Chemotherapy isn't exactly fun - no, it's quite boring! But it's, unfortunately, a necessary part of some people's lives and it can be pretty scary. So, this journal goes out to anyone who has just been told they'll be needing chemotherapy, or for anyone simply interested in the process - hopefully this will put your mind at ease and show you what it's like to get a simple round of R-CHOP chemotherapy.
First of all, you get your blood taken to make sure you are fit to undergo chemotherapy - this can be done the day before in the doctor's office, or on the same day as your chemotherapy in the chemo ward. Naturally, if they do it the day before, your chemo gets started quicker because they don't have to wait for the results on the day. However, I get my chemotherapy on a Friday - Thursday is the chemo day in Laurel House, so I avoid most of the people and I get seen to a bit quicker. This is just my experience.
You're taken into the room and placed in a comfortable chair, or it's done in your hospital room, someone comes to put your cannula in - which is basically where an IV goes. It's a plastic needle in your arm, and you get your chemotherapy through there. Generally they don't like to put it in the bend of your arm, but they will if they have to. This part is common practice for anyone undergoing chemotherapy so you all probably know, it's not very painful at all. Or, you might have a PICC line in - I'll be getting my first PICC line next month - which means you can skip the cannula and such, as all your blood tests can be taken from the PICC and all your chemotherapy can be given through the PICC. This is a dream come true if you don't like needles - and if, like me, your veins are horrible, too! If you want to know more about what a PICC line is, Macmillan Cancer Support has some great resources on their website.
Now, there are different types of chemotherapy - I am talking in this post about R-CHOP. R-CHOP is made up of five drugs: Cyclophosphamide (C), Doxorubicin hydrochloride (H), Vincristine (O), and Prednisolone (P), as well as a monoclonal antibody named Rituximab (R).
(Bear in mind, please, that as I am only a patient, I don't have an extensive knowledge on the drugs used, their side effects, and so on. So please, any concerns, questions etc. should be directed to your oncology team and not me. I cannot/will not give any medical advice. Your doctors are here to help!)
First of all, you will either start with the CHOP part, or the R part. But before this you are given a few extra drugs such as anti-emetics and antihistamines and paracetamol. These are given through your cannula or orally so it's really no big deal, nothing to worry about. For your first treatment, it will most likely take the longest. This is because some people develop a reaction to the Rituximab - this is usually not severe. Your nurses will be keeping a close eye on you, so if you feel any adverse reactions you must tell them - they will get you sorted, even if that means slowing down the infusion a little bit.
I can't stress enough that it is important to voice your feelings, even if it seems insignificant. As I keep saying, your nurses and doctors and there to help you and only you know how you are feeling. Keep them informed at all times! You might feel like you're calling on them too often, but you are not. They are there to help and keep us safe, and it is always better to let someone know if you're feeling unwell.
You should be keeping your arm as straight and as still as possible during chemotherapy, but talk to your nurse about this. Some drugs can cause damage if they leak into your tissues - but this is very rare and, because your nurses will be keeping such a close eye on you, they will get your sorted out immediately if they feel there is an issue. This is a key reason why it is very important to mention how you're feeling - is your arm hurting where the cannula has been put in? Mention it. Anything abnormal in the slightest is worth mentioning.
You are then given the rest of the drugs through your cannula or PICC line - doxorubicin, I believe, is bright red. Something I wasn't told was that this turns your urine red for a short time after entering the body and that scared the life out me! I thought there was blood in my urine - so if nobody mentions to you, keep a note in the back of your mind: it's just the drug and it is a good sign that the medication is going round your body well.
Cyclophosphamide is my least favourite drug. I don't have reactions to any drug besides this one, and even then my reaction is a very common and very, very mild one: My nose feels hot. Weird, right? It feels like my sinuses and the back of my nose are hot/tingly. But as well as that, I get a bit... well, what word is there for woozy? It's not quite lightheadedness, but a kind of dizzy, cloudy-headedness. It's not terrible and goes away within five minutes - but when you have no reactions to anything else, naturally even a minor reaction means it's your least favourite. Nothing to worry about. It also gave me a burning sensation when I urinated and made my urination quite frequent but difficult - I was so scared, because I had never had this issue until my third cycle, but it passed within 24 hours, was not overly painful (just a normal burn-when-you-pee thing) and, after doing a bit of research, I knew it was the cyclophosphamide and not an infection of any sort. If you're concerned, though, talk to your medical team. They are much, much more reliable than any google search!
You are also given an infusion of saline (I think it's saline, anyway) to flush the chemicals through your body and finish up. The prednisolone, however, is taken for five days after your chemotherapy as an oral medication. The tablets are generally very small and are coated to prevent you tasting anything. They are extremely easy to take, and some advice I received from my nurses was this: If you're struggling to get them down (as there are alot of them - sixteen per day is my dose) put them on a spoonful of yoghurt. I only eat one or two types of yoghurt, but I love the stuff I do eat, so this was perfect for me. A spoonful of petit-filous completely masks the taste and it slips down easy.
R-CHOP is given in cycles that are usually about three weeks apart. I have six cycles, then we will re-assess what treatment needs to go further and so on. If anyone doesn't know, I thought I would share the news, however: As of Tuesday the 19th of July, 2016, I am officially HALFWAY through my entire course of chemotherapy! This is the reason I wrote this post, in particular - now I have some good experience, I feel confident enough to offer some advice on what to expect. Of course, chemotherapy is different for everyone, but it is much scarier sounding than it really is. You don't need to worry too much. I have always been petrified of the unknown; Still am! I'm a scaredy cat. So believe me, if I can tackle three cycles and not worry about the next three, you can do it. It's not scary at all, but if you're a bit nervous, bring a family member with you.
If your chemotherapy was done in a day unit, then you are pretty much free to go when you are feeling well - your tablets should be discussed with your chemotherapy nurse because generally there is alot to keep on top of. They are so helpful and talking about it really gets it straight in your head. And that, my friends, is the end of your chemotherapy - I really hope I'm not missing anything obvious! I tend to sleep during my chemotherapy or play on my phone or something to keep me entertained. I usually have a stash of sweets nearby and my family with me, so we all sit and chat or whatever we feel like.
Two of my chemotherapies have been given as an inpatient and one as an outpatient. This was because my first was given when I was originally diagnosed - my second, outpatient - and my third was given as I recovered from an infection and had not yet been released. I have experience with both and neither is worse than the other.
Something that scared me at the start was seeing the nurse all geared-up for chemothreapy - aprons, gloves, the works. This isn't something to be scared of and you don't need to worry about your own safety with this. It is simply due to the fact that chemotherapy can be harmful if it makes contact with the skin, so your nurses take precautions to avoid it - but they know exactly what they are doing and how to administer it so there is nothing to worry about.
I will leave this entry here, as it's already so long - but hopefully you, or someone you know, will find it helpful. Chemotherapy is a big step, but it's a worthwhile step. If it gets you better, it's worth the boring afternoon of getting it. My next entry will talk about another type of chemotherapy I receive, called intrathecal chemotherapy. This is where the chemotherapy is injected into your central nervous system and spinal fluid to prevent the cancer from spreading or growing any further - but for me, it's simply precautionary as I am 100% cancer-free in my nervous system. WOOHOO! Some good news!
Thankyou for reading, and best of luck with your chemotherapy! You'll do great.
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