Hour 10: Insomnia

Dear diary,

For the past hour I have been captivated by the song ‘I can’t get no sleep’ by Faithless. For once it was not due to its catchy rhythm (thought I have to admit to having jiggled and wiggled a bit with it), but it was due to the only lyrics that anyone who has ever heard the song will remember: I-can’t-get-no-sleep. I thought they summed up quite well my state of mind (i.e.I can’t sleep). I thought I would be able to, especially since the events of the previous hour. It turns out that once again I am one with the pretty sparkling vampires: I can’t sleep, because I don’t sleep, because I will never sleep. Although unlike them, my problem isn’t that I am a vampire. I can’t sleep because I am a cancer cell. And cancer cells don’t sleep. Not ever? I hear you ask. No, not ever. Not even for a second. And it isn’t because there is no space for a comfy bed in the human body. Well, ok, technically, it is true that we suffer from a lack of bedding. But we also suffer from a lack of limbs, and that has never stopped us from anything.

I will not go so far as saying that healthy cells sleep, but I will have to admit that they do undergo this dormant stage called senescence, which us cancer cells have decided to overcome (surprise surprise). And whilst dormant cells do not technically sleep, they do, at one point in their lives, stop replicating. If you ever read any of my previous posts (particularly Hour 2: The cycle of life) you will know that us cancer cells instead live to replicate…so obviously we had to overcome this whole senescence non-sense. See, healthy cells have this thing called ‘telomeres’ attached to their DNA…Like a cell pedometer, though instead of counting our steps (which, as we can’t walk, would only count up to 0), it counts how many times our DNA gets replicated (1 every time a cell decides to split into two). Once it reaches a certain number, which changes according to which cell-type we are talking about, this cell-pedometer decides you’ve had enough of cloning your-self, and will from here-on-after remain a dormant cell: continue working as you always have, supporting your tissue or whatever, and stop creating more of your-selves. To me, this concept sounds amazing. Do you have any idea what it is like to be one of many, many cells exactly like you? And it’s not like I’m talking about identical twins, who look the same, but are not the same person. No. I’m talking about same insides, same outsides, same voice, same aim, so much so that you would never be able to discern which one of us came first (starting the trend of ‘who came first, the cell or the cell?’).

But alas no, us cancer cells don’t even get the luxury of being in any way unique at any point in our lives. And since our aim in life was to proliferate, of course we managed to get over the whole pedometer system. I am not going to bore you with the details of HOW we did that… we tricked the pedometer making it reduce the number it recorded, and again over-came the restraints of a functional P53 (see Hour 3: Chinese whispers). And so we made any form of dormancy and uniqueness a thing of the past, and moved on.

And this leaves us with only one more question to answer: If we don’t sleep, what do we do? Easy to answer for my fellow cancer cells: the same thing they do every day, try to take over the body. As for me, well, I do what most humans find them-selves doing in the middle of a sleepless night. When they are surrounded by that deafening silence that only the wee hours of the morning can grant you, and all dreams can seem so real, and all fears become terrors. I become one with the darkness, and let its calm seep into my pores. I try to keep all thoughts of despair at bay; after all, we are all soldiers in our own wars, and victory may not coincide with our own survival. I then pretend I can control the rhythm of the heart, the seeping of the fluids, the spinning of my own personal earth. 

Let the night come with solace; let it heal the wounds of your days. Make it be your armour, your shield: an elusive guardian angel.

Cell X

Hour 9: Drink respons-hic-ly

My dear readers, I am not proud to present you with this piece of writing. However, for the educational intent of this blog, I should not omit any events in my life as a cell. I suggest you read the rest out loud should you wish to understand a word that was said.

