Alison's Breast Cancer Diary
Feelings after diagnosis, surgery, and chemo-therapy

30 March - 4th chemo session
After today I 'll only have two more sessions.  I 'm so looking forward to the end of this.  The last time I went in for chemo the doctor said she would book me in for overnight for the next session.  When I reported how well I felt, on the Saturday, we agreed I wouldn't stay overnight.  They gave me a bed to lie on while I took the chemo.  They also give relaxing drugs so the day is reasonably peaceful.  I arrived at 9:10 a.m.  Talked with the Oncologist at 9:30 .am. to discuss how I found the last session, what drug improvements could be made.  She also mentioned the bone scan I had the previous week.  She said the contrasts between bone and dye were difficult to read.  She said there were a couple of doubtful parts in the bone that should be investigated. One section was in my ribs and the other in my spine. 

Yes, when you are told things like this of course you can feel a little concerned.  I wanted to be told that everything was fine just as I wanted to be told this when I had my mammogram. I really don't want to learn that I have cancer in my bones.  It should be unlikely, in my opinion, that this would be the case because I had no lymph node involvement.  The lurking concern is that the tumour was very large and had created it's own vascular system.

The oncologist said that since I had had a bout of mastitis in my breast that week the infection may have been showing up rather than cancer.  The back- well we 'll see.  She has now requested that I have a body scan.  There is no point in worrying about these tests until we have the results. 

My liver function tests are always abnormally high and she arranged to have me tested for Hepatitis, A, B, and C.  I mentioned that when I had my ectopic pregnancy I was given a blood transfusion in 1991 which turned out to be the same time the our Government had chosen not to test for Hep. C due to the cost.  I wrote to our the Prime Minister Jenny Shipley and she assured me that I would have been informed of having contracted Hep. C had there been a risk.  We will see.

It took two attempts by the nurse to find a vein to insert a catheter into my hand to receive  the chemo.  Every time the needle goes in it hurts.  They don't just push it into a vein they go hunting for one under the skin.  Have I mentioned before that I 'm a big woos?  I don't like needles and I don't like pain.  The nurse called the doctor who managed to find a vein.  It still hurt and stayed hurting for the next few hours but only moderately.

The treatment starts by administering a litre of saline solution via the drip.  This is to dilute the potency of the chemo, to protect the organs.  While I was having this I could walk around, several times for a trip to the toilet.  I went and sat with Fiona.  She introduced herself to me while we were going to the Blood and Cancer Centre.  She recognised me because of our car number plate Lyfords.  Fiona has Myeloid Leukaemia.  She will be having treatment to knock off the blood cells in her bone marrow and will then have a stem cell transfer from someone who is a donor.  This person will come from a donor list.  It is a dangerous procedure because she will not have an immune system once her while blood cells have been knocked out.  She was having a blood transfusion to bring her energy levels up.  She has completed several Iron Man competitions and used to be full of energy.  Understandably she is a bit disappointed about having Leukaemia.  She felt the same way that we all do when we get cancer - I 'm healthy and happy - can't a sick person get it?

Non malignant cancer is a friendly easy to get rid of sort.  I only understand a little about breast and bowel cancer.  Grade one breast cancers can be fatal grade three cancers are faster growing and can be survivable.  There are so many variables.  We just need to get on with our lives and think positively.  There is no point is worrying about things over which we have no control.

Fiona and I talked about being heroic and stoic as others say we are and agreed that we have no choice.  It's a matter of getting on with the treatment or dying.  We also reckon that women probably handle the treatment better than men.  Sorry reader if you are having cancer treatment and are a male.  It's just that I remember my darling husband suffering from a bad bout of gout and having the flu at the same time on a ski holiday.  He lay in the motel bedroom in a very miserable state and said in total dismay that he thought he must have blood poisoning.  His dear little petal had twisted her knee and was told to keep it elevated.....Who looked after the child, prepared the meals and was general nurse maid to the invalid? Hmmmm if the bloke had twisted his knee the way I had twisted mine he would have been plonked in front of a TV watching rubbish and I would have been pampering him.  What can a woman do?

With the second chemo cycle I decided early on that the anti nausea medication wasn't working and I went cold turkey.  It took about 14 days to start to come out of my state of misery.  New drugs were prescribed and I took them as required for the third cycle.  I was pretty good until the Tuesday after the chemo then I became exhausted, had to lie down in the office and I was very weepy.  My exhaustion came and went as did the tears.

The nurse on Friday immediately said that the steroids stopped on Monday and my collapse in stamina would have been related to those drugs stopping.  Can't keep taking steroids the whole time though.  Crikey they make you hungry.  The Oncologist said you do put on weight while having the treatment.  Humbug.  Partly it's due to an increased appetite and partly due to fluid retention.

Every time I go in for chemo I am weighed.  This time the nurse declared joyfully that I was the same weight as the last time.  Great! Yes really great until I said that time time I wasn't wearing my prosthesis which weighs 800 grams.  I can't keep on eating with abandon as I have been so I am planning to eat carefully based on Weight Watchers.  The key is to find the time to work out what we will eat, purchase the required foods and then prepare them.  It takes a lot longer - but it's necessary.  I want to be thin - impossible says my loving husband.  You have to accept who you are.

