Pragmatic 37: The Sledgehammer Solution

15 September, 2014


Cancer is the number two cause of death in the US and can affect anyone at any age. Federico Viticci joins John to talk about the history of the disease, what it is, how we fight it and Federicos first-hand experience with Hodgkin’s Lymphoma.

Transcript available
Welcome to pragmatic pragmatic as a weekly discussion show contemplating the practical application of technology and real-world trade-offs with great ideas are transformed into products and services can change our lives nothing is as simple as it seems this episode is sponsored by audible visit audible for a free audiobook down and this is also sponsored by many tricks are makers of helpful apps for the Mac long-time sponsorship thanks and then our visit many tricks or one more information about the apps but like Kimo Leach desktop curtain time syncopation Moon name angler and which if you visit that URL you can use the code pragmatic 25 that's pragmatic the word and 25 the numbers in the shopping cart is a 25% on any many tricks product and are on John Geagea and I'm joined today by MIR guest host Federico Petit Chi Hayden Federico hey John thanks Romy no problem at all thank you for coming on before you stuck in today's topic and we do have strict Thomas were beginning to an out-of-date arm I decide to quickly reiterate that day by popular request I've now added separates RSS feeds the show that are just episode only as well as follow-up only in both MP3 and AAC format so you can choose which you would like to subscribe to the existing Visa because they're unchanged and they can all be found in a nice little casts/pragmatic so also once again we are live streaming the show yes and there is an icy chat room on but you you go to the URL to you can access a stream that all you can use the embedded IRC chat box to join in that way are we also have a Q&A segment after every show so during the course are shown the chat room if you have any questions please feel free to pose those questions with' QA and we will try to address them at the end the run I do have a basic show what you can subtitle suggestions and you can vote afterwards and yes it's using case ellipses are a arm accidental bot or other four, so thank you Casey are also a quick shout out to Daniel H from Germany for the lovely review on iTunes always greatly appreciated and if you are enjoying the show are don't forget please get rated or regular review on iTunes if you got a few moments as it really it really does help and I really appreciate it so today is potentially going to be a heavy topic it's something that's arm has affected my life and is also affected dumb Federico so are today were going talk about are the C word and that would be cancer so I guess it's our one as well as topics that are I realise it is wise is that people are over five herds of the expression that someone knows everybody know somebody who's been affected by cancer in our lives and I wanted to talk about this because it's a people I talk about this you know and it's it's so common and it's such a it's it's a big deal and is not a medical pod because on the doctor II know this and that's fine are wet and not manual annoying Federico Wright I'm I'm assuming you're not Dr Ray know I'm not know if Nelson were not medical practitioners of any kind okay but we both have vested interest in the subject mine is from only second and third hand experience but Federico's is from first-hand experience so that's why the reasons I want to get you on the show to talk about it because you can talk about it from first-hand experience so thank you for agreeing to come on to talk about I know it I sure armour they are extremely comfortable document this a really have no problem in because I used to you not let you sad I'm used to be Cana we are in a stucco cancer before you now it's like diking about the location from incidents and just another experience so no problem at all fantastic that's great so I can't call so start like a start most episodes of the chauffeur of pragmatic by just going through a bit of history arm really quickly better the aim of this is to sort of increase people's awareness and sort of demystify what is really quite quite a complicated and can be a personal arm sort of an issue so in any case our cancers also known as arm a malignant tumour is a group of diseases and involves abnormal cell growth and has the potential to invade and spread other parts of the past the body not all tumours are cancerous and this is something that people's and I struggle with is there is such thing as a benign tumour and that does not actually spread to other parts of the body doesn't affect bodily function in any way so are possible signs and symptoms are included are a new lump where there was one before abnormal bleeding prolonged coughs unexplained weight loss you know all sorts of things like that is theirs there is a multitude of potential symptoms but those in the loan don't indicates that you necessarily have cancer or arm yet because they could locate all sorts of other other issues so there is over 100 different known cancers that affect humans and traditionally it was Russell and she sometimes referred to as a wasting disease because arm in its in its latter stages it tends to people tend to lose their appetite and they get very very skinny and very you yet its needs not pretty so and the earliest known descriptions of cancer actually appeared on the papyrus are written they think around about 1600 BC and I believed open source from our story from medical stories going back as far as 2500 BC so certainly not a new thing and arm Hippocrates so describe several kinds of cancer referring to them are with the Greek world arm Carson switch it actually stands for causation is crab or crayfish roughly loosely translated Messiah so I so I am assured and it comes in the appearance of the carton the surface of a solid malignant tumour with the vein sort of stress on all sides arm like an animal like a crab has its feet if that makes any sense crab feed you know I guess their feet anyway not a biologist either sorry engineer so that the treatment back then was based on tumour theory which I will admit I had not heard of until I just brushed up on this one arm the theory of four bodily fluids okay here we miss I'm sorry I got I got three listings I read as my I got a black and yellow bile blood and flam is right flam's are based on the hosts arm that is those bodily fluids they would decide what treatment would be for you which would could be dietary bloodletting or laxatives's anyway that the really depressing part about that is that that was actually the most popular method of treatment until about the 19th century when they realise that there were these things called cells and anyhow so nevermind okay so arm in our Latin the word data Celsus are sometime between 25 and fifth are 25 BC and 50 A.D. roughly arm translated Carson Centre Latin anyway also because men crab and our second century A.D. they started to call benign tumours are on costs are which is Greek for swelling and they reserved Hippocrates original our cousins for malignant tumours later on they added a suffix Omar on the end of it and I'm terrible at Latin and Greek so I discovered Oma arm anyway so our hands that leaves the name carcinoma which is still in use today okay so what causes it the human body consists of somewhere between 60 to 90 trillion as a lot of individual cells and each cell has its own DNA genetic structure that tells it first of all obvious how to behave react grow and it and and and is the blueprint a master copy of itself such that can replicate when it dies and is the perfect example cell replication