My Chemotherapy and Radiation

My first visit with my oncologist involved a long discussion regarding the type of cancer I had (HER2) and the type of treatment that is the Standard of Care set by the medical profession for my type of cancer. My oncologist encouraged questions and was extremely patient with my need to know what were choices and what were not (of course, everything is a choice, but I wanted to do everything possible to increase my odds for a healthy life). He explained that I would require 6 months of chemotherapy (eight treatments three weeks apart). I would require an out-patient surgery to implant a port in my chest. The port is a disc about 1-1 1/2 inches in diameter. It has a long and hollow tube, known as a catheter. The tip of the catheter lies in a large vein just above your heart. The other end connects with the port, which sits under the skin on your upper chest (sometimes they are placed in the arm). You can see and feel a small bump underneath your skin. With a port it is not necessary to have needles put into the veins in your arms every time you have a treatment.

The first four treatments would be with Adriamycin (this is the toxic drug that causes hair loss) and Cytoxan. My doctor explained that the hair loss would begin before the second treatment, so I should decide on a wig and should have it ready for use between the second and third treatment. I did some research on wigs and found that synthetic wigs are very susceptible to heat (such as bending into the oven to remove a dish, they can singe a bit), but many women prefer to buy a few different synthetic wigs in different colors and styles to change it up a little. But, I enjoy cooking and I wanted to look as much like myself as possible. With my husband’s urging not to worry about the cost, I chose a human hair wig. I always have short hair which is a dirty blond with lighter blond highlights. I selected a wig salon that only works with cancer patients and my stylist and I selected three different swatches of hair color and the basic length. She also suggested that I buzz cut my hair into a stylish boyish cut prior to the start of heavy hair loss, so it would not be quite so drastic for me. I followed her advice and everyone, including those that did not know about my cancer diagnosis, loved the look on me. When my wig came in, my stylist placed it on my head and styled into my normal hair style. If you didn’t know that I was wearing a wig, you would not have known. Losing one’s hair is not easy to deal with and the first time you run your hand through your hair and come out with a handful, it is one of those gut clenching traumatic moments. A sense of sadness can be overwhelming. However, it is good to remember that hair is a fast growing cell and so are cancer cells. It is the chemo’s job to kill those cells, so think of it in terms of success.

Of course, chemo can’t tell the difference between cancer cells and healthy cells, so with chemo therapy you and your doctor begin a very important “balancing act” to keep you “healthy” while your treatment is working. You require close monitoring of your red and white blood cells and platelet count, etc. To increase your red blood count (red blood cells carry oxygen throughout your body) a shot of Procrit is required a few days after treatment. An injection of Neulasta is given to increase your white blood count. It is your white blood cells that fight infection in your body. The Neulasta does have side effects. The main problem is bone pain, but that can be helped with pain killers.

The last four weeks I took an infusion of Taxotere. My doctor explained that most doctors were giving infusions of Taxol at the time, but that the long term effect with Taxol is often neuropathy, a numbing of the feet and hands. He thought that I would have the same benefits with Taxotere, but less of a chance of long term neuropathy following treatment. I decided on the Taxotere. I was hoping to return to as normal a life as possible following my treatment. My doctor explained that I would need to contact my surgeon and schedule a day surgery to have the port inserted in my chest in which they would administer the chemo treatments. Not only does the port eliminate constant pricking of your veins, it is also unwise to use your veins as you would with a normal IV. The chemicals are so toxic that they can cause damage if a vein should be missed during infusion and veins that are used often for treatment can collapse after repeated usage and make treatment much more difficult.

As I stated earlier, I used “every weapon in my arsenal” to feel as well as possible during treatment and to minimize any long term effects of treatment. I believe that a monthly massage not only feels wonderful, but aids in blood circulation and relaxation. Prayer, meditation, positive visualization, gentle yoga, acupuncture, and journaling all contributed to the healing of my mind and my body. More details on each are available in other blog posts.

My last day of chemotherapy was in June, my first day of radiation on July 25th.  There were three preparation visits requiring a physical, a CAT scan, a permanent blue dot tatoo on chest for correct “placement” of radiation.  There was also a “dry run” so I would have a better idea of what to expect.

The radiation went well.  I did not experience any nausea or debilitating fatigue (had radiation every week-day morning prior to going to work; did not require any sick days).  I only experienced some very mild pinkness and slight rash in a small concentrated area.  I used only aloe gel on my breast at the advice of my radiologist.  I had a total of thirty-three treatments.

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