After I received the saline I proceeded to my bed and waited, it was about 11:45 a.m. by then.  The lovely nurse administered the first three 60 mls of Doxobrubicn via injection into the vein.  It's red.  For the next day when I peed my urine was read.  After the red chemo they give me the other one, Cyclophosphamide  which is administered via a one litre drip and after this I have another one litre of fluid via the drip.  By the time the job had been completed it was 3:00 p.m.

Richard collected me and we went to the pharmacy to stock up on a range of medication.  We were home by 5:30 p.m.  It had been 26 degrees during the day but I saw none of it.  Not complaining.  My chemo day was over.  Two more to go - Oh - I 'm so looking forward to the end of it all.

Drugs
The pills I take now are many.  When I was first diagnosed with blood high pressure I tried for several years to reduce it by diet and exercise.  Eventually I had to start taking pills and when the combination for three medications came right the blood pressure settled down to a respectable level.  Today I take the following drugs:

For blood pressure Candesartan, the strength of this has been doubled since my Mastectomy.  Felodopine the strength of which has been trebled since the Mastectomy.  I think breast cancer is stressful.  In addition to these two pills I take Bendrofluazide which is a mild diuretic.

For chemo I take Doxorubicin also called Adriamycin.  Common side effects are susceptibility to infection due to low white blood cell count.  You know you have infection when your temperature is more the 38 degrees.  You can also get colds, sore throats, and urine infections.  I have suffered from the latter but not too badly.  Hair loss is also a side effect.

Chemotherapy may rarely be associated with delayed effects such as secondary cancers and memory problems.

Doxirubicin slows or stops the growth of cancer cells.

The other drug I receive of chemo day is called Cyclophosphamide.    The drug also slows or stops the growth of cancer cells.  Cyclohphosphamide is a clear liquid that is given via infusion, a drip into the vein.  This drug can damage the kidneys which is why we are given lots of fluids into our veins.  We are told to drink lots of fluids to protect our kidneys.

Side effects are as for Doxorubicin along with bleeding or bruising cased by low platelet counts, difficult or frequent urinations, blood in the urine, increased sensitivity, ulcers inside the mouth.

But wait there's more:  less common side effects are darkening of skin and finger nails, nasal stuffiness, running eyes, sneezing, abdominal pain, fast or irregular heart beat, shortness of breath and or chest pain.

Fertility is definitely affected.  I believe I have been accelerated into being a post menopausal woman.  I 'm not too upset about that - my time was coming.  I 'm hot flushing all the time.  My head becomes sweaty and clammy.  I've heard that some women get intolerable hot flushes so far I think they are just rather amusing.

Based on the above two drugs I am referred to being on A/C chemo treatment which is short for Adriamycin/Cyclophosphamide.  This form of chemo results in moderate to severe side effects and nausea.  Other chemo treatments do not make the patient feel so nauseous.  There are many different sorts of breast cancer and many different sorts of treatment.  Breast cancer is only one form of cancer.  All the other cancers, bowel, liver, Leukemia, bone and other have different treatments and different side effects.

When I went to the supermarket today I read one of those No Idea magazines while waiting in the checkout.  It mentioned a man who was getting over the grief of the loss his wife after an eight year battle with breast cancer.  At vulnerable time such as today when I feel tired and nauseated this is not encouraging reading.  I need to focus on the positive and remind myself that all cancers are different and we all have different bodies that respond differently to treatment.  Ultimately I always conclude that I can only accept with grace the adversity I am given and live each day with joy.  There is absolutely no point in worrying about possibilities.

Now, back to the drugs.  A/C has horrible side effects that I have already mentioned so I am given the steroids Dexamethasone (two tablets once daily)  and Tropisitron once daily. I take these pills until day five.  During this time and until I think the side effects have eased off to a manageable level I take Domperidom, 2 pills at a time up to four times per day and at night time Nozinan and Lorazapam.  This one is like a relaxant, sleeping, anti anxiety, and anti nausea pill rolled into one.  For my third cycle at day five I stopped taking Lorazapam and for the next two nights didn't sleep.  This time I will reduce the drug by half for a few more nights.

But wait, there's more.  I was getting heart burn because the chemo can hurt the lining of the stomach and I was having 'reflux' which is like vomiting into my mouth.  I am supposed to take Comerprazole (Losec) all the time for this but given I don't have a problem can't see the the point (uh oh - I 'm self medicating)  Along with Comerprazole I am supposed to take Mylanta which is a tasty little antacid I can purchase over the counter.

Then we come on to the vitamins.  I am not taking anti-oxidants at the moment because there is a rumour from the Cancer Society that these can interfere with the chemo.  I am taking selenium, vitamin C, women's multi vitamin, dissected liver, liver pills, flax oil for Omega 1 & 2.  Who needs to make dinner with all of this?

Prescriptions from my GP cost $3 each.  The A/C steroids are prescribed by specialists and cost $15 per prescription.  My firm pays hundreds of thousands of dollars in tax every year and it's nice to see a little of this tax money subsidising the cost of my medication.  I sure will be glad to 'get back to normal by the end of May, but I am told it can take 4-6 months for my hair to grow back '.

Useful websites
www.cancerhelp.org.uk 

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