On Chemo

I have just completed my second round of palliative chemo. People keep asking me if I’m happy about that, as most patients celebrate completion of chemo as the first step to wellness, especially when they finish with no evidence of disease (NED). At my former hospital, a bell (thanks to The Bell Fund, which also provides comfort kits to chemo patients) is rung in celebration of the end of each patient’s final cycle.

Things are different for me. This chemo has kept me stable since the beginning of this year, but there is no telling how my tumours, which are still there in my belly, will respond without chemo to keep them at bay. They may go straight back to rampant growth, and I could be seriously ill again in no time, as I was in December. Or if I’m really lucky again, my disease won’t progress for a few months, like after my first chemo regimen, and I’ll have a nice spring and bit of summer. At this point, I have no idea which it will be, or if there are other possibilities. So it is hard to be excited about this chemo being over.

It is also impossible to plan. All I can do is remind myself that I have today and make the most of that gift!

00009img_00009_burst201804140716466412336604299247132.jpg

Me and my snuggly cat Piggy, almost ready for the day.

Now that I’m on the topic of chemo, I have a few other things I’ve been meaning to share. I sometimes hear of people, when newly diagnosed with cancer, refusing to try chemotherapy in fear of the side effects. I used to be pretty negative about chemo myself, especially for palliative patients. Some cancers simply don’t respond well to any of the chemicals currently in use, and there is little point in pursuing such treatments, especially when they are so toxic. I’ve read of so many patients who, desperate not to die yet diagnosed with terminal, untreatable cancer, would try anything to prolong their lives. They often end up making themselves sicker and weaker with ineffective or trial chemo than they would have been from their cancer symptoms alone—and even thus hasten their deaths. Such cases are discussed in books by physicians like Atul Gawande’s Being Mortal and Sherwin B. Nuland’s How We Die (both excellent books). When I was first diagnosed, my initial position was to not do chemo, since the chances of just partial success were so low, but I changed my mind and am glad I did both times. I would almost certainly be dead already without it. Instead, I have enjoyed considerable wellness, even in the thick of the chemo treatments.

chemo warning

There is an important difference between curative chemo and palliative chemo. Curative chemo is the kind that can actually make cancer go away completely and even permanently, which is a miraculous thing. Sometimes it works very effectively and even immediately. Sometimes it’s a little more hit or miss. This all depends on the kind of cancer and the specific chemo regimen it is matched with.

Palliative chemo, while it may follow the same protocol as curative chemo, is simply meant to extend the life of the terminal cancer patient by slowing or halting the growth or spread of the disease for a time. At its best, it also relieves some cancer symptoms, as it has for me. Some terminal cancers are not treatable even by palliative chemo, though sometimes people try anyway.

There are many different chemicals used for chemotherapy, and as one patient next to me in the treatment room noted, they have some very fancy names:

  • Gemcitabine
  • Docetaxel
  • Doxorubicin
  • Carboplatin
  • Vinblastine

to name just a few. (I’m on the first two.) They each also have their own potential side effects. Not all of them, for instance, produce baldness, that hallmark of chemo. Nor do they all lead to vomiting or mouth sores. Most of us imagine people desperately hunched over toilets, puking their guts out after chemo. It isn’t always like that anymore. In fact, chemotherapy’s reputation for producing debilitating illness is no longer accurate since advances in research have fine-tuned treatment protocols to minimum effective doses. Many people are able to continue to go to work throughout their treatment or to continue their regular routines with only minor modifications. I have witnessed some women showing up to the chemo chair as if to an appointment at the beauty salon before a fancy lunch date—they look fabulous!

Physically, I have handled these months of chemo very well. With two treatments in a three-week cycle, I usually have a few days of fatigue when I take some long naps, and maybe a day or two of slight nausea that is treatable with very effective anti-nausea medication. Then after a few days I usually feel as well and energetic as normal (thanks to other medications for pain that I take every day). As far as effects that impact my everyday life and wellness, that’s about it. I’ve often noted that my days post-chemo are no worse than a mild hangover from a couple of glasses of wine.

Some chemo side effects:

Chemo_Effects_Pinterest_crop.jpg

Of course I’ve also experienced a range of the more visible side effects, including hair loss. And my fingernails did become discoloured and partially fall off (painlessly) last summer. This is something the medical professionals don’t like to mention—in fact in the literature I was given they only called it “nail changes”! The one that is bothering me the most now is the weight gain with “moon-face” from steroids (not chemo), which I don’t like because I don’t look like myself. And lately there’s also been a weird thing with my eyeballs, but never mind that.

All in all, I have felt much better on chemo than before it (when I was terribly weak with anemia caused by internal bleeding), so it’s been definitely worthwhile for me to pursue this treatment. If you happen to get cancer (and sadly, chances are about 1 in 3 that you will) there is no reason to say no to chemotherapy for fear of the side effects. They really aren’t necessarily that bad, and the therapy can be discontinued if they are (allergic reactions are one of the more serious problems). But if you’re taking palliative chemo that doesn’t work and is therefore making you sick for nothing, it would be wise to rethink that and come to terms with death.

poison

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About susanbriscoe

English teacher, writer
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12 Responses to On Chemo

  1. Perpetua says:

    Good to see Piggy keeping you warm and fuzzy..

    Liked by 2 people

  2. graphicgrub says:

    That was an interesting read. The only problem is, of course, that one does not know if it will work. It is good that it has worked for you. Wishing you good days!

    Liked by 2 people

  3. Hope you enjoy the summer. I used to have a cat, called Ian, with the exact same face. I’m sure your Piggy helps you relax. Cats are such experts in the art of resting.

    Liked by 2 people

  4. Elly Jackson says:

    In this post, Susan, you have given an intimate, and dispassionate description of a subject in all of its depths that seeks nothing more than raw and simple truth. Atul Gawande would love reading this, as you have a gift for living and for writing. I don’t know the right word for the opposite of self-serving, but I will say other-serving. Thank you.

    Liked by 4 people

  5. Susan, you have provided so much insight into why palliative chemo can be an option. I can’t just “like” your posts because they affect me deeply. I wish you sunshine and happy, pain-free moments as we move from Spring to Summer. Counting my blessings.

    Liked by 4 people

  6. christi72013 says:

    Thanks for sharing Susan. Helps me to know how your day to day experiences are going. Sorry for the delay in responding to your post. Would love to speak to you soon, if possible. Hugs and lots of love. 💐
    Peace and love Chrissie

    Liked by 1 person

  7. Renee says:

    You made me count my blessings on days when I’m too focused on trivial things in life. Reading your posts always brings me back to track and gives me insights on thoughts of a cancer patient so now I can better understand how my mom felt when she went through all these. Thank you so much for sharing.

    Liked by 1 person

  8. Shiner says:

    So odd to think that I’m on palliative chemo. I never really thought about it before reading this. You’ve done a great service with this post, Susan. Xo

    Liked by 2 people

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