Some of you may be familiar with the diary I wrote in February after my cancer came back. I've been thinking about and planning to write another one, but first I was too sick to write as the result of treatments, and then I went back to work to finish up the semester before retiring, and I was too busy.
I've had a lot of people ask me questions about chemotherapy and radiation, and I've realized that if you or your close friends or relatives haven't had any, you may not really understand what they are. In addition, every cancer is different, and what is done for one kind of cancer is not necessarily done for another kind. With that in mind, follow me below the fold:
My first cancer diagnosis resulted in six weeks of combined chemotherapy and radiation for cervical cancer, and two sessions in the hospital for internal radiation. A year later I had a PET scan (an imaging test that can show if you have cancer, and where it is located) and although the news about the initial place was "good" (no more cancer there), apparently a cancer cell had escaped the treatments and traveled north, and now I had cancer in a new spot, in a para-aortic lymph node. So back to the drawing board, and back to the radiation and chemotherapy.
Getting a Port
As an aside, I have to tell you that I have very shy veins. They don't like to stand out like those of some lucky people I know. They are small, hard to find, and move around a lot. During the chemotherapy the first time, it sometimes took three nurses and five sticks to find a vein that would work. (Each nurse is generally allowed two sticks and then has to go find another nurse to continue.) Sometimes I would have one on each arm, using heat pads, telling me to clench my fist, etc. I really really really didn't want to have a port (an implanted device that can be used to access veins.)
This time around, I felt I had to get one, and I had a Powerport implanted. I was very nervous about it, and didn't even realize it was put totally under the skin so it is difficult to see. Thanks to those who told me after my last diary to go ahead and do it. It was a good decision. I must tell you, however, that sometimes even with the port, my veins don't want to give up any blood. Even after accessing a vein through the port, sometimes the nurses have difficulty seeing a blood draw which they need in order to proceed. They usually ask me to take a deep breath to see if that helps. The last time the deep breaths weren't working so well, so the nurse suggested standing up. Then she suggested moving my head from side to side. Finally, she told me to lift and wiggle my arms. So here I am in the chemo area, taking deep breaths, waving and wiggling my arms and moving my head from side to side and it worked! And the nurse told me I looked like I was doing a prayer dance to the blood gods. (I will do that dance every time if I have to!)
Radiation
I know that radiation can be different depending on the kind of cancer you have and the kind of treatment that is required. In my case, the radiation was every day, five days a week. The whole thing--set up and treatment--probably took ten minutes. The actual treatment was very quick.
During the treatment, they have to make sure you are positioned properly on the treatment table. To do this, they first make a mold. I am not sure of the material they use, but it is a powder mixed with a liquid that puffs up and then hardens, and matches the contours of your body. After that, they gave me a few tattoos (not the flower and hearts kind) so they would have something to line up. They also take x-rays to ensure they know how everything is lined up. Each day I would climb into the mold, and they would push and pull until I was lined up correctly and then proceed with the treatment. In my case, I was face down; however, some other people are face up. I know this because one of the other people in the waiting room once told me she had especially appreciated the clouds painted on the ceiling in one of the rooms. I said I didn't know about that, because I was always looking down. (The next time I looked up before I started, so I could see them.)
Radiation itself does not hurt, like an x-ray doesn't hurt, but there are various side effects depending on what kind of treatments you have. One of the side effects can be nausea, and another can be fatigue. Since I was having chemo at the same time, I never knew whether my fatigue and nausea were all from the chemo or from the radiation too. (The treatments for the particular kind of cancer I had were supposed to do better if they were done together; some people have one thing first, and then another.)
Chemotherapy
Chemotherapy also varies according to the kind of cancer you have. The first time I had it, I had chemotherapy with Cisplatin. Cisplatin does not cause you to lose your hair (I can't tell you how many people asked me if I was going to lose my hair--I asked the same question myself.). However, it does cause terrible nausea. I was lucky to have insurance (I have good insurance thank goodness) and had some expensive medications for nausea approved.
The second time, the doctor changed the chemotherapy to Gemzar and Carboplatin. He told me the nausea effects wouldn't be as bad, but I seem to be especially prone to that, and after the first week I got the same expensive medications. They helped, but not completely.
As DrLori said in her diary,
The funny thing about cancer is that it rarely makes you sick. In fact, after fifteen years of treatment, all of it talking to other cancer survivors, I've learned that most of the time you feel like you're the picture of health. That is, until chemo. Chemo is what makes you miserable. So does radiation.
So basically, you make yourself sick taking the treatments in the hopes that the cancer will disappear or at least be managed.
Side Effects
The side effects for cancer treatments vary with the kind of treatments and the individual. I can just tell you some of what happened to me. The treatments are cumulative, so in the beginning I had a "good" part of the week and a "bad" part of the week. I would feel my best on the day of my chemo, Monday in my case, when I had some heavy duty anti-nausea medication. As the week progressed, I would feel a little worse and worse until about Friday when I felt pretty bad. Then it would start to get a little better and better until the following Monday. That worked for the first four weeks, but then the last two weeks were really terrible. I didn't have any of the "good" parts of the week, and I spent most of my time eating and drinking liquids (because I had to, not because I wanted to), sleeping, and actually reading this website. (You'll find, however, that my comment posting disappeared and I lost TU status at that time.) The worst thing of all was that I lost my sense of humor. When that happens, I know I am in sad shape.
Finally, the treatments stopped, I stayed home another week and then I went back to work. That was about four weeks ago and I'm really feeling pretty good now, although I think that I am at about 85% of what normal used to be. It is probably the "new normal" now. I don't know if the latest treatments were successful or not, and I have some more chemotherapy sessions scheduled for the middle of June.
I'd be happy to answer any questions anyone has. Just remember my experiences will be different from anyone else's because the treatments and the body's reactions vary.