Research

The Cure

            The light snuck through a crack in my blind on a cold Tuesday morning in March. I looked at my alarm clock and it read 8:53am. I could not suppress the moan as I rolled over to grab my phone. I started to go through all my social media sites as I do every morning. People were posting excited statuses about the snow day we received and about how they are going back to sleep for the rest of the day. As I kept scrolling through my Facebook feed, I came across a post my good friend Carmen had posted earlier that morning. It made my heart drop to the pit of my stomach. “Please pray for Devin! Stay strong Dev.” I immediately sent her a text asking if anything new happened to her brother Devin, who was also like a brother to me. Her response shook me to the core. “There isn’t anything more the doctors can do. They say he probably won’t make it through the night.” Everything went numb. I sent him a frantic text telling him to be strong, that he’s a warrior, that he can beat this cancer, and that I love him. I blindly walked out to the living room and cried as I told my mom everything. She reassured me that he can do this and that he will be okay. I repeated that over and over as I got myself ready for the day.

            Later that day I was at play practice in our school’s cafeteria. I told my best friend Abby, who also knew Devin very well, and we supported each other as we tried to keep ourselves held together. After practice she took a few of our playmates home while my exchange student, Alice, and I went to the gym where the regional girls’ basketball tournament was being held. I was about halfway across the gym when my phone buzzed with a text message. It was Carmen. “He’s gone.” I inhale sharply as I stare at my screen. Everything around me seemed to go fuzzy. I could not hear and I could not see. My legs gave out as I started to hyperventilate. Tears flooded my vision as the realization that Devin was gone hit me. Alice collapsed next to me rubbing my back and holding my hand. Everyone around me was looking at each other frantically, wondering if I was okay. I called Abby to tell her. I heard her voice crack as the tears fell as she asked “He’s really gone?” She came back and we cried together on the blue bleachers of my high school’s gymnasium. Nobody knew what had happened and nobody would understand.

            Devin “Warrior” Gauna passed away of Hodgkin Lymphoma on March 5, 2013. He was surrounded by dozens of friends, his loving girlfriend, and his wonderful family. He was 18 years old; He did not graduate high school. He found out he had cancer a few weeks after New Year’s Day in 2012 and was a warrior until the end. Devin touched more people in 18 years than most people do their entire lives. He will always be an inspiration to me and everyone that was in his life. He helped me through the lows and enjoyed my highs with me. I will forever be grateful for knowing Devin and for having the honor of calling him my brother.

            Hodgkin Lymphoma, also known as Hodgkin disease, is most common in early adulthood, usually between the ages of 15 and 40 (“What”). In the United States alone, there is an estimated 181,928 living with Hodgkin Lymphoma (“SEER”). It is more common in males than in females, effecting 5,070 males and 4,220 females in 2013. The 1-year relative survival rate for patients diagnosed with Hodgkin disease is about 92%. The cancer cells tend to reproduce and grow rapidly so it almost always spreads beyond its origin (“Hodgkin”). With the technology of today, how do we not have a cure for cancer? There are a few popular treatments for Hodgkin Lymphoma, including chemotherapy, radiation, and stem-cell transplantation, however chemotherapy is the preferred method of treatment.

            Chemotherapy is the use of medicines or drugs to treat cancer. Chemotherapy can either be taken orally or put directly into the blood stream using an intravenous, or IV. Chemotherapy was first discovered in the 20th century during World War II when naval personnel who were exposed to mustard gas were found to have toxic changes in the bone marrow cells that develop into blood cells. In the course of studying the chemicals related to mustard gas, a compound called nitrogen mustard was studied and found to work against lymphoma, a cancer of the lymph nodes. These agents killed rapidly growing cancer cells by damaging their DNA. Aminopterin, which was related to the vitamin folic acid, produced remissions in children with acute leukemia. This compound blocked a necessary chemical reaction that is needed for DNA replication. Since then, researchers continued to discover drugs that block different functions in replication and cell growth. That is when the era of chemotherapy began. (“Evolution”)

            I believe chemotherapy is the most sensible and effective treatment. According to Lymphoma Canada, it may be used as a cure, to prevent spreading, slow the growth of the cells or kill cancerous cells that have spread to other parts of the body, or relieve some of the symptoms. A very common chemotherapy used to treat Hodgkin Lymphoma is ABVD (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine). Each of these drugs targets the cancer in a different way. A combination of chemotherapy drugs is more effective than a single drug in destroying the lymphoma. For Hodgkin Lymphoma, a typical chemotherapy regimen is usually given over a period of six months involving six cycles of a combination of drugs. (“Hodgkin”)

