'So these are the basics of what you can expect when you undergo your treatment. Basically it'll be a two week off one week on programme you'll follow, and the specific treatment you will be given is Intracavitary chemotherapy. This is known as intrapleural, when we administer the drugs via a catheter into the chest cavity. And the type of drugs you will be given are luckily the ones that won't cause hair loss if you use the cold cap system, but they will of course cause the diminishment of the hair follicles if you decide against it. It isn't comfortable, I've been told by my patients it's similar to brain freeze, so naturally it's up to you if you use it or not.
I can also confirm with these drugs there's no risk of you passing them to your husband via sexual contact or bodily fluids, but since they will render your birth control medication I must insist you use condoms if intercourse occurs to avoid pregnancy which would have to be terminated for the sake of the foetus as chemotherapy is very damaging to unborn infants. As explained before it can have a negative effect on your sexual urges, but this differs from person to person. Also prolonged bouts of chemotherapy can leave you infertile, but this tends to be with drugs different to the ones you are using although the possibility I'm afraid cannot be completely ruled out'.
Keri just nodded meekly as she sat in the doctor's office feeling a little sick with fear under her brave facade, learning more about her treatment scheduled to start ten days from then. She had been released from hospital two days ago and signed the papers on their new home just that morning, and now was facing the next hurdle on her long road to hopeful recovery.
She received another round of the same leaflets she'd had before, except this time as Shannon drove them home she actually read them word for word instead of skimming them. The following were the side effects she'd already heard amongst other things from the doctor, but wanted to absorb again-
Nausea and vomiting Sore mouth Hair Loss Bone marrow suppression Tiredness Sore eyes and runny nose Diarrhoea Urinary problems Fertility Immune system It is important to remember that different types of chemotherapy affect the immune system differently and that individual responses to treatment can vary widely. You will have frequent blood tests during chemotherapy so that your doctor can monitor the levels of different blood cells in your body. Your white blood cell count may not go down significantly during chemotherapy. However, if it falls below a certain level, you will have a condition called neutropenia (pronounced: noo-tro-PEE-nee-ya). In this condition, your white blood cell level is extremely low and you are at a high risk for infection. If your blood tests show that your white blood cell level is low, or that you have neutropenia, you will have to: Preventing Infection There is nothing you can do to prevent your white blood cell count from dropping as a result of chemotherapy. What you can do is take extra-special precautions to avoid any situation that might increase your risk of infection. Because your immune system is weak, you can develop infections from bacteria that are always around but that normally do not affect you. Common areas for infection are your skin, mouth, digestive tract and genital areas. As a general rule, take extra care to keep these areas clean and to avoid injuring them. Here are some specific ways to reduce your risk of infection: Super Hygiene Maintenance Protecting Vulnerable Areas Avoiding High Risk Situations Avoiding High Risk Activities Avoiding Raw Foods Signs of Infection IMPORTANT REMINDER: If you have a fever, do not take any medicine (aspirin, ibuprofen, or anything else) to lower it. Your doctor will want to monitor your temperature to keep track of the infection. Here is a list of the most common signs of infection. If you have any of them, call your doctor immediately: • fever, chills or sweats Boosting White Blood Cell Levels If your white blood cell counts are low, your doctor may prescribe injections of a growth factor. Growth factors are substances that can stimulate the production of different cells in the body, such as white blood cells. By stimulating white blood cell production, growth factors strengthen your immune system and reduce your chance of getting an infection. You may receive growth factor injections from your doctor, or you can learn to inject them yourself. Your doctor may recommend that you start the injections before, during or after each course of chemotherapy.
Nausea can start immediately after chemotherapy or up to several hours later. It can last for several hours or for as long as several days. It can usually be controlled or at least lessened with anti-sickness drugs. Some people find complementary therapies like relaxation therapy, hypnosis or aromatherapy helpful.
You may have a sore mouth or gums, or develop mouth ulcers, so good mouth hygiene is important during treatment. If you already have tooth decay or gum disease, see your dentist so that these can be sorted out before treatment starts.
Hair loss can be one of the most distressing side effects of chemotherapy. You may cope more easily if you know in advance that you will lose your hair. Hair loss usually happens gradually and begins within two to three weeks of starting treatment, though it may be much more sudden. You may lose all your body hair, including eyebrows and eyelashes. Remember that your hair will grow back after treatment has finished.
Chemotherapy can affect the bone marrow, meaning that it is less able to make new blood cells. Before each course of chemotherapy you'll have a blood sample taken. This is to make sure that the levels of these cells are within safe limits for you to have the treatment. Sometimes blood cells can be affected to such a degree that treatment is postponed. Blood cells generally recover sufficiently within a week, and treatment can start again.
