The act of willingly letting your medical oncologist, oncology pharmacist, and oncology nurses fill your body with poison (chemotherapy/chemo) to rid you of cancer is not simply permission to get treated to get better. It is an act of physical, mental and emotional preparation and experience.
I will start my first chemo treatment on July 12. It is a three-week treatment cycle. I should feel reasonably well by the third week to celebrate the joy of our daughter’s wedding on August 1, concurrent with sharing in the happiness of our son and daughter in-law also taking possession of their first home on the same day.
Two or three days after the wedding weekend, I will undergo my second cycle of chemo treatment.
The sessions will continue for six cycles, ending just before Christmas. Then I will have a month off and will follow up with several weeks of radiation, likely starting sometime in January. Hormonal pill therapy for up to five years ends the treatment cycle.
Before one consents to undergoing chemotherapy, there is a litany of side effects that you’re warned about by your medical oncologist and oncology nurses. Some of the side effects in the chemo cocktail occur with all of the various drugs, while some have their own side effects independent of the other chemo drugs.
The side effects are the price you pay for getting better. You have to get really sick first with poison permeating all of your body. Then you can get better.
Without chemo, my risk of cancer recurrence is 50%. With chemo, it’s 10%. I’ll take the chemo and its risks to get better and live longer.
One can expect to suffer a combination of some chemo side effects such as: nausea, vomiting, diarrhea, hair loss, loss of appetite, weight loss, weight gain from steroids, dry mouth, harm to your teeth, dry skin, skin rashes, susceptibility to sunburn, nasal congestion, headaches, a lowered platelets count causing easier bruising and bleeding, taste of metal in your mouth, fatigue, anemia, allergic reactions, fluid retention, nail changes or loss, aching joints and muscles, numbness, tingling or burning in fingers and toes, a change in the way you walk, and a compromised immune system due to a lowered white blood cell count.
The medical oncologist predicts that I will get through chemo easier than many other patients due to the strength and good condition of my body. Overall, I am in excellent health. I have never been on any prescription drugs for other medical problems, am not overweight, and have never smoked. I have retained a several times weekly regime of physical activity for many years, primarily aerobic. Because I am gluten and lactose intolerant, a healthy and well-balanced diet of non-processed foods has been a lifestyle for several years.
For the first three cycles of treatment, my chemo consists of three drugs that form the FEC (Flurouracil, Epirubicin, and Cyclophosphamide) cocktail. I will get the chemo injection once every three weeks along with anti-nausea medication. For the following three cycles, the chemotherapy changes for more effective treatment. This second chemo drug, Taxotere, is given in the same treatment timing as its earlier counterpart.
Physical prep for chemo includes day surgery on July 2 to get a port inserted. A port is a central line into a vein through which chemo is administered and blood is drawn for monitoring tests. I will have this port for the duration of my treatment, which is inserted below the skin below my collarbone on the side opposite to where I had my mastectomy. A different surgeon than to the one who removed my cancer will perform the insertion in a different hospital.
I also have a pre-treatment muga (heart function) radioactive scan on June 28, and a radioactive bone scan on July 8. In between these scans are pre-surgery blood tests and other treatment visits with my care team. I am still waiting for a CT scan of my chest, stomach, and liver.
I’m briskly walking for 45 minutes daily to improve the strength of my cardiovascular system for the day surgery anaesthetic, and to improve the chemo circulation with a stronger cardiovascular function. On days when I’m feeling well with chemo, my hope is to continue to keep walking for a few minutes each day to stay strong and healthy.
I was advised by my oncology nurse to see my dentist prior to treatment for x-rays, cleaning and a check-up. Ideally, one wants healthy my teeth and gums prior to chemo and any cavities need to be filled as chemo can affect tooth enamel, can create a dry mouth, and can cause mouth sores. My dentist told me to buy artificial saliva spray to keep my mouth hydrated and to lower the risk of infection, to brush my teeth before and after each meal, to floss daily, and to gargle several times a day with alcohol-free mouthwash to reduce bacteria.