in the most obvious visible one is asking rights are damaged by sunlight scratches just general wear and tear skin cells die and fall of every single day to be replaced by new skin cells from underneath and when you live in a house and sweep the floor one of the constituents of dust is dead skin colour that mental image for a second soloist freaks me out actually mind you that the dust mites and in pillows and stuff also freaks me out so there is some good and I okay so in every lifetime the cells in our body will regenerate thousands and thousands of times and that's normal so how cancer stance is when something goes wrong with that replication so the new cells delays and copied correctly and another option is that there is a hereditary trait for certain types of cells that was inherited from your parents that they can go wrong after a certain period of time so like those cells were always destined to go wrong at some point statistically would happen some point a genetic predisposition to a copy in Gasser getting the right to copy and paste error really leaderless time about the tech anyhow so arm the immune system is able to track them down destroy them usually well but the problem is a cause of the immune system is also based on sales and that immune system can also go wrong when it replicates so essentially through one means all the other either through through the actual arm defect being replicated in a cell or a defect in the immune system trying to filter out those cells one through one means all the other artists the cells can be missed and be allowed to survive and eventually the folly cells themselves replicate and they will form what they what was referred to as a tumour now we reach the point at which we have now okay that's that is that is what cancer is and that alone doesn't mean you have a cancerous tumour again I consider could be benign arm and there is a great number tumours that are but and they don't spread and that unimpeded polyfunctional and stuff but of course it could also it could be cancerous so every animal can get cancer tumours aren't special and outweigh every animal can can get cancer so and every person is at risk although the geyser for genetic history thousand family histories DO people can get prewarned in some cases there are genetic tests that they could be a high risk of certain cancers now the reason that this is such a big deal is that in 2010 the Centre for disease control United States reported that cancer was actually close to equal number one not quite number one it was beaten out by heart disease but very close as the number two cause of death in the United States but the thing freaks me out about cancer is that unlike heart disease which is that the as is the leading cause that's very heavily lifestyle dependent whereas a lot of cancers that you that that that manifests have nothing to do with your lifestyle and this is the thing that you can eat healthier and so on and that will you improve your chances but you'll have more of an impact on improving your chances of of of some of not condemning heart disease then it will of getting of getting cancer so the mediator freaks me as you live the healthiest lifestyle that you like and still that's no necessarily note no no no real protection so is at this point we talk about detection of cancer which is the problem because a semi-different kinds so it's possible you'll have no symptoms or use them as you might just ignore but thankfully most the common cancers will cause some kind of secondary pain discomfort or be related to soft tissues we feel lumps on the surface of our skin or in soft tissue you and we can sort of we can see discolouration our skin to skin cancers and so on and you get them checked out by medical professional and it's more or less at this point that I mash up a second and I would like to talk to you about your experience and about how you discovered that you actually had that had cancer and actually what type of cancer also that you had your welded symptoms were the ones that commission arm weight loss are losing my update and coughing up blood Lake each morning and lumps of course arm and were the money kind of cancer was blood related cancer it's our lymphoma and in so there is two kinds of of lymphoma the one in that the one that I go was the Hodgkin's lymphoma where chert is yet is in a one of the two variations under arm this one cast basically like our leads made to fevers just randomly and may my skin was very itchy just for no reason so basically are a last arm around 20 kg which compounds are the adenomatous so that once is a 20 per kilo so that would be arm 40's 45 year was allowed it will only was super strange for me and the signals that are basically the blood initially a style that maybe it's because you know I was a smoker back down and side quit smoking and I started there was the reason and but the blood dinner stop so each morning I would just sooner are cough a lot and an inner that there was blood and so after after a while and in fact I could I should have a lease I think I should have your talk to a doctor earlier and when I decided when I realised that I reached the point that something was off was too strange not the weight loss and and I was feeling we can sometimes arm a denied a foot a failure like arm like I was not really there mentally like KRA could lose focus and just wound the inner and just completely your blackout everything else and fever are sanded I didn't have much update so eventually I decided to to go see my doctor arm which could have folly and any could inflate anything you because you listen to a two made to make breathing and all the basic doctor does and here he told me to do to have in the usual procedure Alaska they can MRI Ian and Elsie were based on the images what if there was something strange and of course they found like a large spot in my in my right lung and so after opening I am a weekend else but I'll forward you know that various other procedures to diagnose what exactly what the cost was arm Italy was this lymphoma the cars like arm basically like a lack of it the problem with the blood is that the bad cells are cast like arm like I would say basically like a little cut in my in my lung tissue and discards were basically a lot of sales accumulating there and they were busily producing a mixture of fluid and blood so from the images you could see this large spot and but the main problem was not necessarily just in the lung he was in the on my inner arm blood system basically and that's the problem with the lymphomas that you cannot treat an area specifically you could I could have a procedure to just cannot fix my my lung because the problem was was in the blood so I needed start arm mentally I was stage IV which was which was the highest stage for for undercover cancer and in that that's not why I say that I probably should have your go should go to the doctor arm a few months earlier and are inner initially forgotten and I was a law a rollercoaster of emotions we were parents and girlfriend and my friends and but a about a learn a gas quickly to understand that when a doctor tells you arm when oncologist as you are look it's it's serious but we can fix it you you gonna believe and so are all and a another is no thing is that arm evens i.e. a continued to have my in all my symptoms after I was diagnosed officially arm D appear at some somehow less you notice concerning anyway because a new that which the what the problem was so I just need to fix it and anything that one of the hardest thing about you not having cancer is not knowing what happens next but the moment I had a plan right and that a and that they had a oncologist that that I could trust