What’s Treatment Like: Chemo

I have gotten lots of questions about the treatment I’m getting for The Cancer. So, let me explain how it’s working.

First off, I’ve gotten chemotherapy. Lots of women with breast cancer have a mastectomy or lumpectomy first, and then chemo, and then radiation. Not so when you’re stage IV–we gotta treat the tumors everywhere in my body, not just the breast. So, I get chemo first, and other treatment later. Because my flavor of cancer has neuroendocrine features (I have no idea what that means except it’s rare, especially in the breast), I’m not getting the most common breast regimen. Instead, they have me on cisplatin and etoposide, which my doctor says is an extremely tough regimen.

What does that look like when we say ” an extremely tough regimen”? Well, here is how a 21-day chemo cycle looks for me. Day 1, a Wednesday: I go to my doctor’s office and plop down in a recliner. They access my portacath (or port for short) with a IV thingy, and start pumping me up with fluids, because cisplatin will ruin your kidneys if you don’t flush them before and after treatment. So, after the fluids, they give me some killer antinausea meds, including a steroid called dexamethasone that can cause perianal burning unless they give it to me slowly. I also get a nausea med called Emend, and finally, my good buddy lorazepam. Then they give me the cisplatin.

By this time it’s about lunch time, so The Hubs (who comes to all my treatments) runs out to grab us lunch. I usually am only hungry for half of it, because round about that time, by body says “Aaaaannnnnd I’m spent” and I fall asleep in the recliner with my nice handmade quilt and my comfy neck pillow that smells like Christmas. (Yay for cancer gifts!) I wake up when they switch me to the etoposide, and usually I get up to go pee sometime in there a time or two, wheeling my IV stand along with me. Then it’s back to snoozeville until the next bag change, an IV of fluids again (must flush those kidneys!), and then eventually they unplug me and send me home, where I sleep some more. By this point, I’ve been there all day.

That’s day 1. Day 2 and 3 are just etoposide, so no kidney-flushing fluids, and no emend. Just the anal burning steroids (that thankfully have not yet caused any anal burning) and the lorazepam. So, it’s a much shorter day, just a couple of hours, but I usually nap anyway, because dude, living with chemo drugs in your body is EXHAUSTING. Like, I thought I was tired when I was pregnant, ha! Hahaha! This is way more so. I never slept 18 hours a day when pregnant.

As for the nausea, man, I am on so many nausea drugs, it really isn’t that bad, as long as I take them. One day this cycle, I waited to take one because I knew I’d be getting that one at chemo time that afternoon, and that was stupid. I will not make that mistake again. I haven’t puked yet but my appetite is definitely off. Like, when I was pregnant, the smell of certain foods would make me queasy, and that’s happening now too. I also get halfway through a meal and just don’t want any more.

I said it’s a 21 day cycle, right, and I described days 1-3. Then what? Well, day 4 and 5 (the weekend) I’m still pretty tired and still really need the nausea meds. Day 6 and 7 I start to have a teeny bit more energy and usually by day 8 or 9 or 10 I feel mostly human again. Tired, but not, like, can’t get out of bed tired, can’t concentrate tired. Just worn out, like after having the flu.

So, usually by day 12, I’m back at work, trying to catch up on everything I missed while I was away. Although, I end up with so many doctor appointments, it can be hard to actually have time to go to work. Having cancer is like having a second job, frankly.

Now, in terms of longer term treatment, my doctor plans 4 cycles of this chemo regimen, and then we see what happens. I’ve been through 3 so far. After the fourth one, we see what the tumors look like, and come up with a next step. Because I am young, and otherwise healthy, and the chemo seems to be shrinking the primary tumor quite nicely, I may end up being a candidate for surgery, or I may have more chemo first, or I may have hormone therapy, or all of the above. To say the plans are up in the air at this point would be a gross understatement, but my doctor is talking to other doctors and we hope to have a more solid plan sometime soon…ish.

Stay tuned for my next installment: radiation therapy!