You may become very tired during your treatment. Some people find that this lasts for several months after their treatment has finished. If you become anaemic (have low red blood cells) you may be more likely to feel tired, though you may still be tired even if your blood levels are normal. You may also find that the treatment affects your ability to concentrate or think clearly.
The drug 5FU used in some chemotherapy treatments can cause sore, gritty eyes and a runny nose. Eye drops may relieve the soreness.
You may have some diarrhoea, but medication will help control it.
It's important to drink plenty of fluid when you have your treatment as chemotherapy drugs (particularly cyclophosphamide) can irritate the lining of the bladder. Tell your specialist if you notice any irritation or pain when going to the toilet.
Epirubicin will make your urine red for up to 24 hours after you have your treatment. This can be alarming but is a normal side effect of the drug.
Some younger women may find that their periods become irregular or stop temporarily while they're having chemotherapy. Others may find that they stop completely, which may indicate permanent infertility. This often depends on your age. Women around 40 and above are less likely to get their periods back after completing chemotherapy than women under this age. If you're concerned about your fertility, it's important to talk to your specialist team before treatment begins.
When receiving chemotherapy treatment, you may face a high risk for developing infections, and your body may be less able to fight infections once they develop. This is because chemotherapy hurts your immune system by lowering the number of white blood cells produced in your body. White blood cells are important in preventing and fighting infections.
Chemotherapy tends to lower the number of white blood cells because it destroys any cells in your body that grow quickly. These include cancer cells, but also the rapidly growing healthy cells in your hair, digestive system, and bone marrow—where blood cells are produced.
• take special precautions to prevent infection
• report any suspected infection to your doctor immediately
• possibly receive injections of a substance that stimulates the growth of white blood cells
• Wash your hands frequently.
• Do not use antiperspirants or tampons.
• Do not cut or pick at your cuticles.
• Do not squeeze or scratch pimples.
• Clean any cuts and scrapes immediately.
• Always wear shoes.
• Use gloves for dishwashing and gardening.
• Use potholders when cooking.
• Use sunscreen to avoid sunburn.
• Use electric razors to avoid nicks.
• Do not receive any vaccinations or have any dental work done without consulting your doctor.
• To protect your rectal area, do not use suppositories or enemas and do not take rectal temperatures.
• Stay away from people who are sick and from anyone who has been recently vaccinated.
• Avoid crowds and public transportation.
• Avoid anything that might have high concentrations of bacteria like standing water (birdbath, humidifier) and animal litter boxes.
Do not do anything that's likely to result in injury, like bicycling, skating, or skiing.
Do not eat raw fish, seafood, meat or eggs. Even raw fruits and vegetables and uncooked herbs can be risky.
If you have neutropenia, your doctor may ask you to take your temperature several times a day and report any changes. Even a small fever can indicate that you have an infection.
• cough, painful breathing or sore throat
• diarrhea
• mouth sores, or a change in the color of your gums
• pain or burning with urination or frequent need to urinate
• unusual vaginal discharge or itching
• redness, pain or swelling of any area of the skin
• redness, pain or swelling around cuts, sores, pimples, tubes or catheters
Keri absorbed all the information like a sponge, mentally noting she would have to stick the last sheet of information on the refrigerator to keep as a guide if she had problems with her immune system dropping to a dangerously low level. There was so much to take on about that particularly important part of the treatments side effects she knew she'd never remember it by heart, but that it would be good to have it to hand for quick reference. She was going to have to make many changes to her life because of the risk of infection, and also she had decided to quit smoking for that reason and also to help the success rate of the second of her treatments, the radiotherapy she went on to read about-
Radiation therapy (also radiotherapy or radiation oncology) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). Radiotherapy may be used for curative or adjuvant cancer treatment. It is used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit and it can be curative). Radiotherapy is used for the treatment of malignant tumours (cancer), and may be used as the primary therapy. It is also common to combine radiotherapy with surgery, chemotherapy, hormone therapy or some mixture of the three. Most common cancer types can be treated with radiotherapy in some way. The precise treatment intent (curative, adjuvant, neoadjuvant, therapeutic, or palliative) will depend on the tumour type, location, and stage, as well as the general health of the patient. Radiation therapy is commonly applied to the cancerous tumour. The radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with tumour, or if there is thought to be a risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumour to allow for uncertainties in daily set-up and internal tumour motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumour position. To spare normal tissues (such as skin or organs which radiation must pass through in order to treat the tumour), shaped radiation beams are aimed from several angles of exposure to intersect at the tumour, providing a much larger absorbed dose there than in the surrounding, healthy tissue.