and when she told me look we we it's gonna be hard and you got you gonna receive a lot of treatments and got up and got a bit in a gonna be seeking gonna be interviewing Kim what other stuff up at the moment that I that I that I knew what the plan was in data and I saw that she was certain about the outcome he became more would see more comfortable and so began to accept that I just needed to trust magazine and you just keep going and yes it was that the initial process I was in the early 2012 so and how how old were you when you first had symptoms are was 2023 now okay and our you first saw a doctor arm how long after the first symptoms roughly fibre six months ago your eye I should have really issued. A gun earlier because this months are allowed the in the blood to 222 basically cost a little problem remain in my lung and enough goods that are several months can facilitate arm cell growth over the Association should really gone earlier but thankfully it was I was just the last minute was a list so far he worked anyway well will okay so in your particular case the detection was like you said there's there were quite a few things that like you you listen you know that you had done some discomforts were blood and coughing up blood that's yeah okay that's generally considered bad our lumps and sign and you are feeling lethargic notes and no energy assets and survey spacing out I don't know what the technical medical worker spacing out is but yeah yeah I mean all yes it's a really strange feeling because I remember it distinctly one day a set down in my computer and I was looking at the screen and I panicked and I called my girlfriend because I I was seeing an article on Mac stories that they didn't write right I was seeing words on screen that that I didn't publish so I completely painting to make a microphone and I asked her what you see on screen I didn't publish this article and she looked at the screen and she is worry you talk to others the article just published so are you a you I drank a glass of water and a compost myself and I looked at the screen again and sure enough there was the article that I just published so I well are a side thing that just wasn't there and I and a party for no reason and that was super super strange and and I remember that clearly because at that moment to realise what is going up yeah you becoming a little disconnected from reality which is here not guard alright well you've talked about are some of the similar treatment that you've had just briefly I guess are just to cover little bit of the of the history just before we go to much further are is are the obvious one is that if there is a physical trim that they can remove then the simplest and most obvious ways to cut it out and cauterise it and which is the arm the oldest description going back to 1600 BC where they noted too that they could cauterise ulcers of the breast that they found are but then noted also that there is no long-term treatment other than that and yet the thing is with with cancer as a people realise from a treatment point of view than that of research needs to go on to try and try and find better ways of fighting it since the early 70s the US alone is invested over $200 billion in research and that's both public and private donations but yet despite that effort is that this is a really tough nut to crack this is a really difficult problem and they've only really seen in the US at least 5% decrease in their cancer death rate over from between 19 52,005 which is where this the stats I got for from which should illustrate that is a difficult problem to solve so it also an ageing population and is obviously arm that was not the case for you being 23 at the time are greater than 3/5 cancer diagnosed in people aged 65 and over however as young and in your case obviously that was not the case so it does just because you're younger does not mean your exempt and that something that a lot of people need to get their head around I think so so I just I just looked up the definition for the lung involvement that I do but basically it's in the adult arm kind of Hodgkin's lymphoma is called the lung parenchymal involvement with lymphoma okay so you're cooler than what the officer of the was a bunch of awards that occur sure enough I just need a good look you almost 9 and I try not to mean an IM it's the sort of thing that they rang them off when you're sitting in a round them off so fast here and you and though I brother foam a wider hammer to hike is exactly that yes if you like to be taking notes sometimes I will always be the kind of guy that wants to actually know what is being told just so I will are are was always asking questions to my colleges and the team of other doctors in the structure and because the rear they understood that I was a very visual gardener wanted to know everything so they started to to do main maps on upon upon piece of paper for me to explain you know that the various magazines and drugs they were into the chemo and saw the bids rather than the jewelled's little arrows and boxes to explain the process to me and every time is what it was pretty funny because that date so that I'd I didn't really need to understand what was going on must file wanted to know all the details so people like us we need to know they say we don't need another we need to know we to steer your asset blood that's great I'm glad they took the time to do that because failure some some doctor's orders know they're not interested there like I'm a doctor you're not know and I'm just not going to because while computers were understandable I don't know actually what they think that sometimes it feels like that excites you now but hey you while I'm on relatively intelligently I take gimme gimme five minutes to explain it to me and I'm sure I'll get the gist of it so you were the day that I was the officially diagnosed because they are designers can write and I went to the hospital in my town in Viterbo and them are the doctors there were super unprofessional and rude and the bitterly told me that I was gonna die in right away before an official diagnosis yet just after a scanned lease of this spot and the day conduct my parents and the cellular the guard the body as unfortunately doesn't have much time left on the cover crap that it was super unprofessional and Anna are so open after a few minutes I I went to the oncology department in my town's hospital and I was called into this room but is supposedly oncologist only told me that it wasn't even looking looking NDA it was just this is serious and we can try to do something and they didn't need anyone allow my girlfriend to be in the room and so are our I don't want occurs on the shell but you can imagine my reaction sell you that I had a year and so I went to the only treatments were done in another in other city in another region of Italy and I will Anna and I really found professional people there in your in these other two cities actually and are some sometimes it I think about not going to see this doctor removing trying to approach in annihilating the parking lot and see how you know what you and that eventually a realisation made this guy doesn't even need my attention in the human need my time at blood but I don't want to lose my temper you want what was going to walk up way and say hey guess what I'm not dead you suck by by you may has a very positive but hard to her right cool Bible SL anywhere there are some some doctors are really uncool people but there are many many doctors likely their adjusting of the save lives and that they help you in your that they listen to you and explain stuff to you so I was lucky enough to find many many of them in just one bad guy so minor I'm really