            Along with chemotherapy come the nasty side effects. According to Lymphoma Canada, the most common side effect of chemotherapy is hair loss, also called alopecia. It can affect the hair of the scalp, arms, legs, eyebrows, eyelashes, and pelvic region. Some people may lose all of their hair while some may only experience a thinning of their hair. Hair loss or thinning begins gradually, usually within two or three weeks of the first treatment. Some additional side effects include decreased blood cell production, fatigue, loss of appetite, changes in taste, nausea and vomiting, diarrhea, mouth sores, and a sore throat. When Devin was sick, his immune system was severely weak. His mother would not allow anyone to use the bathroom closest to his room and hand sanitizer was a common occurrence throughout the entire house. He lost 40 pounds by the time he was diagnosed because he had no appetite and when he did, he could not keep it down. The side effects a person may experience are just as heartbreaking as the cancer itself.

            Although chemotherapy is the best option for most cancers, radiation is used if the cancer is limited to one part of the body. In 1896, German physics professor Wilhelm Conrad Roentgen presented a groundbreaking lecture entitled “Concerning a New Kind of Ray.” He called it the “X-ray.” Within months, systems were being devised to use x-rays for diagnosis and within 3 years radiation was used to treat cancer. Radiation therapy began with radium and relatively low-voltage diagnostic machines. There was a major breakthrough in France when it was discovered that daily doses of radiation over several weeks significantly improved the patient’s chance for a cure. Today, radiation is delivered with great precision to destroy cancerous tumors because at the beginning of the 20th century, it was discovered that radiation could cause cancer as well as cure it. Recent advances in radiation physics and computer technology made it possible to aim radiation much more precisely. (“Evolution”)

            Radiation therapy is frequently used in addition to surgery or chemotherapy and is usually applied in lymphoma through external high-energy ray beams or radioactive isotopes. External radiation treatment is painless (similar to having an x-ray) and lasts only for a few minutes. A complete course of treatment is typically five days a week for four to five weeks. This course of treatment is for the use of an outpatient setting depending on the cancer type, tumor size, and location in the body. Not all types of Lymphoma respond to radiation treatment. Therefore, it is determined by the healthcare professional if radiation is the appropriate treatment for the situation and stage of cancer the patient is in. (“Hodgkin”)

            In the unfortunate circumstance that a patient has a relapse of Hodgkin Lymphoma, the most common treatment is stem-cell transplantation. This is also called a peripheral blood stem-cell or autologous bone marrow transplantation. Stem cells are a group of cells within the bone marrow which are immature that grow and change in platelets, white blood cells, and red blood cells. The treatment process for stem-cell transplantation is quite simple in a sense. Before chemotherapy some of the bone marrow cells are removed and then given back afterwards. (“Hodgkin”)

            Each patient is a partner in their care and it is important to understand the treatment plan – before the treatment he or she will receive now and the treatment they will receive later on, should it be necessary. Sometimes the first treatment may affect the next treatment the patient will be able to receive. In Devin’s case, he just ran out of time to fight.

            If you walk down the streets of Devin’s hometown, you will witness a sight not many people have ever or will ever see. Around the light posts are purple ribbons tied into bows. On the glass door of the salon Devin’s mother works at is a top to bottom purple ribbon with angel wings and “Zōe” written across the middle. A zōe is someone who shows strength, and up until the very end, that is exactly what Devin did. This past summer I was talking to his girlfriend at the time that he had cancer (and who I still call his girlfriend) and she told me how she found he wasn’t going to make it when she was in Florida for her spring break. She told me how he waited until she was by his side to let go and how she could never forget how Devin loved her or she loved him. The entire community of his hometown has come together to raise money through donations to help his family pay off medical bills and to build a memorial for Devin. T-shirts, cozies, and magnets that read “I will not fear for you are with me” (which was tattooed within a cross on his left shoulder) are also sold to raise the money. Devin left behind his friends and his family, but he also left behind love, passion, memories, and strength. Those are the things we have to hold on to and to get us through each day.

 

 

 

Works Cited

"Evolution of Cancer Treatments: Chemotherapy,” “Evolution of Cancer Treatments: Radiation,” “What are the Key Statistics of Hodgkin Lymphoma?” American Cancer Society. 2013. Web. 21 Nov. 2013.

"Hodgkin Lymphoma Treatment.”, “Side Effect Management.” Lymphoma Canada. 2013. Web. 21 Nov.2013.

"SEER Stat Fact Sheets: Hodgkin Lymphoma." Surveillance, Epidemiology, and End Results Program. N/a. Web. 21 Nov. 2013