

Stem cell transplants are nothing short of the vision—if small-scale—of Victor Frankenstein.  And, there has been some success with this procedure in the intervening 200 years.  Not so much that you’d run out and get a new, better immune system if yours wasn’t up to snuff, mind you.  These monstrous transplants are saved only for those who have no other options—like me.

So, after years of willingly taking into my body chemicals banned by various war crimes tribunals (that is, chemotherapies of many flavors), I’m left with two options:  Replace a very large, important part of me (all the cells in my blood, including my entire immune system) and hope for alternate ending to Shelley’s great work, or do nothing and have that rogue part of me kill the rest.

With great reluctance, I’ve chosen to take my chances with fire theft.