glad you found some good some good doctors because yet it makes all the difference in the world and that's and it's really good to hear a case before we go to the next section is what could little benefit sponsor which is a audible so audible as a leading provider of premium spoken audio information and entertainment that allows listeners to choose from audio versions of their favourite books why would you want to do this well so many of our day-to-day activities we do need our eyes on the job so when is a book you really want to read but you're so busy doing other things is can't find the time that's were audiobooks coming this much easier to multitask when you're listening to music a podcast or an audiobook whether you are driving doing housework or yardwork with audible you can still read your favourite book and not miss out it's pretty cool so you can buy books individually or in some of the audible listener 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original authors may not necessarily do as good a reading of their own book as someone else of sometimes I have books are read and that action narrated by somebody else and is planning other options for example are Harry Enfield if he reads longer teatime as well are if you prefer him his narration and those only memories he played down in men behaving badly that's if you ever what that show was and how the minor I'm showing my age their AI portal has books and business classics are sufficient history romance mystery thriller sci-fi fantasy self-development kids and young adult and so many model list I think that'll do so yes with over hundred 50,000 titles and pretty much every genre you can find what you're looking for so running it free audiobook with a 30 day trial by signing of oil audible make sure you that specific URL audible of your free audiobook so I like to personally thank audible for sponsoring pragmatic so the next thing I want to talk about was so startling that it was you that the treatment options in the first and most obvious one is RDO find the tumour and coming out only works for certain kinds of cancer course but when they do do that I'll also take a bit of the surrounding tissue and tested to see if there's any other cancerous cells in the surrounding tissue sometimes if they find some in the surrounding area they all have a follow-up surgery to remove more tissue to make sure that they get it all or at least get as much of it is possible sometimes in certain cases and certain cancers they can actually tested quite quickly I can test that that that tissue around the out that the tumour during wide when you actually still in there in surgery under general anaesthetic and they can actually are the only works for me a certain cancers doesn't work for all of them and it requires a very fast test sometimes I have to put in at the slicer put on slides microscope out and visually check for the cells a lot of the time and sometimes nonobvious other times I can use and dies in different different other techniques it's different for every kind of cancer so those different methods of doing that without obvious that is the first step for most cancers that are obviously in the form tumours that you mentioned are chemotherapy and that is you are by far away some of you score chemo is by far and away the most common are treatment after you've had a surgery knots not always prescribed but in many cases it is the thing that IVR didn't realise about this originally and only found that recently was it was actually discovered as a side-effect of mustard gas in World War I which is kinda crazy but it wasn't until 1942 that there are a group of related compounds nitrogen mustard is there loosely referred to as and they were used intravenously as an attempt to reduce the replication rate of cells in the body the people that had done had cancers and they had actually the a short short lived but they were effective results and enough so that they continue investigating it so the chemicals and refined over the years but work in much the same kind why they either stop or significantly slow down the replication rate of aggressive fast replicating cells and that's a trait of a cancerous tumour unfortunately this is kind of the medical equivalent of hitting a nail the sledgehammer and unfortunately it takes out other normally quickly replicating cells or like hair follicles for example and hence people many people on chemo tend to lose their hair which is something I'm into I'm I was curious about your cases you arm have been on our how long have you been on chemotherapy at this point arm I wasn't chemo for eight months okay you did you lose your head up from all year after five months of the four or five months your I did you wasn't a problem that I actually I quite enjoyed my new hairstyle of life thereof and I shave my hair off so I can time on with you on that it's simpler now you a letter from the main shave my late cut my hair really short when a realise I was losing Aris of the transition would be too weird and we know we took photos and videos and and the year was quite focusing on my phone is not a hairstylist for Medicaid and the be after a few weeks AIA started seeing this little you are our hair, you may pillow in the morning and the cilia they took four or five months to get there fair enough while arm find interesting like that my parents actually took it in a worst enemy because arm I've always had medium to long hair aerosol number for my mother especially seeing me in that we was very rough here yet splits pretty is pretty confronting when used to seeing some of the full head of hair and then suddenly their bought out it's our generally air through through normal natural means something would happen gradually over a decade or more in my case you know I'm losing my hair but it's very gradual but lose it in a matter of I'm in you say took a few months for months or so for five months but arm the point which she just would use was like two or three weeks she just is started losing on hours like right that's it and is gone it is get rid of the rest of it or did you how long was it before was a psychiatric that certain it's all bawled now would you say few weeks or year we are just a few weeks I think society is pretty shocking difficulties are sinful and answer and is the best from chemo that he is thinking is that some people don't actually lose their habit it's it is very very common and certainly arm and my my secondhand arm seconds are secondhand experience are now my my relatives lost their hair so anyway so chemo drugs are actually referred to as arm cytotoxic and there simply poison right so when handling these things in hospital the hospital staff are usually required to wear protective clothing and gloves and is after my rent recollection not sure with it's the same the world over but certainly there are large bright warning labels on these bags DO caution warning you know this is not stuff that you were here yet and that the doctors and hospital staff did not always work production right are Alyssa Alyssa may experience you in other Donna was were like protective gloves undercover staff it just solely when the need to our lake to do an injunction or to freeze and say you had a Port-A-Cath insult which is a little bit silly Leica Lake a little button under your skin that is a tube attached the girls into a big vein and so when they needed 222 flush that ought to inject chemo into that into the little vile arm they needed to work production and not under on their hands in your arm when breathing presence near you the need to have the little mask and the but not all the time in a cell and it i.e. had all of them many kinds of chemo that I did it required