Deer dairy,

I was abaut to right a posssst but-hic-then samfing magical hapnnnd. Brief pose to sway in the rythm of the heart. Brief pause to laugh histerically at how the word ‘blog’ sounds like ‘blob’ and that’s so funny. Extra brief pause to continue hysterical giggling because I can’t remember why we are laughing, and that’s funny too. May host decyded to go and partieiei (I don’t know what that means) HOW-EVER ai fink that… brief pause while attempting to regain train of thought. Brief pause laughing at the expression ‘train of thought’.  Rite, I fink dat she met my deeerest new bestest buddy called, weight, wat’sss your naime again? Ohh-hic, rite: ACETALDEHYDE. Only Brief pause to laugh at how funny this whole event is shi didn’t no! Shi had noooo adia that mai baddy ACETALDEHYDE was coming, be-hic-cause More laughter, you get the drill she fought shi was juuust drinking alcahol!! So shi drank alcahol, ai fink shi call-hic-ed it WAYNE (whaaay wud you call a drink WAYNE), and then the bloooood star-ted smelling funny an den it aaaaalll went reeeaaalllyy calm, nd den ACETALDEHYDE came!! Brief pause to hug Acetaldehyde and tell him how much he is the bestest buddiest ever. Hey guys –hic- guys!! LISSTEN to mi, its important. What you didn’t no, is dat whenever you drink WAYNE or ALCAHOL, mai buddy Acy heeer comes, aaand you no what he das? No? Tell him Acy!! Brief pause to try and force ‘acy’ to speak to no avail. Acy is, afterall, only a molecule. FAINE, Ai attempts to point at itself only to realise it doesn’t have arms will tell dem. Acy heer, makes cells laik ME! Brief pause to dance to ‘I’m sexy and I know it’ because ‘wiggle-wiggle-wiggle-yeah’) It heyds in wayne and den cams to healthy-hic-cellssss (whu are sooo boooring, dey NEVER party) and den it messes up their DNA UNTIL dey becom cancer too. Brief pause to await response to this monumental statement. Brief pause to realise ‘Acy’ is actually quite sexy. Hey Acy-hic, did-I mention, you are so hot you are causing a fever? Sleazy smile with half-closed eyes. You know which I mean.

I have decided to not report the rest of the experience as for your educational purposes (and the maintenance of a slither of my dignity), that bit was more than enough. But don’t worry, you didn't miss much. Most of the rest was an incomprehensible and deeply embarrassing slur. However, just in case you missed the not so subliminal message behind the enthusiastic mispronounced words I just reported above, here is a quick summary: alcohol contains a substance named ‘acetaldehyde’ which can cause DNA damage in cells. Still lost? Drinking alcohol can cause cells to become like me and my cancer cell ‘buddies’. With every drink, you increase your risk of cancer. Humans, is it really worth it? Drink responsibly. Or really, do yourself a favor, and just don't. I'm going to have a nap.

Excell

Hour 8: Betrayal

Dear diary,

If I had been told that the reason we would thrive would be our alliance with the immune cells, I wouldn’t have believed it. Just a few short hours ago, we were distraught at the thought of what the encounter with the immune system could cause us. We feared the closeness, the contact: surely they would realise we weren’t meant to be there. But then we were spared without so much as a second glance. I mean, I know we put a lot of work into those fake I.D.s, but come on: they really should have more reliable ways of determining what’s real and what isn’t. I feel like we are a Trojan horse, welcomed into our host’s body with ceremony, only to turn out to be the one that will cause its destruction.

And then the immune cells left, and with the lack of other cell debris, I thought we wouldn’t see them for a while. Instead, the macrophages started to come and visit us more and more regularly, until they became an almost constant presence around us. For the humans reading this, the macrophages are part of the ‘rumbling-tums’ army of the immune system (see post entitled ‘Hour 7’): they are huge cells, the biggest I have seen in my existence…For humans they would be like glowing white dinosaurs. And like dinosaurs, they do not seem to be so smart, but their size grants them authority amongst other cells. Their sheer aim in life is to eat, and their only selection in their meal is that they will eat anything that is not meant to be in the body. As if a human would pick a house, and start eating anything that entered it without his/her permission…ugh!

