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	<title>Comments on: Anna Donald: Confessions of a chemo-veteran</title>
	<atom:link href="http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/feed/" rel="self" type="application/rss+xml" />
	<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/</link>
	<description>Just another blogs.bmj.com weblog</description>
	<pubDate>Sat, 06 Sep 2008 05:29:29 +0000</pubDate>
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		<title>By: Martin Ashdown</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2745</link>
		<dc:creator>Martin Ashdown</dc:creator>
		<pubDate>Sun, 17 Aug 2008 02:10:18 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2745</guid>
		<description>Hi Anna,
i'm a clinical cancer researcher collaborating with the Mayo, Royal Women's Hospital Melbourne, Peter MacCallum Cancer Melbourne and others. We have discovered that in the late stage cancer patient, the patient's immune system is persistently and repeatedly oscillating on and off against the tumor burden in a process of endogenous vaccination / autoregulation over an approximate 7 day cycle. The "off switch" autoregulation lymphocytes are synchronously clonally active over a narrow 12hr window every ~7 days.....within this narrow window these cells are exquisitley sensitive to being ablated by standard cytotoxic agents. Once these cells are killed off the unregulated immune system can dispatch the tumor burden relatively quickly. We know this from the mouse experiments. We have good evidence that when chemoRx is spectacularly succesful in a late stage patient, it is due to fortuitous ablation of these regulatory cells and not direct cytotoxicity against the cancer. Consequently the patient must be treated at the correct point in their idiosyncratic cycle for best therapeutic outcome - a complete response ......so its a bit like the menstrual cycle and fertilization/conception....as my wife says....."if you want the baby, you got to get the timing right. Last year I was an invited speaker by the NCI/NIH Dept. of Surgery at the cancer immunotherapeutics conference in Banff, also by the TGA in Canberra and this year (May2008) by Ian Frazer to address his oncology collaborative group at Princess Alexandra re our clinical work at the Mayo Clinic and with Michael Quinn director of oncology at RWH here in Melbourne. I would like to discuss this with you....as I think you would understand it, as this cycle explains the heterogeneity of responses to chemoRx and why chemoRc doesn't work most of the time.
Prof Martin Tattersall is also aware of this work.
best regards
Martin</description>
		<content:encoded><![CDATA[<p>Hi Anna,<br />
i&#8217;m a clinical cancer researcher collaborating with the Mayo, Royal Women&#8217;s Hospital Melbourne, Peter MacCallum Cancer Melbourne and others. We have discovered that in the late stage cancer patient, the patient&#8217;s immune system is persistently and repeatedly oscillating on and off against the tumor burden in a process of endogenous vaccination / autoregulation over an approximate 7 day cycle. The &#8220;off switch&#8221; autoregulation lymphocytes are synchronously clonally active over a narrow 12hr window every ~7 days&#8230;..within this narrow window these cells are exquisitley sensitive to being ablated by standard cytotoxic agents. Once these cells are killed off the unregulated immune system can dispatch the tumor burden relatively quickly. We know this from the mouse experiments. We have good evidence that when chemoRx is spectacularly succesful in a late stage patient, it is due to fortuitous ablation of these regulatory cells and not direct cytotoxicity against the cancer. Consequently the patient must be treated at the correct point in their idiosyncratic cycle for best therapeutic outcome - a complete response &#8230;&#8230;so its a bit like the menstrual cycle and fertilization/conception&#8230;.as my wife says&#8230;..&#8221;if you want the baby, you got to get the timing right. Last year I was an invited speaker by the NCI/NIH Dept. of Surgery at the cancer immunotherapeutics conference in Banff, also by the TGA in Canberra and this year (May2008) by Ian Frazer to address his oncology collaborative group at Princess Alexandra re our clinical work at the Mayo Clinic and with Michael Quinn director of oncology at RWH here in Melbourne. I would like to discuss this with you&#8230;.as I think you would understand it, as this cycle explains the heterogeneity of responses to chemoRx and why chemoRc doesn&#8217;t work most of the time.<br />
Prof Martin Tattersall is also aware of this work.<br />
best regards<br />
Martin</p>
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		<title>By: David Anthony</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2440</link>
		<dc:creator>David Anthony</dc:creator>
		<pubDate>Wed, 28 May 2008 09:27:41 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2440</guid>
		<description>Dear Anna,

A late comer to your blog, but you have been in our thoughts. Such clarity. Why would I expect less. I smile through tears imagining you exploring this frontier within yourself.