me to be in a hospital bed for 22 days 20 nonconsecutive days and I needed to be in a in a locked room and because you know arm he was a super are basically like hard chemo that destroyed my immune system and rebuilt it from the ground up and saw during the process I needed to be in the special room is special air-conditioning and only people with extra production could visit me only twice a day was yup there are different mania gas many kinds of chemo require a different kinds of attention for the patient and MA Casey was a bit of booking I did Kim or I could just go down to give one the Optus hop back into my car and go back home and they did other key was that required me to be completely alone so through our production measures absolutely when you're in there for 22 days arm we you allowed an iPad you it was are mainly deducted the doctors and staff needed to arm basically wash it with a special fluid before you and was like a like some kind of you not to remove the battery bacteria and other stuff so the day they cleaned all my devices may phone my iPad in a header and intended yes they think and by year I was allowed to keep that cool so you I would have it I would go crazy I was gonna say I would not have been your 20 days of isolation from you that would have been run out you had the iPad so we we are posting on Mac stories during a 20 days yes gasoline is awesome the days that I that I could barely move or in I was constantly are you not throwing up on the counter staff and to this day is up was just a hint to survive mostly arm of the other days before and after the chemo arm Ya just needed to do your to bust the times I did a bit of email I actually think I was riding Python script so one point arm because I was trying both only study the iPad up earlier that he was a were I use that time to you not to do something because otherwise if you just gotta stay there and keep thinking about my got doing chemo on your liquor suffered doesn't help you think you it's it messes with your head you too much time to think you expressed your toady ever owning updating it's great that you're able to do that because it yet having a creative outlet mix or your difference so I think that may may work and you know my job and and the people on Twitter and the readers of this site arm were huge hard for me because Lee had me in on lodges with encouragement and the current positive reactions that you get but also to distract me and you not to as you said a creative outlet and it's it's it's been a huge challenge for me fantastic cool right while you sort of alluded to this there are different kinds of chemotherapy and yet so you've got different strengths different blends I mean I make it sound like coffee but it's not obvious has terrible different flavours of fishing with different flavours chemo so sing a single agents arm and a poly chemotherapy which is now was in multiple chemicals in the one go and I was it's depends on the specific kind of cancer being treated and obvious it is the ones that you just described that will completely destroy your immune system and then it it builds itself back up again from from the ground up which is DO quite extreme but also I Bob understandably wrote very effective it's just it's quite a bit to go through so the dosage interesting interestingly I know there's a lot of our debates are about dosage and traditionally was based on a person's height and weight and their their bills but is not really 100% accurate and tends to oncologists tend to overdo lean towards overdose rather than on the dose to otherwise if yonder dose then the other treatment is not to be effective so it's that they tend to lean towards the over the knee under so anyway and again also suggested is different to our different ways of doing it and people refer to site oncologists refer to a round of treatment as are your start your go in for you usually daily or you sometimes you can do as an outpatient other times over 22 days you're actually not doublechecked since you are an asset but other times it'll be a gay could be a few weeks and it's daily and gather that's like one quite a round of chemo and then you break and recover and then it's your back for more so that the terminology was for me the hardest part to figure out because when the when the kit document around the more I thought that around was this a session a single session on a single deck and turns out that around differs from chemo chemo yes so I did around war could be a day for me or twice a week or three times a week with a break of 21 days between each round and I also wanted to quickly say that many people and myself included before I started you're doing chemo for the chemo was some kind of obscure run you not strange kind of medicine which is all that is just a navy you that it's messages drugs are being jacked into a vein just like any other AV and the other different colours i.e. there are some kind of beverages that I don't drink anymore, so collar remote yet the collar reminds me of chemo you are you familiar with compulsory yes yet I don't drink umpiring anymore because it reminds me of a drug of one of the types of chemo day did I eyed I don't because I like the taste of yours are far more could associate the association right because the chemo makes you feel terrible young really wild comment so I am assured I have not been through it but you can tell me I'm sure it generally doesn't make you feel that great does it now it doesn't make you feel like you're doing it is just a navy so you don't feel anything mostly and there was a drug that this idiot was this limit little bags rate of fluid of medicine of your chemo stuff and there are different cotton different label salmon and that you don't feel a single thing why you're doing chemo but it was a drug and a think it was the covers in which was part of the EBV did treatment are difficult to which appeal is a list of those kinds of chemo and EBD is that the first one that you do while when you have Hodgkin's lymphoma and there was this rugged bitterly when they injected in your vein and you can feel the vein burning because the drug is so strongly because there are tissue of the vein and that's also the reason why I did enough to either I didn't want to have a Port-A-Cath installed right away any money in my upper chest so I did the few the first few rounds of chemo as a as a normal young procedure with with a needle in my MA MA I'm right soulmate vein may been some my arm did Don give blood anymore because they've been borrowed by the chemo that's fine year every time I need to do some some blood tests arm they need 2222 not to defined small been slacking my MA wrist or in my hand because once my arm are completely gone yet I'm in coming they do that you work the just the Don give blood anymore understand your IIA I had heard that Butner might never have I didn't really wow okay well moving on from chemo let's talk about the other goody which is radiation therapy on the other soft some of the initiatives you love radiation therapy because it emits just like five minutes a day you don't feel a single thing and it's quite fun because the machinery super cool there are there are literally there are there are lasers scanning like forming agreed into this room and you need to be aligned with greed because there was this huge machinery that rotates around you and that basically beams are protons and other kinds of light beams into your body and you don't feel anything is just five minutes and it's done and it's super effective really and and the addition is that that it was for me the final step of my treatments and he was the one that basically consolidated the sales in my right lung and no way of basically