Monday, October 31, 2011

Chemotherapy Schemotherapy

I have seen this tagline on several things - "Cancer sucks". Disagree. Chemo sucks.

"Everyone is telling me I NEED to have chemotherapy. But NO ONE is telling me WHY, " I said to my oncologist, Dr. Deb Wilbur. "It isn't in my lymph nodes and we got the tumor out."

However, what I learned is that studies have shown breast cancer cells to spread through blood stream and grow in other parts of your body - brain, bone (2 Bs), liver, or lungs (2 Ls). Dr. Wilber showed me a database that  I think is called the Finprog Study, but I am not sure. The database gives a percentage of breast cancer recurrence over the next ten years, based on the following factors of my cancer diagnosis:
  • Lymph node status - negative
  • Age - 39
  • Tumor size - 3.3 cm
  • Histological grade - 3
  • ER - positive (even tho it was only 1% positive)
With this diagnosis, based on national studies and statistics, if I don't do chemotherapy there is a 34% chance this cancer will reoccur in the next 10 years. If I do chemotherapy, there is a 17% chance this cancer will reoccur in the next 10 years. The average person has a 8-10% chance of getting breast cancer. Easy peasy. Gimme my chemo cocktails.

I had my first chemotherapy treatment 3.5 weeks after my surgery, on September 26. I am scheduled to have six treatments, three weeks apart:




  • Monday, September 26 (COMPLETE)
  • Monday, October 17 (COMPLETE)
  • Monday, November 7 (COMPLETE)
  • Monday, November 28 (COMPLETE)
  • Monday, December 19 (COMPLETE)
  • Monday, January 9 10 (COMPLETE)
My chemo cocktail, or regimen, consists of:
  1. Dexomethasone  - steroid that treats the side effects of potential nausea, taken orally for 3 days, starting one day prior to chemo
  2. Emend - steroid that treats the side effects of potential nausea that may occur 24 hours after chemotherapy, given IV thru my port, takes ~20 minutes to administer 
  3. Aloxi - anti-nausea medication that treats the side effects of potential nausea that may occur up to 5 days after treatment, takes 5 minutes to administer. 
  4. Dexamethasone- steroid that treats the side effects of potential nausea that may occur 2-7 days after chemotherapy, given IV thru my port, takes ~30 minutes to administer 
  5. Adriamycin - called the "red devil", weakens or destroys breast cancer cells, given by push IV thru my port, takes ~15 to administer, can cause mouth sores, so I suck on ice or popsicles during this infusion to constrict the blood vessels in my mouth, with the hope it will prevent mouth sores.
  6. Cytoxan - reduces risk of cancer recurrence, given by IV drip thru my port, takes ~1 hour to administer. 
  7. Wait one hour between infusions.
  8. Taxotere - interferes with cancer cells dividing (growing), given by IV drip thru my port, takes ~1 hour to administer
  9. Neulasta - stimulates white blood cell growth, injection in my upper arm, given 24 hours after chemotherapy is done
When I arrive for treatment, they do labs to check my white blood cell counts, platelets, etc. Then I meet with the Nurse Practitioner, every other time with the oncologist, to review any issues with the last treatment, discuss any questions, and have a check-up. Then I start chemo. During chemo, they have an on site massage therapist. I schedule my time with her during the one hour wait period mentioned above.

There are so many more details I could include here, but this is the jist of my treatment.

As far as side effects, so far...
  • I lose my taste buds the morning after, lasts 4-6 days; new after the third treatment, lasts 2-3 weeks
  • Starting same day, I either have diarrhea or constipation (lovely!), lasts 5-7 days; new after the third treatment, we figured out if I start taking stool softeners three days prior to treatment, for one week, this side effect goes away
  • By the day after, I crave certain foods, have indigestion, and eat constantly, lasts 4-6 days - for those of you who have been pregnant, it is very much like that
  • Two days after I have extreme flu-like symptoms, headache, all over body ache, chills, lasts one day
  • Follow that day with same flu-like symptoms, but not as bad, lasts one day
  • New after the third treatment was nausea that doesn't go away
  • New after the fourth treatment was extreme discomfort and inability to focus, feels as if my brain is not firing signals correctly to my body and it is very hard to move, lasts 4-5 days 
  • My finger and toe nails get very soft and buttery, after about two days, lasts 10-12 days
  • Major bone areas ache due to Neulasta shot 2-3 days after the injection (#9 above), because the white blood cells grow in your bone marrow, lasts 2-3 days
  • General fatigue, lasts 2 weeks; new after the fourth treatment, fatigue doesn't go away 
All in all, this is not bad. It's not a party, but it is something I can manage. If all goes as scheduled, I will have my last chemotherapy treatment on January 9, and be cleared for surgery after February 8. At that time, I will schedule my secondary breast reconstruction surgery to remove the expanders and place the implants. I will also schedule my hysterectomy (oh yeah, remember that?!), and possibly, my foot surgery. Lordy.

Quote for today:
"Instead of looking at it like chemotherapy with a little bit of life, try to think of it as LIFE, with a little bit of chemotherapy." ~ Dale March, co-worker, mentor

I try. I really do. But it is very difficult sometimes for me. Because no matter what I do... no matter how much progress I make at work... no matter how much fun I have with my friends... no matter how much quality time I get with my family and John... no matter how hard or long I cuddle with the kids... when it is time for chemotherapy, I HAVE to go there. ~ Gwen

Philippians 4:13
I can do all this through Him who gives me strength.

Strong Enough, by Matthew West

Thinking about the words that Matthew West chose for this song, I know I am not at rock bottom. But I know I am weak right now. I am not giving up, and I know I don't have to be strong enough. I just need my God to be strong enough... for both of us... right now. ~ Gwen