Sending all our hope and love.

David</description>
		<content:encoded><![CDATA[<p>Dear Anna,</p>
<p>A late comer to your blog, but you have been in our thoughts. Such clarity. Why would I expect less. I smile through tears imagining you exploring this frontier within yourself.</p>
<p>Sending all our hope and love.</p>
<p>David</p>
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		<title>By: Alan Lovell</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2439</link>
		<dc:creator>Alan Lovell</dc:creator>
		<pubDate>Tue, 27 May 2008 15:58:02 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2439</guid>
		<description>Hey Anna,

I loved your metaphors about chemo... it's already been pointed out so many times but you really do have a wonderful turn of phrase (I'm sure you've already read some Wodehouse at some point in your life, but if not give him a go - you'll appreciate him as one wordsmith to another). And you should get a book deal, as your writing is too good to be wasted on the blogsphere.

As for Tom and Mai's idea of Drs being obliged to under chemo - yes, quite, absolutely! Oh, and imagine what we could do to dentists!</description>
		<content:encoded><![CDATA[<p>Hey Anna,</p>
<p>I loved your metaphors about chemo&#8230; it&#8217;s already been pointed out so many times but you really do have a wonderful turn of phrase (I&#8217;m sure you&#8217;ve already read some Wodehouse at some point in your life, but if not give him a go - you&#8217;ll appreciate him as one wordsmith to another). And you should get a book deal, as your writing is too good to be wasted on the blogsphere.</p>
<p>As for Tom and Mai&#8217;s idea of Drs being obliged to under chemo - yes, quite, absolutely! Oh, and imagine what we could do to dentists!</p>
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		<title>By: Urmila</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2438</link>
		<dc:creator>Urmila</dc:creator>
		<pubDate>Tue, 27 May 2008 10:19:40 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2438</guid>
		<description>Dear Anna

You are always in my thoughts and prayers, Anna.  I hope you continue writing your blogs, which have touched and inspired so many.  You write beautifully and explicitly about your experience, which I hope will make a difference to cancer patients.  I miss you and can't wait to see you. With very best wishes and tons of love.</description>
		<content:encoded><![CDATA[<p>Dear Anna</p>
<p>You are always in my thoughts and prayers, Anna.  I hope you continue writing your blogs, which have touched and inspired so many.  You write beautifully and explicitly about your experience, which I hope will make a difference to cancer patients.  I miss you and can&#8217;t wait to see you. With very best wishes and tons of love.</p>
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		<title>By: Neelima</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2437</link>
		<dc:creator>Neelima</dc:creator>
		<pubDate>Mon, 26 May 2008 12:25:44 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2437</guid>
		<description>I look forward to reading your blog.I must admit, there are certain words and phrases which I cannot understand.However it is coming from your heart which makes it such a beautiful reading.Keep writing.</description>
		<content:encoded><![CDATA[<p>I look forward to reading your blog.I must admit, there are certain words and phrases which I cannot understand.However it is coming from your heart which makes it such a beautiful reading.Keep writing.</p>
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		<title>By: Rick Niederman</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2436</link>
		<dc:creator>Rick Niederman</dc:creator>
		<pubDate>Sat, 24 May 2008 02:41:40 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2436</guid>
		<description>Anna:

I am just catching up with you after a too-long delay.  Your blogs are simultaneously heart-breaking, uplifting, and funny - although I didn't get the right hand / left hand humor on the previous blog.

Your description of the epirubicin so reminds me of Asha's first encounter - with the drug and the toilet bowl - it brought me to tears, again.

In an odd twist Asha currently plays an electric violin with an Aussie rock and roll group in Los Angeles, Porcelain, who are all from Wollengong (did I spell that right?).

I dearly miss seeing you, and hope the cough is a short-term setback.