I've like a scar in Emma in my right lung optician and it burned completely whatever was left after the chemo and yet that radiation is is I'm sure you have a really solid explanation in history but in practice for me was like just not basing 30 minutes every day between non-going there and doing their addition and near my super cool that the machinery was amazing letter sounds pretty cool i.e. arm that's one of the one things I didn't actually physically witness was so was over I was not going on with my relatives when they do have a radiation therapy are chemo yes radiation therapy know that are the yes the only radiation therapy is the aim prematurely set it which is the aim uses a yarn I spoke to ionising radiation such as a photon our source and usually older sold machinery typically used are cobalt cesium are they they call the new machines are Linux machines which are essentially a linear accelerator and they accelerate done that are photons and they actually will our pastor your body and you disrupt the DNA and while but I disrupted NAL destroy the DNA chain such that you they either sell simply will die are they can't replicate after that so obviously if you've got tumour cells try get rid of them and you chemo didn't get them while this will get them and it's not gonna survive so it destroys DNA in cells in the area it's also a bit of a blunt instrument but it's a lot less blind than the chemo because it can be physically focused on a specific spot and obviously again that only works in cases where the cancer is a tumour specific spot and which was in your case some in where it had manifested in your lung and other radiation is measured in grace and is our range between 20 and 80 depending on the type of cancer being treated whether it's our applied curative Lee or preventively and yes so the gas radiation therapy and the apparently it's is a very cool machine CR Llanes fought on CSL are not protons its forces right because I remember there was a little like a little late with a description of how the machinery and the machine worked and I was super fascinated by this machinery moment there was a I took a photo with my form of the of the room and a doctor she was 18 she was my age and she approached me and she said earlier when I found a recipe inside their addition room we started talking about arm she said I ever I ever see the galaxy iPhone and it was like with as many other galaxy iPhone and solicitor she had a Samsung is reopening self because AIA started sucking by the iPhone and you know we started I can make stories and should realise that we we spent 10 minutes document my job in the iPhone and I should have your I was in my underwear because any at great there were people are because there are cameras right you know what's what's going on to the room at one point a doctor from the other room was back in and said why you guys doing their addition legislator was walking instead just talking just document the iPhone it's brilliant are cool all right well then are a little bit about some some newer treatments then and I guess the areas that are showing the most promise are supposedly targeted therapies are sometimes referred to as the molecularly targeted therapies or precision medicines and unlike chemo which is a broad-spectrum drug also drugs it will affect all the rapidly dividing cells in the body cancerous and noncancerous like so good and bad targeted therapies are designed specifically to disrupt the division of a specific type of cancer cells are as a result obviously they have to be specific and they tend only work on a much smaller subset are of cancer is so because every specific there are a lot less common them are expensive to produce and is that the office of the flipside was a reason you want to go down that road is because you have a lot less side-effects and you have a much faster recovery time but the bottom line is that you know it's still experimental there's hundreds of different kinds of cove of cancers and is the still developing these there is still a lot of them there are like ourselves that the Kent Cassels Academy treated this way yet and they're doing a lot less reliable research is going to try and create these are as well I guess the one they were to design a drug specifically targeting the problem rather than the other sledgehammer solution so that sort of as far as I'm aware that's that that's where it's that's where it's heading so anyway now I didn't do any of those a new about this kind of new like techniques I just sat straight up old-fashioned chemoradiation and the only year the only the only new kind of thing that I did was and there was I think the strangest part of the experience is the chemo and their idea shown after you learn how to work there. Marching boring stuff one is NAV the other is a is a machine you are it was that the extra stuff that you do around those inner this treatments that that's the strangest periods like i.e. had to one point I needed to bitterly stimulate my May bone marrow to produce stem cells can and to do that you you buy this a little little like medicine that it's like a little tube but with some fluid in it and it casts like 5000 for just this little thing and the Presidium pay a single euro for these because you're in in Italy we get free and empathy after-tax is of course you you get a the Duxbury taxpayer euros but only I didn't pay myself sell arm this this little thing you injected into your muscles anywhere on your body doesn't matter and this fluid goes into your bones & it's the bomb to produce stem cells and so a few days past you do this one once a day and miscue stuff in this crazy crazy crazy pain inside your bolts because your bolts are trying to put more stem cells the necessary into your blood so you get a recess for a couple of days with this insane pain that I was I was busily screaming all day and night I wanted to I wanted I wanted to just I hope I needed I I was asking for morphine one point because it just couldn't really was too much value varices and when you simply the bomb to do produce all the cells that go into your your blood your goal and the end they basically the particular blood they wash it with a machine the desolate that this as from that you of the other the plasma in the other parts of the blood and in the other are they give you your blood back so you you you you wash you do this little washing push procedure you escalate the sales and then dose out there get frozen for a couple of months and when I did the key mind that I told you but for 20 days and they destroy your immune system and the use DOS out to help you revisited backup in just a week instead of like three months so that was super strange and it was strange to do in on the stimulation arm it was strange because the pain was insane more much more insane than the chemo and the other stuff and the symptoms and but only works surprisingly that's the strangest part is that all this crazy stuff that you bitterly stimulate your bones to do more than the necessary and the new use that the result is as it is in need do you not to do grow your immune system back spreader was super strange yet it's very cool but a strange and painful OEA on the painful Pete was not called that you hear that another was that there was insane or screaming all night and I couldn't sleep I could like I couldn't stand I couldn't sit down I just in a fit if I like a thousand knives into your bones in each part of your body and year 1.8 it was helped that much or we today does not do that must not touch it all was yah basically my oncologist wanted to avoid painkillers because lead the that she wanted to avoid any additional heart toxicity are buddy became too much so I didn't