At first I thought that the macrophage’s constant presence was due to their hunger: maybe they were just hoping one of us would drop dead so that they would have more debris to snack on. Or maybe they were suspicious of our presence, so they were waiting around in case one of us would make a false move, and then they would have an all-you-can-eat buffet of tumor cells to devour. I would never have suspected that these cells were actually there to help us: like corrupt policemen, macrophages work against their human host. As a rapidly growing mass, tumor cells need a constant supply of nutrients and oxygen. Other organs attain it through blood vessels, which have been carefully orchestrated to grow in a manner that ensures that all cells are irrigated with a sufficient supply. However, as tumor cells are an unplanned presence, there will be no blood vessels in their close proximity. And molecules can only travel so far (they do not, after all, have any form of transportation other than random floating). Hence, until we can somehow increase our blood supply, our tumor mass will not be able to grow (yay!). Unluckily, the macrophages not only planning to protect us against all other immune cells, but will also help us attain a good blood supply. And that is only the start: they mentioned that one day they could even allow us to be able to wander around the body! Now, before you start panicking and accusing macrophages for all the evils in the world, just be aware that if you are a healthy human, it is probably thanks to those macrophages. They are not all bad: they are mostly amazingly good. I think it’s just us tumors that somehow corrupt them, and make them work against you. At least human scientists are beginning to pick up on this behavior: seems macrophages are playing the double game in most bodies. Some believe macrophages should be targeted for anti-cancer therapies. I think they deserve it. Let’s hope it won’t come to that though, as anti-cancer therapies will also wipe me out.

Gosh diary, what can I say? It’s hard. It’s hard to be a tumor cell, born evil, trying to fight your nature with every diffusion of oxygen. It’s hard to pretend to be just like every other tumor cell, so as to strike at the most appropriate moment and somehow make a difference. But it’s harder still to realise that the cells that were meant to support you in the fight are actually working against you. Is there any good left in this body?

Cell X

Hour 7: They-who-cannot-be-named

Dear diary,

After what was probably the most stress-full hour of my existence, the inspection has finally come to a close. Now that the remaining cell debris have been disposed of, and we are actually surrounded by clean fluid, I can’t help but think back to how the immune system is actually made of so many types of cells. And how, like most things in biology, they are named in the most complicated way. You see, after the freak-out part in which I was inspected, during which I may or may not have slightly panicked and saw my life flash before of my eyes (let’s never talk about that again, and pretend I handled the situation in the most macho way ever), I actually started to pay attention to the cells doing the inspection: their shapes and sizes and what I grasped of their main function. Immunologists like you to believe the immune system is the most complicated thing ever. And to make their point, they have devised a way to make it SOUND complicated. So complicated in fact, that the brain will get stuck trying to identify the word it has been handed, and forget to follow the explanation on what that cell actually does. Don’t understand what I’m talking about? Fine, see for your-self: here is just a sample of my immunologist ABC.

CAUTION: Not for the faint tongued.

A for antigen

B for basophils

C for cholecalciferol

D for dendritic cells

E for eosinophils (pronounce that, I dare you)

F for the very rude word you might be thinking right now

G for gamma delta T cells

H for major histocompatibility complex

I for interleukins

J for just stop trying

K for keratinocytes

L for leukotrienes

M for macrophages

N for natural killer cells (take that, James Bond)

O for the shape of your mouth as you read this list

P for prostaglandins

Q for questioning scientists sanity

R for really, you are still trying to pronounce them?

S for state of your tongue by this point

T for T lymphocytes

U for urine (did you know it was full of pathogens?)

V for vescicle

W for why. Just why.

X for xanthoma

Y for ‘You’, i.e. what we would call each other if our names were on this list

Z for the sounds the audience make when people use these names.

These names are the stuff of nightmares, letters so unmemorable, that students are forced to resort to sudden spurts of bad handwriting skills  in the middle of a perfectly written paper, in the hope that the examiner might read the right word in that jumble of letters. Now, let’s not forget that most of the scientists who actually have to use these words are not native English speakers, so most of these words will have to be slightly mispronounced. Just for that, I tip my (metaphorical) hat to the immunologists.