The oncology nurse told me to buy toothpaste without whiteners. She also recommended using products with natural ingredients in sunscreen lotions, bug sprays, shampoo, soap, skin lotion, and deodorant, as antiperspirant cannot be used with chemo. As well, I am to use olive oil or baby oil to hydrate my scalp. The goal with these products is to use as few chemicals as possible on the body while in chemo treatment.
She also told me to use plastic utensils for dining to prevent the increased taste of metal in my mouth. Other cancer care materials suggest that food may need to be cooked in non-metal vessels (glass) also due to metal sensitivities with chemo.
I am to be very careful when using knives, as cuts can create problems in infection and healing due to low white blood cell and platelet counts. I also have to try and prevent any bruising. My house is to be as clean as possible to reduce the risk of contaminants that can cause infection.
While in treatment, I am to limit coffee to one cup per day. It’s been recommended to consume yogurt 2-3 times per day to line the stomach to minimize digestive side effects, eat multiple small meals and snacks daily vs. three larger meals, and increase fluid consumption so that the body flushes the chemo more readily. Foods used should be high in anti-oxidants and nutritional value. Sugar should be used sparingly as it grows cancer.
While in treatment, one could say that I may be adopting a “Diva” look--particularly on our daughter’s wedding day. My oncology nurse has confirmed that wearing gloves is a good idea to reduce the risk of infection during a time of low immunity. The gloves will help to reduce the transfer of germs from others’ multiple handshakes in the wedding receiving line. The color of gloves I needed was not available locally, but with the help on on-line shopping I found opera gloves I need to wear with my evening gown.
Jennifer, my hairstylist, is helping to further the “Diva in the making” by assisting me in shopping for and buying a wig, as I will lose all of my hair within two weeks of the first treatment before the wedding. (Not all things will bring out the “Diva” in me; I won’t be singing any arias!)
The wig we chose is not at all like my own healthy crop of hair. Its not natural grey color, nor is it short and spiky. I won’t give away all the details…needless to say we had fun in selecting the wig along with some head coverings and natural hair eyebrows. I found natural hair eyelashes elsewhere. A make-up artist will add the finishing touches for the wedding to ensure that I don’t look sick in the wedding photos.
The next few weeks will be ones that will cover the full range of emotions in the ups and downs of living with cancer and in celebrating the gifts of others in my life. I look forward to the celebrations of life in a daughter’s and son-in law’s wedding and a son’s and daughter-in law’s first home. I enter into chemo treatments knowing that I have given love to others and receive it back as they help me in fighting cancer with Strength, Courage, and Determination.
I had my first medical oncology appointment earlier this week. Admittedly, there was some trepidation about this appointment since my cancer diagnosis. Happily, it wasn’t as difficult as I thought it would be.
My cancer surgeon had briefed me well about what to expect on this first medical oncologist appointment. I had also done a lot of reading about chemotherapy and radiation so that I could pose questions to the medical oncologist during the appointment. The information given by the medical oncologist was similar to what my surgeon had said, but was more in-depth.
The medical oncologist taking care of me has kind eyes, a warm smile, and a sparkling personality. She was very thorough in her discussions about how we will manage my cancer treatment along with other medical professionals whom I have yet to meet.
As the head of breast cancer oncology in the province, I am fortunate to have her as my medical oncologist. She carries a large patient load, is compassionate and patient, and took the time that was needed to ensure that I was comfortable and clear about the information she was imparting.
She is also a cancer researcher who is involved in a patient research study. The oncology research study is being offered to all new breast cancer patients to participate in voluntarily. It involves using an electronic audio recording device to record the medical oncologist’s initial discussion with their new patient about their pathology report and cancer treatment plan. The patient then gets an audio copy of the discussion to take home as a reference resource.
Participating in the study involves a brief pre-appointment survey by an oncology nurse researcher, an audio recording of the patient’s diagnosis discussion and treatment plan with the medical oncologist, and two post-appointment interviews with the oncology nurse researcher. I may also be asked to participate in a focus group when the patient interviews are done. There is a possibility that the study findings will lead to a future journal article for a medical oncology publication.
My medical oncologist is one of several doctor researchers involved in the study with others in Manitoba, Alberta, and British Columbia. The aim of the study is to improve doctor-patient communication using an audio recording of the discussion regarding the cancer diagnosis and treatment plan.