get morphine but a guard arm where I don't know what the name in other countries is but especially one step before the morphine and that that the lot year career it was an injunction Amanda it took like two minutes and then it was a mess yes you switch flicking a switch so I sighed as I recently was and I'm not suggesting this is of the same level of pain as we were describing that I had the kidney stones and are and I was in quite a bit of pain and is are when they gave me the younger shot of morphine it was it was like a switch being flicked in your brain from being in an unbelievable agony to being able to so I look around the room and and actually have a conversation because you just this is incapable and then suddenly it's it's fine here is that's why was my experience anyway and I'm sure I was another lead near the level of pain you're in no other stuff this stuff is weird hearing when you when you talk about and you remember the experience for me like in my expense I think that describing the chemo because that's the thing most people are curious about rate that they ask you is sometimes even you sometimes I feel like they want to ask me but there are not asking me so just as you can feel when somebody is interesting the sob body schema like what is radiation and you can understand the want to know but you don't have united if you're uncomfortable asking so I just explained that but then when you need to explain the other extra stuff that you need to do and the consequences and the other side effects that's the strangest but because they these sound just crazy you now that the steroids and the effect of the cortisone on your buddy and nodded this to the growth stimulation done on purpose and that that stuff is just crazy call fair enough okay and you don't hear too much about some glad that where the word they were talking about so right before we arm going to do so until about arm my my secondhand experiences arm which I don't too much more to say animal property wrapup before we do want a massacre sponsor this episode and that many tricks a long-time supporter of the show and so this matrix there are great software developing company whose apps do as the name suggests many tricks there apps include Butler chemo Leach desktop curtain time sink Usher Moon name angler and which that the Somerset of average apps I will do is will touch on some highlights for just four of them so with which you can then that which is a supercharger view command tab apps which are on your Mac which is great for and are very popular with ex-Windows users like myself if you've got three or four documents open at once and anyone out then with which is beautifully simple pop-up you can quickly and easily pick exactly the one you're looking for with name angler Sega whole bunch of files that you need to rename quickly efficiently and in large numbers while name angler can extract meta data from the files used to rename those files with certain replace as well as grading staged renaming sequences and if you mess it up you can revert back to where we started and just have another go great moon it's makes it so easy to move your windows to which ever position you want halves corners and edges fractions of the screen whatever you like and then you can even save and recall your favourite window arrangements and there's even a special auto arrangement feature when you connect or disconnect an external display it like when you arrive at work when you when you arrive at home it's awesome so will usher that you can access any video stored in iTunes average iPhoto or any connected hard drive on your Mac allowing you to easily group sought tag organise all on the one lap if your store. Insert the mark than this you have to say to convert anything into iTunes format to watch it so if you got a video collection and scanned across different programs and drives and Usher can help you straighten out this four of their great apps but this still five more than I haven't spoken about you can check them out at on their website so all these apps I took you have have free trials in download them from many tricks all one and try them out before you buy there also available to buy from the respective pages on the site or through the Mac App Store however if you visit that URL before mid-September and yes they have extended their office just for pragmatic business you can take advantage of the special discount off their very helpful apps exclusively for your pragmatic business assemblies pragmatic 25 that's pragmatic the word and to find the numbers in a discount code box and a shopping cart to receive 25% off the price and this offer is only available to pragmatic business for a limited time to take advantage of it while you can so many thanks again for many tricks for their continued support of pragmatic so I haven't so talked about our one the reasons that I won't cover this topic and that is that's arm in recent years in my life are my mime myosin close family have been affected by bike cancer and I don't want to gonna too much detail but I'll just touch on the the key points and are old because everyone's experience with cancer is subtly different because there are so many different kinds of cancers there are lots of common things that we talked about and that's and that's fine but some are specific details vary based on where the cancer was sending you how severe it was and how early they detected and so on so my grandfather are was dying is about cancer was 1st to take your 74 years old and I can't section the value underwent chemo and they thought that they had got all unfortunately they didn't and when he was 77 they found that had come back and it was considered to be inoperable at that point and so he was given the option to chemo having been through it once he said they are they told him that the chemo would at best give him go a few extra months but he decided not to take that option and he passed away many of 78 so my father-in-law are he had to our prostate cancer is diagnosed that when he was are 60 years old are they operated they got all with no further treatments and thought he was all good and in the clear unfortunately there was a melanoma are on top of his head was initially wrongly diagnosed as an age spot that was when he was 62 and about Humbolt I figured out that it was actually a melanoma and as I had surgery to remove it but it had spread to lymph nodes in his neck and he had multiple rounds of radiation therapy are around his neck at which point some he lost the sense of taste and they did some muscle chemo bites by which time it had spread to his bones are in his ribs and his liver and he passed away within five months of its initial detection he was at 63 years old at the time he served in Vietnam in the Australian Armed Forces and is having two different cancers so close together they ruled that it was mostly what the mostly explanation was that his exposure to agent orange and other defoliant that they were using at the time witches are a very sad but very common story unfortunately arm so is the two sad stories the arm the one positive positive story is my mother-in-law and she had a routine mammogram where she 62 found AER lump she had had no idea it was there was not visible was not physically detectable but a biopsy revealed that it was cancerous arm it's her two positive which means it was suffered by oestrogen and are the breast tumour was so surgically removed are though they are required to separate surgeries to get all she's had around chemo and radiation therapy and Dar during that time she was at hospital twice with low but low blood count but Dar is also was only a drug called Dar to mock tamoxifen are which are specific to