My very best wishes and love,

Rick</description>
		<content:encoded><![CDATA[<p>Anna:</p>
<p>I am just catching up with you after a too-long delay.  Your blogs are simultaneously heart-breaking, uplifting, and funny - although I didn&#8217;t get the right hand / left hand humor on the previous blog.</p>
<p>Your description of the epirubicin so reminds me of Asha&#8217;s first encounter - with the drug and the toilet bowl - it brought me to tears, again.</p>
<p>In an odd twist Asha currently plays an electric violin with an Aussie rock and roll group in Los Angeles, Porcelain, who are all from Wollengong (did I spell that right?).</p>
<p>I dearly miss seeing you, and hope the cough is a short-term setback.</p>
<p>My very best wishes and love,</p>
<p>Rick</p>
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		<title>By: Andrew Herxheimer</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2430</link>
		<dc:creator>Andrew Herxheimer</dc:creator>
		<pubDate>Thu, 22 May 2008 13:32:21 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2430</guid>
		<description>Dear Anna,
It took me a while to get to your blog - it's wonderful, I can hear you saying it all.  So much important truth from the heart &#38; mind.  I'd like it to reach everybody, &#38; shall try to get DIPEx to link to it.  Delighted to be in touch with you again!
Love, Andrew</description>
		<content:encoded><![CDATA[<p>Dear Anna,<br />
It took me a while to get to your blog - it&#8217;s wonderful, I can hear you saying it all.  So much important truth from the heart &amp; mind.  I&#8217;d like it to reach everybody, &amp; shall try to get DIPEx to link to it.  Delighted to be in touch with you again!<br />
Love, Andrew</p>
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		<title>By: Diana</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2429</link>
		<dc:creator>Diana</dc:creator>
		<pubDate>Thu, 22 May 2008 11:56:44 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2429</guid>
		<description>Reading your blog makes me feel like I'm sitting in the living room with you, looking at the glorious view.  Hope things went OK today.</description>
		<content:encoded><![CDATA[<p>Reading your blog makes me feel like I&#8217;m sitting in the living room with you, looking at the glorious view.  Hope things went OK today.</p>
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		<title>By: Richard Smith</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2435</link>
		<dc:creator>Richard Smith</dc:creator>
		<pubDate>Wed, 21 May 2008 15:32:41 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2435</guid>
		<description>Dear Anna,

You've taught me more about chemotherapy in these few paragraphs than I ever learnt in my medical training--and the last proper medicine I did was a spell in oncology.

I'm walking the Dalesway, which is "heavenly," an entirely appropriate word. Everything is simultaneously ancient and reborn, the fields are full of blubells, lambs, and the freshest, greenest grass. But I had to snatch a moment in Sedbergh Library to catch up with your blogs.

Lots of love


Richard
XXXXXXXXXXXXX</description>
		<content:encoded><![CDATA[<p>Dear Anna,</p>
<p>You&#8217;ve taught me more about chemotherapy in these few paragraphs than I ever learnt in my medical training&#8211;and the last proper medicine I did was a spell in oncology.</p>
<p>I&#8217;m walking the Dalesway, which is &#8220;heavenly,&#8221; an entirely appropriate word. Everything is simultaneously ancient and reborn, the fields are full of blubells, lambs, and the freshest, greenest grass. But I had to snatch a moment in Sedbergh Library to catch up with your blogs.</p>
<p>Lots of love</p>
<p>Richard<br />
XXXXXXXXXXXXX</p>
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		<title>By: Tom</title>
		<link>http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2434</link>
		<dc:creator>Tom</dc:creator>
		<pubDate>Wed, 21 May 2008 10:46:40 +0000</pubDate>
		<guid isPermaLink="false">http://blogs.bmj.com/bmj/2008/05/19/anna-donald-confessions-of-a-chemo-veteran/#comment-2434</guid>
		<description>I agree with Mai Luen (hey Mai!) and thought similar when reading: Cancer doctors should do one round of chemo to experience it so they can truly empathise with their patients.

Thinking of you all the time Anna, and hope (like Sam) that the elephants stay away as long as possible.  But if they come, remember they like peanuts, and Ganesh is widely revered as the Remover of Obstacles.
Much love, Tom.</description>
		<content:encoded><![CDATA[<p>I agree with Mai Luen (hey Mai!) and thought similar when reading: Cancer doctors should do one round of chemo to experience it so they can truly empathise with their patients.</p>
<p>Thinking of you all the time Anna, and hope (like Sam) that the elephants stay away as long as possible.  But if they come, remember they like peanuts, and Ganesh is widely revered as the Remover of Obstacles.<br />
Much love, Tom.</p>
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