I think recording the initial appointment is a good idea. The experience of hearing of your cancer diagnosis and treatment plan involves receiving a lot of information, some of which may not be retained as so many details are being disseminated in a mere few minutes. An audio recording allows you to revisit the discussion for clarity.
Looking back to the beginning of this cancer journey that started in late January, I have come to realize that the mastectomy and its post-surgery complications were the easiest part of the treatment plan to rid my body of cancer.
Six three-week cycles of chemotherapy are next (starting by mid-July following surgery to implant an intravenous port line for chemo and blood work), followed by a month off to rest and rebuild my body from the toxic treatments.
Then I am will undergo daily visits (5 visits per week with weekends off) of 15 minutes of radiation for five weeks, followed by daily hormonal therapy for up to five years. In between both sets of visits are blood work tests and various scans to check for cancer (CT scans for chest, abdomen, and liver; a bone scan, and a muga [heart function] scan) and to monitor treatment effectiveness and side effects. Various medical doctor specialist appointments will be sprinkled in between treatments and tests.
When all is done, the treatment success rate against cancer recurrence is anticipated at 90%. Without any kind of treatment it’s 50%.
It’s going to be a long and difficult journey during this yearlong treatment cycle. There may be bumps along the way that could include multiple types of infection risks due to a compromised immune system and the potential of low white cell blood counts that can delay chemo treatments. With an inserted intravenous port, there is also a small risk for blood clots to form.
People I know that have had cancer treatments tell me that the hardest part to get through is chemotherapy as it can make one quite sick and very tired. They claim that radiation is an easier treatment.
For me, both are new and “big” experiences to undergo.
I’m looking at this whole cancer experience as yet another new project to undertake. It’s more of a nuisance rather than a disease to conquer. I’m up for the fight and have spent the last four months “in training” learning about this disease and building the mental muscle I need to get through this next year of treatment and recovery.
Over the years I have fallen into a predictable pattern in how I handle all new projects I undertake. I research the topic, read extensively about it, and ask a lot of questions from people who know more about it than I do. Then I process the information, come up a plan on how I want to pull it together, and “attack” the project with fervor. For me, this has been a fail-proof method that garners positive results.
It’s now time to attack my cancer treatment. I’m calling it “Project Chemo: Getting on With Getting Better”. Bring it on.
I feel somewhat like an army general in this next phase of the cancer fight. Chemotherapy books and other cancer publications tell me that I am the most important member of my healthcare team. Nice terminology, but not fierce or visual enough for me. Cancer is a battle to fight and we are at war. So in my mind, the term “army general” applies.
The “army general” has been doing a lot of positive self-talk to herself these past few weeks as she prepares for battle. The battle is mental, physical, emotional, and spiritual. My troops—the other people involved in my cancer care are a war team of soldiers that are doing their part. It’s now time for me to do mine—again.
As the army general, I am the lone constant member on this battle team. The medical caregivers, like soldiers in an army do change, but I am still the one heading up the battle against the cancer opponent.
During my appointment this week, the medical oncologist told me that I was in excellent health, fit, and cancer-free for now. All of the pre-visit cancer blood tests came back negative. She said my health and fitness states would be of great help to me to get through the chemo and radiation these next few months.
I’d like to be as fit as I was pre-surgery. I went down a clothing size by just working out with 45 minutes of aerobic activity five times per week for the six weeks prior to my surgery. I felt great, not sick.
Unfortunately, my physical conditioning was set back with surgery and cellulitis. Just this week, I have finally been strong enough to resume a half hour of aerobic walking each day. I won’t get to my pre-surgery fitness level, as there isn’t enough time to do so prior to chemo beginning. But getting fit at a higher level will still help.
There was a lot of information given to me by the medical oncologist and her oncology nurse during my lengthy appointment. I will share the information in a series of blogs in the next few days. I am always learning about this disease and how the many day-to-day things I take for granted can become hazards when I’m in cancer treatment with a weakened body.
For now, this army general gal is working with her medical troops, the Women Warriors of the Amazon Tribe, and the Male Warrior Action Heroes to continue the battle against cancer. I am leading the charge with Strength, Courage, and Determination.