Adenocarcinoma Chronicles. After the Radiation.

Last week I finished 38 x-ray treatments on the Varian Linear Accelerator with IMRT for my prostate cancer. This device uses a variable leaf collimator for continuous dose adjustment as the beam rotates around the patient. Each treatment is preceded by a CT scan with a built in CT scanner mechanism on the accelerator. This is performed for purposes of alignment of the target area to the beam which rotates about a fixed axis, coincident with the center of the target.

Along with the 76 Gy of x-ray therapy is hormone ablation with Lupron. The standard treatment for advanced prostate cancer, Gleason 8 in my case, is hormone ablation and radiation therapy to the prostate.

Initially, the trick to impeding the growth of the cancer is to suppress testosterone which is needed for reproduction of the cancer cells. The pituitary controls the signaling for testosterone secretion from the testes.  The adrenal glands secrete a small amount of testosterone as well.  Lupron suppresses the signaling by the pituitary gland. This is effective for a period of time, perhaps as long as 24 to 36 months.

Eventually the cancer becomes resistant to this approach and enters the so-called refractory or castration resistant stage. In response to the lower testosterone titer in circulation the cancer cells produce more testosterone receptors, called AR for Androgen Receptor. The number of AR’s multiply by 3x to 5x, increasing the sensitivity of the cells to what little testosterone (or dihydrotestosterone) there may be in circulation.

Blocking the androgen receptors is an approach to treating castration resistant cancer, but it does have limitations. This will be explored in a later post.

An observation from a patient’s perspective. Insurance will generally not pay for off-label or experimental therapy. So unless the patient is self-insured, the treatment profile will follow the board approved protocols for a given diagnosis. This isn’t a bad thing, but often a medication or other treatment will show effectiveness in other applications.  While the doc has some discretion here, the insurance company may not approve payment. And, they may decline to pay months down the timeline when their internal review staff have had a look at it. They make their profits by declining services, not offering to pay for it.

Initially I had hoped for the possibility of participation in a treatment study if this disease went south, as it is likely to do. What I was told is that because I have had 2 cancers, throat and prostate, I am almost certainly disqualified from participation. This was disappointing but I understand the reason for it. Even so, I am barred from a Hail Mary pass down the road.

So, what now? Well, it is watchful waiting. While PSA numbers are given less importance in checkups for ordinary patients owing to the history of overtreatment, for a post-treatment Gleason 8 patient like myself, the PSA number is a direct indicator of disease progression. Once the disease becomes castration resistant, I  suppose that some kind of AR therapy is next. The docs have been evasive when asked. Apparently there are several paths available. But I suspect they would rather the patient focus on the present and not the damaged bridge miles ahead of the train. We’re all headed for that bridge, it’s just that some are further up the tracks.



Liptonian Symbolism

Originally posted on Lamentations on Chemistry:

Never one to allow reason to interfere with sentimentality, my blackened heart is softened somewhat by the recent shipment of Lipton Tea bags delivered to Th’ Gaussling from an online admirer via the US Postal Service. 

The tea in this gift shall be symbolically applied to the local waterway, but not before being used to formulate some refreshing iced beverage via aqueous extraction.  A vessel filled with aqueous goodness (OPE-Our Pure Essence) will be charged with the anthocyanin and alkaloid laden forest litter for extended exposure to solar radiation. Brownian motion will be relied upon to disperse the colloidal value away from the biomass.

Once so processed, the fortifying beverage will be passed through a pair of kidneys as a symbol of my dark contempt for the IRS. This nephro-raffinate will be discharged into the municipal fluid collection system for a kind of Nicene rectification that will provide further philosophical processing of the…

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US Russian Policy is Pathetic

I just have to say that in regard to the deteriorating situation with the Soviet Union Russian Federation, it does not appear that either the EU or the US have their best thinkers working on it. I think US leaders have misunderstood Putin from the beginning and I see very little to convince me that Obama’s people, the Congress, or any other high level functionaries known to me have a clue how to get their arms around Russian behavior or a workable diplomacy.

Certainly recent (post-Ford) US incursions into foreign lands with troops or drones have taken us off the moral high ground in this regard. How can the US lecture Russia on the invasion of Crimea when we invaded Iraq based on lies, subterfuge, and outright errors?

Bush 43 and Clinton had historical opportunities to gain better alliance with Russia. But we supported Yeltsin in the Clinton years and ignored Putin’s offers of assistance after 9/11. The Russian people were mystified when the US supported Yeltsin, widely regarded as a drunken buffoon. Gorbachev’s memoirs paint a lackluster and untrustworthy picture of Yeltsin.  And the US has done nothing but confirm Putin’s paranoia about US intentions by adding membership to NATO, ABM’s in Poland, petroleum wars in the middle east, and the general appearance of weakness by in-house political fratricide.

We have no use for milquetoast administrations like Obama’s, nor do we need rabid swingin’ dicks like John McCain or his hawkish brethren. We do need Russian and Slavic scholars who speak the language and understand the history of Russia at least back to Peter the Great. They can be immigrants from former Soviet territories of the ilk of Zbigniew Brzezinski, Madeleine Albright, or even a world savvy guy like Henry Kissinger. Who are the current brain trust for eastern European politics and is the CIA giving them good intelligence? Did the CIA predict the takeover of Crimea?