Now that we are on the same page, let me enlighten you on what these poorly named cells actually do. The simplest way in which I could explain it is by categorizing them in the 'picky-eaters' vs the 'rumbling-tums'. The 'rumbling-tums' are large (yes, I meant fat) cells who are ruthless eaters, satisfied with engorging themselves on anything that doesn't belong in the body. They literally enforce the law by eating law-breakers. Makes guns look so silly, doesn't it? Then there are what I call the ‘picky-eaters’. They are slightly more sophisticated than the 'rumbling-tums' in that they are more specific to what they kill: to each pathogen (body-invader), one ‘picky-eater’ immune cell. Now don’t get me wrong, ‘picky-eater’ cells still kill whoever broke the law (even thought usually not by eating them, as they are too picky). And sometimes they resort to calling the ‘rumbling-tums’ to do it. But they do tend to wander around with an air of superiority, as they are the ‘high-class’ police that will only be called for more important investigations. And that’s that. The immune system. Made of unspeakable words, and things talking to each other through more unpronounceable ways, just to make everyone cringe and turn the other way. But don’t worry, you already understand all there really is to it.

Oh, and just for the record, I introduced myself to what the immunologists call a 'macrophage' cell as it wandered by: its name was Bob.

Cell X 

Hour 6: The blind wanderers

Dear diary,

They came gliding like ghosts in the darkness, an army of cells of so many different shapes and sizes that for a few moments I was lost in wonder, and forgot all fear of what was to come. The first cell appeared like a beacon in the dark, and then there were many, until their presence over-came all of my senses. Slowly they made their way towards us, attracted by the debris of the cell that had died what seemed like a life-time ago. All cells, good and bad, stayed as still as statues, their ID clearly in sight, hoping the procession would move on and leave them unscathed. As I waited, I wished I had been born on the other side, a few mm away, from a healthy cell. I wished my nucleous was not damaged and mutated. I wished I could have deserved to live. And then whispers pierced the air, violating that deafening silence around us. Like sirens they were wails breaking our reverie: “Police! Nobody migrate! Keep your junctions were we can see them!”.  As if we could have migrated if we had wanted to.

It seemed like a life-time before they reached us, but it can’t have been longer than a few seconds. Their bodies started pressing onto the tumour mass, as they anchored them-selves to facilitate their wandering. As they glided along, they checked IDs like a blind person fumbling in the dark: the blindness was not their weakness, but their strength, allowing them to concentrate on controlling our antigens and ignore all forms of deception. All too soon, I saw an immune cell edging towards me. As its filopodia touched my membrane, I recoiled at the slimy-ness of its touch. Slowly, I felt it pull it-self across my surface, greedily searching for my antigen. I thought of looking into its eyes, hoping it would look into mine and see the goodness of my intentions. Then I feared it might also see the truth, that I didn’t belong in this body, and so I shut my eyes tightly. Finally, I realised the immune cells didn’t even have eyes. Meanwhile, its extensions were still probing my membrane, hunting hungrily. In my terrified state, all I could think of was of Harry Potter’s dementors, and how they sucked the happiness out of you until they could reach you and inhale your soul. This was my dementor, and so I started hoping I didn’t have a soul. And then the immune cell shifted covering my whole membrane, shielding me from life. I could not breathe. Panic choked me and I thought this must be it, it’s over. Instinctively, I moved, one last desperate effort to save myself. Stupidly, I thought to fight dementors you need to find a happy thought and produce a patronus.  What was my happy thought? I looked back of what life had given me and flashes of cells showing off their cell cycle states flooded my mind. I remembered my will to be different, to do some good. Maybe this was the best I could do. Maybe dead was the best I could be. So I smiled, grateful for the few hours I had been granted.

And suddenly I was free, and there was oxygen, and the immune cell was gone. Was I dead? Tentatively, I opened my eyes and looked around. My membrane seemed intact, with no traces of the immune cell. I closed my eyes in giddiness, and welcomed the familiar sound of blood rushing through the veins. Hopeful, I looked around at my literal other-half. I found her staring at me, grinning. At first I was only shocked she was not ignoring me, as she usually does. I must be dead after-all. Then I noticed she was pointing at something so I looked down and saw my ID. My ID! It was still intact albeit for the slimy remnants of where the immune cell had inspected it. Only then it dawned on me: the immune cell must have gotten hold of it when I moved trying to escape!  So I was alive. And I had passed the inspection. It had worked! I was alive! I was alive! I was saved!