brat that kind of breast cancer that is fed by young oestrogen and she is now two years out from surgery with no further signs of any other issues so so far so good keeping an eye on closely so that sort of been my arm that's been my second hand experience at least both while we wrap up on this I guess I just wrap up with are some advice on again to reiterate arm not a medical professional not Dr R and Lewis Federico bites honestly as is a as you said earlier mate it's about catching it early and if you see or feel anything that isn't right just get it get it checked out you know and if you are unhappy with the ends of the GP gives you your general practitioner your medical practitioner gives you go see a different one get a second opinion asked to see a specialist sometimes is that feeling inside something is wrong that may be what you need to listen to sometimes anyway Australia has a problem with skin cancer because of the ozone layer depletion in the southern hemisphere and CEO Australia is personified as sunburnt country we have one highest in fact of the thing we do have a high sensitive skin cancers in the world as a result the government's arm has a thing with many chemical bulk billing and sorrow skin cancer goes Australia being one of the top bar cancers on the list are there is a lot to clinics around that's our will you can go to and you can bulk bill they'll bulk bill you meaning it does no out-of-pocket expense you just show up and others take photos of our any spots on your skin they'll doublecheck you over and and they they keep the modifiers incoming in six months and I can see if there's any changes or any our discolouration or growth or anything that you might miss just looking at it visibly and Dar rather just relying on you walking into a GP and saying you got was this little lump on my leg and after problem not but that the message is don't matter how old you are don't think it won't happen to you because it could because Federico you at your 23 right and you happen to you so if you had any advice as a sort of the end of my advice what what would your advice be to people was the first one is that ship if you feel that something isn't right go to your doctor and ask for blood tests because those of you can easily spot the early signs in in in in your blood usually and just don ever be afraid or feel awkward or embarrassed about exposing your fears and and the things that you feel in any part of your body because I know that it can be strange to explain to a doctor that you feel something in a specific body of your buddy and you don't want to be touched than you do while you know you want to get undressed but inner establishing to do away you're doing if you you forever and a pure now but if you were diagnosed with cancer and you're doing chemo or other treatments skipping managing to trust seductress dongle read opinions on the Internet because that is full of people to tell you your gut day and just try to always believe in science and medicine and if a doctor ties you that it's doable that it's doable because that person is a degree and it's their job and then they usually know what they're doing but also don't be afraid to ask for second opinions old saw when you're doing treatments issued if you're not sure about your oncologists are glossy and other oncologists because the world is full of oncologists so you can always get second and third or fourth opinions on anything keep an archive of everything that you do either on paper or in PDF in a lot of dropbox revenues you do are my family and I keep two copies of each document and each test and each image in each scan that have and try to organise the archive for typing year and what you're doing treatments keep in mind that life is not all about treatments try to do other stuff if possible try to a foreign try to read over hobby play games. France done it's not a shame it to be thinking not to do radiation are you're not worse than anybody else and it's a perfectly normal thing that happens to a lot of people and you don't have to be ashamed for you for being sick it's not the kind of disease that you give to other people it just happened to you and there is no shame in and after that just always try to be cautious even after the tell you that your you know you worked her truck to be cautious try to keep a log of your symptoms if you feel anything tele-to your doctor right away don't think that it's stupid to Collier oncologists because they don't want to hear from you they want to always hear from you because after all there are people helping other people so the big day become attached to you as much as you become attached to them sell don't be afraid to Collier oncologists and tell you if you feel even after months if something is and isn't right and in general just try to to to think about the fact that he could always be worse because there are worse than that there are other people in the world that are suffering more than you even if you're doing chemo if there is something else there are people that are not as fortunate as you don't have access to treatments and there are people that day without a single chance of having a blood test and just try to dinner to take it easy and and try to understand that it's a lot of people do this and you can do to solve just try to enjoy life in the process if possible and keep focused on your I gonna do this and that I would get better that there was my that was my general policy against cruel but that's only as a good note to leave and on right there and done if you would do if you'd like to talk more about this arm you can reach me on Twitter and John CG and dad check out my writing to as you'd like to send any feedback please use the feedback form on the website and that's we also find Shannon to this episode under pod casts pragmatic are you can follow pragmatic show and went to see show announcements and other related materials I like to thank our two sponsors for this episode arm which is audible and that you can now visit this URL audible feel free audiobook and also like to personally thank you metrics for sponsoring a show are if you're looking for some Mac software that can do many tricks remember to specifically visit this URL are metrics or one for more information about their amazingly useful apps and use discount code pragmatic 25 that's pragmatic the word into five numbers for 25% off the total price of your order. Only for a limited time are I'd also like to add deeply thank my smooth special guest host for today I'm Federico the TG and what is the best way for people to get in touch with you Federico are the confining layer riding dogmatic to confine the interior is that the IGA IC tweeter sometimes the hashtag and it was anyone say cancer would you say are likely fight cancer like cancer exactly thank you so much appreciated thank you thank you�
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Federico Viticci

Federico Viticci

Federico is the man behind MacStories and co-hosts two excellent podcasts on in Virtual and Connected.

John Chidgey

John Chidgey

John is an Electrical, Instrumentation and Control Systems Engineer, software developer, podcaster, vocal actor and runs TechDistortion and the Engineered Network. John is a Chartered Professional Engineer in both Electrical Engineering and Information, Telecommunications and Electronics Engineering (ITEE) and a semi-regular conference speaker.

John has produced and appeared on many podcasts including Pragmatic and Causality and is available for hire for Vocal Acting or advertising. He has experience and interest in HMI Design, Alarm Management, Cyber-security and Root Cause Analysis.

You can find him on the Fediverse and on Twitter.