Getting the pay out of pay dirt

This is an excerpt from a writing project I’m working on.

The impulse to find and extract gold and silver was one of the drivers of 19th century westward expansion in North America.  The discovery of gold in a California stream bed in 1849 and the subsequent discovery of gold and silver in other territories eastward to Pikes Peak and the Black Hills resulted in waves of migration of prospectors, merchants, investors, and swindlers from all directions, including Europe.

The staking of mineral claims in the American west by people who were engaged in the extraction of mineral wealth lead to an inevitable avalanche of settlers interested in tapping some of the wealth of the miners themselves. The open territory created a void that was filled by industrialists, merchants, government, and perhaps most importantly, the railroad. Miners needed supplies and their ore concentrates required transportation and beneficiation.

As claims were made on valuable mineral deposits, the outline of the geographical distribution of mineral value in a region eventually defined what came to be known as a district. The expansion of the railroad, sweetened by land grants, added permanence to the settlement of many regions around and en route to the mining districts.  The simple logistical requirement of frequent stops to fill the steam locomotive with water lead to the establishment of towns along the railway. This expanding transportation network, along with liberal access to land, lead to settlement by farmers and ranchers who then created a demand for goods exported from long distances by rail.

The history of man’s fascination with gold and other metals is well documented and there is no need to reiterate that saga in the present work. The mania for gold and silver in the west is legendary. Indeed, clues to the history of gold and silver mining in the American west are quite apparent even to the casual observer today. A drive to Cripple Creek or Central City in Colorado will take the motorist past a great many long abandoned mine dumps, prospect holes, adits, and antiquated mineshaft head works. These quiet features of the landscape mark the location of what was in times past a great and bustling industry.

Throughout the American west today there are many “tourist mines” and mining museums operated by individuals and organizations who recognize the importance of keeping this part of our cultural heritage alive. Through their efforts, visitors can view 19th century mining technology on site and experience the dark and eerily silent realm of the miner. Visitors can see for themselves the intense and sustained effort required in hard rock mining and the occupational hazards miners were exposed to.

The tourist mines and museums often focus on the activity of mining itself as well as the specialized equipment needed to blast the rock and muck it out of the mine. This is only natural. The gold and silver rushes left behind a large number of artifacts. These items are of general interest to all.

The technology that is often glossed over relates the matter of getting the pay out of the pay dirt. Indeed, this is a central challenge to gold and silver extraction. Once the streams have been depleted of placer gold and the vein or lode has been discovered somewhere up the mountainside, the business of extracting gold or silver from hard rock becomes technically much more challenging and capital intensive.

The panning and sluicing of placer or alluvial gold, while labor intensive, is conceptually easy to grasp. High density gold particles can be transported by suspension in a water slurry of the water is moving sufficiently fast. Gold particles will tend to settle at low points in a crevice or a gold pan where the stream velocity slows. A gold pan or the bend in a stream for that matter will have a flow gradient that will tend to collect the gold particles where the stream velocity slows.  A sluice or a Wilfley table are just devices designed to trip laminar fluid flow by inducing turbulence to encourage the denser gold particles to settle. Riffles or channels serve to concentrate the gold particles.

While gravity and clever tricks with fluid flow can be used to collect placer gold, isolating gold or silver from a hard rock ore body is quite a different challenge.  Gold and silver may exist in reduced form within the ore. They may also be found alloyed with one another or otherwise combined with other heavy elements. While gold tends to be inert even under oxygenated conditions near the surface, silver is subject to more facile oxidation and may be found in ionic form with several anionic species. Thus technology for the isolation of gold may not serve as an exact template for silver extraction and isolation.

Gold or silver may exist in the metallic form as bodies visible to the naked eye within the solid rock. Or they may be dispersed in microscopic elemental form throughout the ore body. Gold ore may be rich in elements that complicate its isolation even though the gold is in reduced form.  Silver ore is commonly found in ionic form and with numerous ionic base metals present.

Lode gold or lode silver, that is, gold and silver found dispersed in an ore body, were subject to considerable variation in mineral composition. As a result, differences in isolation techniques and process economics arose among the various operations.

In the 19th century a considerable body of chemical knowledge evolved as the gold and silver rushes progressed. This chemical knowledge was put into practice largely through the efforts of mining engineers.  It was not uncommon for the mining engineer to conceive of what today would be considered a process chemistry change, draw up plans, press the ownership for funding, and put the change into operation.

Twenty-first century chemists may recognize much of the nomenclature from this period as well as the intended inorganic transformations. However, the older literature is filled with obsolete nomenclature or that which is confined to the mining industry.  What should be apparent to the observant reader is the level of sophistication possessed by 19th century metallurgists and engineers in what chemists today might refer to as the “workup”.  That is, the series of isolation steps used to remove undesired components to afford a reasonably clean metal product. Mining engineers refer to this as beneficiation or as extractive metallurgy. Beneficiation of lode gold and lode silver involved chemical transformation in batch or continuous processing.