I felt light-headed with relief as I turned back to my other-half, who was still grinning at me. I searched my mind for the right thing to say and when words failed me, I grinned back. We stayed like that for a few seconds, both smiling broadly, so happy to have been spared that we forgot all hostility. Finally, my other-half turned away, resuming its formal positioning. However, I couldn’t help but notice that this time, she was not as shifted away from me as she previously was. As if she had forgiven me, slightly, for wearing the same membrane. As if that moment of camaraderie will not be easily forgotten. And for the first time, I felt hopeful. Maybe everything will be alright after all.

Cell X

Hour 5: Even evil fears

Dear diary,

Today has been a frenzy of scribbling and typing, as all tumor cells attempt to create a credible fake I.D. The air is full of tension and the usual darkness that surrounds us broken by the relentless flashing of photography (don’t ask me how we managed to get cameras down here. You should still be trying to establish how it is that I have a computer with a fully functional internet connection. Just accept that we now also have cameras, and read on). I took advantage of the sudden bursts of light to comb my filopodia (those long things sticking out of my body that make me look like an octopus) for my picture. I thought a fringe would make me look more amiable: after all, if Justin Bieber and those One Direction boys pulled it off, why shouldn’t I? Sadly, it seems I too have become a victim of the ‘please-tell-me-I-don't-look-like-that-in-real-life’ syndrome. Not that it is my fault! The photographer instructed (after an eternity of turning me this way and that, look up and down and at the side at the same time) to say 'cheese' right before he took the shot. As I have never heard of a thing called 'cheese' in my life, what I instead ended up whispering was 'what?!’. I think the result is quite clear in my picture. I hear my syndrome is a very common problem amongst humans, usually striking post-adolescent people who are about to take a formal photo that's meant to last them for the next decade. It is such a big problem that humans have had to make their IDs small enough to fit in a wallet, so that they could be hidden from view. Hence, I have decided that after the inspection my ID will remain hidden deep between my filopodia (and constantly rubbed until my picture fades).

Gosh, the inspection. It’s funny how even the most evil of things have something to fear. And if there is one thing us tumor cells fear, it is the immune system. You see, they are the ones who control what survives and what doesn’t in the human body. I’m guessing it could be compared to the human police force, only the human police is not as harsh: where you get a fine, or a warning, or even prison, we get death. There is no middle ground with the immune system. There is no bluffing, or pleading. They are not there to listen, or to be misguided: they are there to protect the body. And anything that is not meant to be in the body will have to be disposed of. Funnily enough, the immune cells have no eyes. Or ears, or noses for that matter. So how do they know what’s meant to be there and what isn’t? Well, they have a very simple, very ingenious system: they call it the antigen check. Now don’t be alarmed at the world antigen, it’s all actually a very simple principle: each cell, of every living being (human, animal, plant), or even of every non-living thing (dust, dirt) has an antigen (which is basically an I.D. stuck on top of its body like a flag). This antigen will be recognised by the immune system, allowing it to understand if it’s a foreign body (non-self a.k.a. terminate) or if it’s part of the body (self a.k.a. peace and love). For each antigen (ID), the immune system will have a specific soldier at the ready. Surprisingly, the immune system will create all soldiers particular to each antigen before each human is even born: these little immune cells will be at the ready, should you ever come in contact with whichever cell of whichever creature it may be, to protect you. It’s as if your police force had the ID of every person, born or unborn, ready in its files, just in case it ever came across you.

Lucky for me, cancer cells have discovered a way to go around this system: the standard norm states that if it belongs to the body, it gets to stay. Now, unluckily for you humans, us cancer cells are actually created by your bodies. Yes, we are mutated to something that barely resembles a cell. And yes, we are evil (at least most of us are) (not me! Not me!). But we are still technically from the body. Which means that, in most cases, our antigens will be the same to those of the other healthy cells. Hence, the fake I.D.s: if our antigens (I.D.s) state that we are from the body, the immune cells will have to move on. And we could be saved.  

