Sunday, 21 September 2014

What chemo is and what it's doing to me

First of all, how does chemotherapy work?

For anyone who doesn't know how chemotherapy works (I didn't really, up until recently) here's a summary. I've taken information from the Cancer Research UK website.

Your body is made up of billions of individual cells. Body tissues grow by increasing the number of cells that make them up. The cells reproduce themselves exactly. One cell doubles by dividing into two. Two cells become four and so on.

This happens very fast between conception and adulthood. But once we are grown up, most cells only reproduce in order to replace others that have died, for example through injury or illness. Some cells carry on reproducing. These include hair cells, cells in the gut and cells that make blood in the bone marrow.

Chemotherapy kills cells that are in the process of splitting into 2 new cells. Chemotherapy drugs circulate all round the body in the bloodstream. They can reach cancer cells almost anywhere in the body. Because cancer cells divide much more often than most normal cells, they are more likely to be killed by chemotherapy.

Some chemotherapy drugs kill dividing cells by damaging the part of the cell's control centre that makes it divide. Other drugs interrupt chemical processes involved in cell division. You may have a combination of different chemotherapy drugs. The combination will include chemotherapy drugs that damage cells at different stages in the process of cell division. So, with more than one type of drug, there is more chance of killing more cells. (I'm having two types of chemo - the first 3 or 4 blasts are a combination of 3 drugs (FEC), then I'll be having 3 or 4 blasts of a different drug (Taxotere).)

Chemotherapy causes side effects because it affects healthy body tissues where the cells are constantly growing and dividing. The skin, bone marrow, hair follicles and lining of the digestive system are examples of cells that are constantly growing and dividing. But, unlike cancer cells, normal cells can replace or repair the healthy cells that are damaged by chemotherapy. So the damage to healthy cells doesn't usually last. Most side effects disappear once your treatment is over, and some only happen during the days while you are actually having the drugs, for example, sickness.

What's the chemo been doing to me (so far)?

Today is Day 12 of my second cycle of FEC (and 33 days after my first blast of FEC).

Last Monday night, 5 days after Chemo #2 I indulged myself in a big moan about not feeling well and not feeling happy. My friends were quick to respond with bucket loads of kindness and sympathy. Some asked more about what it's like being ill from chemo - then I felt like a bit of a drama queen for moaning, because ultimately, I felt less ill than I do when I've got a cold. It's a weird kind of ill and the first time I've experienced anything like it. Aside from the sore scalp/follicles "complaining", I think this is a full list of the side effects I was experiencing at the time of my moan:
  • I had swollen glands.
  • I was aware my heart was beating. It wasn't pounding, it wasn't fluttering, it wasn't beating irregularly, it wasn't painful. I was just constantly aware that my heart was beating, when I'm not normally.
  • I was aware my lungs were breathing. It wasn't painful, it wasn't laboured, I wasn't breathless. I was just constantly aware that I was breathing, when I'm not normally.
  • I was aware of my whole body, because it was sore. I was trying to work out whether it was skin or muscle, but I've come to the conclusion it was my veins (your veins do suffer from transporting the poison that is chemo around your body).
The doctors advise you to listen to what your body is telling you. I felt like mine was telling me it was using all the energy it had to mend what the chemo had damaged, and to stay in bed and just let it get on with that. So I did. And after a few days, I felt better.

To date, I think I've been pretty lucky when it comes to chemo side effects. Through the YBCN (Younger Breast Cancer Network) I've made friends with and got to know a lot of women roughly my age who are going through chemo at the same time as me. I hear about the side effects they are dealing with and have been waiting for them all to hit me but so far I seem be one of those that is getting off lightly. In addition to what I mentioned above, I think this is my complete list of side effects to date:
  • Some tiredness in the week after each chemo. There's also times I've felt a bit spaced out in the days after chemo but I think that's actually a side effect of the steroids, rather than the chemo itself.
  • My hair has thinned a lot, and I am developing an attractive old man bald patch on top of my head. (My early nightmares were of me turning in to George Dawes or Gollum. I now know Friar Tuck is more likely.) It doesn't feel like it, but 33 days in to chemo, this is actually a bit of a cold cap success story. I'll soon be at the point where you'll definitely only see me in public with the wig on, but there's a good chance a load of my own hair will still be tucked away under there. Because if it stays as it is (too thinned out for me to be happy with it, but still plenty of hair there) then I am going to stick it out and not shave my head. It would mean as soon as chemo is done and hair starts growing again I will be able to get back to "normal" much more quickly. Filling out patchy bits enough for them to not be noticeable is much quicker than growing an entire new head of hair that's long enough to do anything with from scratch. Anyway, we'll see what happens (there's still plenty of time for another mass shedding leaving me with no option other than to go skinhead).
  • After both chemos I have had some patches of rough gums for a few days. But they haven't been sore or anything. I just noticed they were a bit rough. Like after you've burned the roof of your mouth on pizza (without the pain).
  • The gum above one tooth receded a bit after chemo #1 but so far doesn't seem to have gotten any worse.
  • There was the extreme vomiting the night of chemo #1 but a different anti-sickness drug given to me for chemo #2 stopped that happening again. I just felt a but sick later on that night (so I went to bed, slept, and was fine the next day).
  • I had one very minor nosebleed after chemo #1.
  • One of the veins in my left arm is hard and sore. You can see it sticking up through my skin. Sore, hard veins in your hand/arm seems to affect everyone that has chemo. It's no wonder - the entire dose of chemo goes through them before spreading out to the rest of the body. But, while it's sore at the moment, I can't say it's a massive issue or intolerable.
  • I'm absolutely going to blame any times where I have been an overreacting stresshead on the chemo too.
I think that's it. The massive bag of lotions, potions, and pills I bought in Boots remains intact. My card for free prescriptions remains unused.

I am hoping I'm now all set to be well until chemo #3 in ten days time (as long as I don't pick up any coughs or colds from anyone in that time). Fingers crossed!

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