The story of the development of extractive metallurgy is in part the story of redox chemistry on complex compositions like rock. In the mid 16th century Europe, key individuals like Biringuccio, Agricola, and Ercker began to capture mining and extractive metallurgical technology in print. Vannoccio Biringuccio (1480-1539) published his De la pirotechnia in 1540, detailing economical methods of metallurgy and assaying. In 1556, the work of Georg Bauer (“Agricola”, 1494-1555) was published posthumously. His De re metallica is regarded as a classic of metallurgy. Agricola’s book describes the practical issues related to mining, smelting, and assay work and is illustrated with remarkable woodcuts.

By the year 1520, do-it-yourself books like Ein nützlich Bergbüchlein and Probierbüchlein were beginning to appear in Europe describing basic mining and metallurgy techniques.[1] By this time methods of cupellation and the separation of gold and silver were committed to print.

Cupellation is an assay technique wherein crucibles made of bone ash were used to fire prepared gold ore samples with an oxidizer, affording base metal oxides which then separated from the gold and absorbed into the crucible to afford an isolated button of gold.

[1] Aaron J. Ihde, The Development of Modern Chemistry, 1964, pp 22-24; Dover Reprint 1984, QD11.I44, ISBN 0-486-64235-6.

Company gets public spanking from CSB

The US Chemical Safety Board (CSB) has publically expressed dismay and disappointment in a letter to Tesoro Corporation in San Antonio, TX. It is in regard the apparent unwillingness of the company to allow CSB investigators to come on site and continue with the investigation of an industrial accident or, if you prefer, incident. Apparently two workers were splashed with sulfuric acid and had to be choppered out for treatment.

From what I gather from the CSB letter, Tesoro doesn’t believe that the incident rises to the level of seriousness to justify a CSB investigation. That is my own interpretation.

At first blush it would seem that Tesoro has a point. While it is something that OSHA would cover, does it really necessitate attention by the CSB? By itself it seems questionable. But when you consider that Tesoro had an 7-fatality explosion and fire at its Anacortes refinery in April of 2010, perhaps the scrutiny seems less unreasonable.

The refinery explosion was determined to result from high temperature hydrogen attack within a 40 year old shell and tube heat exchanger. Catastrophic structural failure on startup after a scheduled tube cleaning resulted in an explosion and fire with immediate and delayed fatalities.

It seems to me that the failure of a high temperature heat exchanger after 40 years of service handling hydrogen and naphtha has more to do management policy on equipment service life than anything else. This speaks to prudent administrative and engineering controls on plant safety. A shell and tube heat exchanger has no moving parts to fail. It just sits motionless doing it’s function. There are no failing parts to replace other than leaky tubes and valves. Perhaps no one considered that the inherent nature of the gas and thermal cycling was deleterious to the integrity of the metal shell? Perhaps there was no enthusiasm to define official hours of operating life. Plant managers are always under pressure to minimize operating costs. This is especially true of plants producing high volume low margin commodities.

But here is the rub. Everything has a failure rate. This is especially critical for equipment under high temperature and pressure. The first layer of administrative control is for management to make allowances for materials in extreme environments. Anacortes is not the only recent incident where component failure has occurred in equipment performing under demanding conditions. Before the engineers can make equipment specifications for this, management has to conform to the notion that some parts of a plant should have better definition on service life. They should demand it of their design people and support engineering when the time comes to replace a component.

If the CSB believes that a company has weak administrative controls that influence plant safety, then I think they should investigate.

The King in Yellow

Being a devotee of the HBO series True Detective I became intrigued with the purported allusions to the 1895 book of short stories The King in Yellow by Richard W. Chambers. I received my copy from Amazon yesterday and read the first three stories.

I have never ventured into the horror genre so this is refreshing. Chambers was reportedly influenced by Ambrose Bierce. His prose is considerably less dense than Bierce’s- closer to a 20th century cadence and vocabulary. H.P. Lovecraft took notice of Chambers as well. Lovecraft and Bierce are next on my reading list.

As with the story line of True Detective, The King in Yellow (or Yellow King) is not really centered on the fictional play of the same name. Rather, it is a kind of story telling device that motivates and launches characters along the arc of another story. It’s an interesting device.

Solvay and AREVA Make Deal to Develop Thorium Technology

I have been an advocate of thorium based nuclear power for a long time. There are certain advantages that thorium based nuclear technology has over uranium and plutonium systems that make it appealing, as long as the nuclear genie is out of the bottle anyway. Others have written about this and there is no point in my wasting bandwidth on it here.  Fort St. Vrain Generating Station, one of the very few HTGR Thorium plants ever operated in the US sat a half hour from here from 1979 to 1989. As prototypical operations go, the plant had a history of upsets and unforeseen complications and was decommissioned after a decade of sub-commercial output. Eventually the plant was converted to a natural gas turbine plant and runs to this day in that capacity.

So it was of interest to learn that the venerable European company Solvay has teamed up with AREVA to develop thorium technology. Uranium and rare earth processing, as well as other minerals produce side streams enriched in thorium.  According to the link, both players have been accumulating inventories of thorium.  Hmmm. What could they be up to…?


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