rhuia (rhuia) wrote in little_details,

Cancer and how to disprove it

Hi, first time poster with some (kind of?) complicated med facts asks and a post that is well into tl:dr territory.  Hope that's okay.

My scenario is:

- MC1 has been diagnosed with cancer (osteosarcoma in the femur) but it's a set-up by evil guy (faked pathology results, planted doctors, etc).  Nothing wrong with MC1, but the resulting chemo treatment (high dose methotrexate) starts to kill him -- also something evil guy has designed to happen.  

- MC2 is out to try and basically find a cure for cancer (oh what the hell, it's Sherlock and apparently there's nothing he can't do so I'm just rolling with it), but eventually finds out what's going on, and the jig is up.

So what I've got Sherlock doing is feverishly replicating all pathology results to see if there's anything that's been missed, and this is the trail that's eventually going to reveal the truth.  It's also the trail by which he hopes to find some ameliorating medical way to keep John healthy (ie, the 'cure').  

What I need:

- What are the steps Sherlock could take to start checking on results?

So far, I've got him doubting the results of an ALP test because he's done bloods on John for calcium (which comes in normal) and GGT or 5'-nucleotidase (which comes in low).  Both seem to contraindicate a bone disorder.  He's also going to do an ALP isoenzyme test to test the rigour of the initial ALP.  (is that logical, btw?  It made sense on the internet but my layperson google-fu has probably missed something really basic.)

What, medically, should/could he check next that would present similar contraindications? They can't be huge glaring errors, but they do need to be replicable so he can find the inconsistencies.

- Chemo: 
Are there any specific protocols I need to use with the chemo? 
How long will it take for John to get really, really sick without outright killing him? I guess I'm looking for cumulative dosage info here.

(John's going to go on a Neoadjuvant chemo cycle, just because it was the most postpone-y thing I could think of without putting him under the knife (and the lit seems to suggest it's gaining popularity as a treatment).  The methotrexate bit will happen here, and I hope to give him just enough to make him sick, but not so much that his bone marrow completely dissolves or anything).

- Experiences of chemo: from what I read, these are variable and can range from outright debilitating to being able to work the next day.  What is the qualitative info I can give the reader that will not completely insult anyone who's suffered cancer, but will still bear a resemblance to a true chemo experience?

- A cure for cancer.  This is not the focus of the story in any way, but it does need to make an appearance in the beginning, at least until Sherlock swerves onto the trail of wrong stuff.  So what can I stuff into his mouth to make it sound like he's actually making a start on this without taking it all the way into crazytown?

Thank you in advance to anyone who can help in any way (and also if you've managed to make it all the way to the end of this post).

I look forward to your thoughts.


ETA 24/5:

Sorry, turns out I've left out some pretty vital info:

- John has had bloods and X-rays.  Both came back looking definitive for cancer, the latter for osteosarcoma in the femur.
- John is definitely experiencing pain -- it's the thing that triggers the check-up that leads to the diagnosis.
- The reason he's experiencing pain is a secret plot point that will probably come back to bite me in the ass.

Thank you all for your comments so far, they've been great.

Tags: uk: health care and hospitals, ~medicine: drugs, ~medicine: illnesses: cancers, ~medicine: poisoning

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