I wish the theory it-self would be enough to keep us calm.  We are a trembling mass as we await the arrival of the immune cells. All seems quieter, or maybe it's just that for once, there is a complete lack of whispering. It's as if even the healthy cells surrounding us are aware that something is about to happen. One more heart-beat and then all goes still: they are coming.

Cell X

Hour 4: Chinese whispers

Dear Diary,

Today a cell on the other side of the tumor went through apoptosis (i.e. it died). We still haven't understood why this happened. Some say the cell was stressing too much because lately we’ve had quite a lack in nutrients. Others thought it hadn’t yet learned how to control its P53 levels. For you non-cells out there, P53 is what scientists like to call a tumor suppressor protein. What it basically means is that in the fight against cancer, P53 is on the human side. It’s really good at detecting when the cell’s DNA has too many mutations in it, and, when it does, it makes the cell die before it can become one of us. Like some kind of anti-zombie prevention. Most of us tumors have learned to control our P53 levels, but some newly split cells are not as fortunate. Like the cell that died today. 

As you can imagine, it was awful: as soon as people realised P53 was causing it to enter apoptosis, there was screaming, and panic, cell were running everywhere and…ok, that’s not entirely true. Maybe there wasn’t any chaotic running. We are tumour cells, we cannot run. We cannot even walk: we are so stuck to each other we put superglue to shame. And maybe there wasn’t any screaming... Cells can’t scream! If we could, each human would be accompanied by a constant unexplained buzzing sound emanating from every pore. Think a swarm of bees makes a scary sound? Well imagine what a crowd of people could do if every cell would scream. And so, we whisper. Really softly. And luckily, we are so tiny that even all of our whispers put together don’t make much noise.. So that when we talk to each other, our human hosts just assume that the noise they hear must be from their clothes brushing against each other, or the wind…humans can be so naïve sometimes. 

Well anyways, today the cell died. But before it did, it whispered: ‘Oh no! Not p53’. This made the neighboring cells  quite alarmed, and soon whispers of   P53 started to spread. Only whispers don’t spread the way words said in a regular tone would. Ever played ‘Chinese whispers’? Something similar happened today. The terrorized murmurs of ‘P53!’, by the time they had reached my side of the tumor, sounded slightly different:

‘Hey guys, pee filthy tree!’  ‘What?!’  ‘Huh?!’  ‘Hey, don’t be rude, say pardon’ ‘Hey cells, I think I’m growing, look! Look! Do you think it’s G1??’  ‘Pardon’  ‘What’s a tree?’  ‘Pee filthy tree!!’ ‘Guys, I really think this is it! I’m fatter!!’ ‘No, I don’t think you’re fatter’ ‘Pee filthy tree!’ ‘What’s that cell saying?’ ‘I think it wants to pee’.

It went on like this for the next half hour. By the time we realised what was happening, the cell was long dead. And I wish the only problem was its passing. You see, human cells don’t die as humans would: we don’t have our life flash before our eyes. We don’t slowly follow the light and peacefully pass on, with our faces angelic and a slight smile on our faces. Cells implode. Literally. Our insides start degenerating, until they become 'outsides'. On every cells around them, outsides. You think the p53 murmur was a cry for help? It was a warning to get out of the splash zone. But guess what, as we are glued together, there was no getting out of anything. All I can say is that I now feel like that dead cell is part of me…..

Overall, it was not the best hour of my existence. And now we have a new problem to deal with: when a cell dies, immune cells come round to get rid of its leftovers (they eat them). It’s purely for protection purposes, they don’t want other cells insides to damage healthy cells around them. The problem is cancers are not what you would call a 'healthy cell', and if the immune cells find out we are here, they will destroy us. 

So guess what? I’m off to get a fake I.D. They might even take my first picture…wish me luck!

Cell X