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一只实验室小白鼠的自白

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小编摘要:实验室里的小白鼠,也许是一个被遗忘的物种, 本文带你去了解一下......

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实验室里的小白鼠,也许是一个被遗忘的物种, 本文带你去了解一下......

一只实验室小白鼠的自白

The news couldn’t have been much worse. The timing couldn’t have been much better.

消息不能再坏,时机不能再好。

In August one relatively healthy year after losing five centimeters of my scalp to malignant melanoma my doctor told me there were some “troubling” new spots on my lungs – and that they were growing. A few weeks later I awoke from the surgical biopsy doped up and under an oxygen mask and had my worst fears confirmed – the spots were malignant. Two weeks later after I pointed out a peculiar bruise on my back during a routine follow-up the diagnosis got even worse – that bruise was another malignant tumor.

一年前,我因为恶性黑色素瘤割掉了五厘米的头皮,过了一年相对健康的日子。今年八月,我被医生告知肺部出现了“麻烦”的新斑块——它们还在不断增大。几周后我从切片检查中醒来,伴随着麻醉和氧气罩,我最深的担忧被证实了——斑块是恶性肿瘤。我在一次例行随访中提到背部有块奇怪的瘀青,两周后的诊断结果更是雪上加霜——瘀青是另一个恶性肿瘤。

In the space of days I’d gone from someone whose friends had hastily branded a “survivor” to a woman with metastatic Stage 4 cancer. But just as I was  blubbering through the news my oncologist offered a life raft in a sea of panic. She explained that my immunologist who’d recently led the clinical trials for Ipilimumab the first new melanoma drug approved by the FDA in 30 years was doing a new Phase 1 clinical trial. It would combine Ipilimumab with another promising experimental drug MDX-1106 and for a longer course of treatment. As an otherwise young healthy person I was a suitable candidate for the sole upcoming spot in the trial.

光阴似水,想想从前被朋友迫不及待地冠上“幸存者”的标签,到如今成了第四阶段转移性癌症患者。不过正当我这个女人在恐慌的海洋中哭哭啼啼的时候,我的肿瘤医师抛下了一根救命稻草。她解释道,我那位免疫学者不久前刚做了易普利姆玛的临床试验,这是一种治疗黑色素瘤的新药,三十年来首获美国食品及药物管理局的批准,眼下他正着手一项新的临床试验Phase 1,是把易普利姆玛和MDX-1106,另一种前景看好的试验性药物结合起来,以实现更长的治疗疗程。我年轻、健康,于是成为了合适的候选人,迎接试验中即将出现的斑点。

When Ipilimumab was approved last spring doctors crowed of its success in extending lives by entire months and its 30 percent success rate. “In cancer ” my oncologist had said “that’s a home run.” Those odds feel considerably less bright when you’re the one with cancer but the treatment nonetheless offered hope. And with that I became one of the fewer than two dozen people with advanced melanoma in America right now lucky enough to be Bristol-Myers Squibb’s little lab rodent.

去年春天易普利姆玛获批时,医生们欢呼庆祝它成功延长寿命达几个月,还有它30%的成功率。“在癌症领域,这算作一个漂亮的全垒打。”我的肿瘤医师曾说。对患者来说,这样那样痊愈的机会都是浮云,不过治疗本身还是给人以希望的。就这样,我作为百时美施贵宝公司旗下一名小小的实验室动物,非常幸运地成为黑色素瘤晚期患者,类似的人全美不足二十四名。

But first before beginning the trial I had to submit to a battery of grueling tests and interviews both to “establish a baseline” and to assure that I qualified as a subject. It was kind of like going for a high-level job except that I wasn’t sure how to ace an MRI and CT scan. For weeks I dragged my freaked-out ass back and forth to Sloan-Kettering meekly answering questions and suppressing fits of giggles every time someone tried to check the lymph nodes under my arms.

不过试验开始前,我得首先接受一连串让人精疲力竭的化验和会谈,原因有二,第一为试验“划定底线”,第二确保我是合格的试验对象。我除了不会磁共振造影,不会CT扫描,整个过程有点像争取一个高级职位的感觉。几周来我的屁股都不得安宁,凯瑟琳癌症中心常常有我缓慢吃力的身影,我要乖顺地回答各种提问,每次有人要检查我臂下的淋巴结,我都要忍住一股傻笑的冲动。

Though the field is still relatively new immunotherapy has the potential to be one of the first true game-changers in cancer treatment to come along in ages. Unlike chemotherapy it works with the body’s own defenses to fight off cancer. And unlike chemo the side effects tend to be more tolerable – and less intimidating to patients. As one of my nurses recently explained “There are people who avoid treatment because they’re afraid of chemo. They see people who’ve lost their hair and lost weight people who are throwing up. They don’t want to look sick.” Aside from its potential effectiveness immunotherapy is quite literally an opportunity to put a new face on the public perception of treatment — one that doesn’t say to colleagues and strangers on the street   “As you can see from my bald fragile countenance I have some messed up cancer here.”

在癌症治疗领域,免疫疗法还比较新,底子薄,不过却有潜质成为长期以来癌症治疗的转折点之一。它结合身体自身的抵抗力来对抗癌症,这一点与化学疗法很不相同,而且它产生的副作用让患者更容易接受一些。正如我的护士里其中一位最近所说的,“有病人因为害怕化学品而不愿接受治疗。他们看到掉发、消瘦、呕吐的例子,于是不愿自己看起来病殃殃的。”免疫疗法不仅具备潜在的疗效,还可以大大扭转公众对癌症治疗的固有观念——一个人不用对同事或街上的陌生人说:“你看我秃头,面色虚弱,你的判断是对的,我患上了麻烦的癌症。”

Yet there are risks with every drug — as you’ve probably ascertained from those horrifying ads for Abilify. And if you ever really want to feel like you’re chemically tempting the fates I recommend a Phase 1 clinical trial. On the list of subjects on whom my drug combination has been tried I think I’m right behind that monkey from “28 Days Later.”

话说回来,每一种药物都存在风险——你很可能是从“阿立哌唑”这种吓人的广告里得知的。如果哪天你真想试试化学品的威力,我推荐这款Phrase 1临床试验。我试服了药方上面的所有药品,感觉已然步入《惊变28天》里那只猴子的后尘。

I realized my life was about to get intense when I was handed a 27-page informed consent form alerting me of my “responsibilities.” I was not to get a flu shot. I “must not” get pregnant. As a mother in her mid-40s that one wasn’t a hard sell but I wondered how that imperative is going over for my fellow subjects. I had to agree that I understand I would run the risk of a battery of side effects from fever rash and fatigue to “rare but serious” conditions ranging from heart attacks to meningitis.

我签署了一份长达二十七页的表格,上面全是提醒我的“责任”事项,于是我意识到未来的人生将变得多么惊心动魄。包括不能打治疗流感的针,不能怀孕。我已经做了妈妈,年龄四十开外,以上条款还是可以接受的,只是不知道那些同伴怎么应对这些责任了。还有一项是我必须甘冒一系列副作用的风险,小到发烧、出疹、疲劳,大到心脏病发作、脑膜炎这类“不常见却严重的”的情况。
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2011-12-20 23:10 编辑:kuaileyingyu
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