Shannon dropped her off at their new place where she was meeting Frankie and then carried on over to the large hardware store to pick up paint to redecorate the lounge and bedroom, which were too bright in the shade of brilliant white they were at the moment. She was keeping two of the bedroom walls the same colour at least, and papering the other two with black wallpaper with a modest embossed design on the front. It didn't even pique her memory that she had dreamt of being in that very room, that once again a dream had let her see something into her future like the one of her standing in her wedding dress had. At that time in her life, what happened when she was sleeping was the last thing she worried about.
'Shit, I didn't realize you could suffer with so many side effects. I just thought it made you really sleepy. Shows how ignorant I am to it all don't it?' said Frankie as she and Keri took a coffee break from decorating an hour later. She had been reading the information leaflets Keri had been given at the hospital.
'And here's me thinking I was getting off lightly! I think I can cope with it though, I know a lot of people going through chemotherapy often say how awful it feels, but I get two weeks off in between treatments so I'm hoping it won't be that bad. I'm going to carry on at uni, but just see if I can stay home in the days after my chemo sessions. I have to talk to Peter and Principal Dean about all that on Monday though' replied Keri, passing a cup of steaming hot coffee to her friend and refusing her offer of a cigarette.
'I quit, smoking can hamper the effectiveness of radiotherapy and I don't want that obviously' she told her.
'You really are throwing yourself into this head first aren't you? I still can't believe how strong you are. Aren't you even just a little bit scared? Because you don't seem it' said Frankie, shaking her head in amazement at her best friends steely courage.
'Underneath......................................I'm fucking frightened as hell over it, having radiation and then all these crazy drugs lined into my body through a permanent catheter in my chest. But I try to keep my composure, and remember that compared to some at least my treatment will leave me with hair, and not infect Shannon with the drugs either. Some can be carried over in bodily fluids and it'd make him sick if he got any of them in his system so that's another worry off my mind. But I am worried about him, and how he'll cope if I get really sick. He's a damn strong man, but this is the second time he's gotta watch someone he loves go through the mill. I really do worry about that, first his dad and now his wife. It isn't fair on him' she said sadly.
'I'll look after him, and I'll look after you too. And I mean that honey, you two mean the absolute world to Hayley and me, we'll do everything we can to help make this as easy as we can for you both' said Frankie kindly, pulling Keri into a hug.
'You're wonderful' she replied, kissing her friends cheek and feeling her rub her back gently, avoiding her stitches.
'You'd do the same if it was one of us' she replied, returning the kiss and picking up her coffee again.
'Of course I would' she replied tenderly. After finishing their coffees they got back to it, Keri doing the smaller and less physically challenging job of painting the bare wood skirting boards in white gloss and varnishing the bedroom door while Frankie did an excellent job of pasting up the wallpaper, assisted by Shannon when he arrived back armed with more paint, rugs, curtains and other items to decorate their home.
'Hey Keri, I found a new way your other half can stick his mo up, watch' said Frankie, giggling as she ran at Shannon with her hands covered in wallpaper paste and tried to get it in his hair.
'Francesca, stop it' he warned, grabbing hold of her hands but not being quick enough to stop one shooting out of his grasp and running through his hair.
'See now all you gotta do is let me put the rest in and up goes your hair!' she laughed, a laugh that then turned to a long high pitched scream as he locked one arm around her from behind and marched her back over to the paste bucket, grabbing a handful and slapping it on her head as Keri just sat there and laughed at their antics.
'I'm getting you back for that, and make no mistake!' she said, taking another handful and throwing it at him so it landed square in his chest.
'Before you two make any more of a mess of your clothes it might be worth reminding you the washing machine isn't plumbed in yet!' said Keri, still laughing as she dipped her brush back into the varnish and continued to seal the bare wood door.
'She only did that because she wants to see me strip. The whole lesbian thing is one big ruse if you ask me, she just wants to perv on guys without anyone thinking anything of it!' joked Shannon as he pulled off his t shirt covered in paste, then threw it right at Frankie.
'Yes Shannon, you sussed me out. I confess, you really do it for me baby' she said, her voice so sarcastically put on she couldn't help but laugh herself as she pulled him close to her by his belt and then ran her hands up and down over his pecks, him and Keri dying of laughter, especially when she added 'shit dude your boobs are bigger than Hayley's!'
'Okay enough fucking about Miss Scarvo, we got another wall to paper yet' he said, picking up another of the sheets Frankie had already measured and cut and putting up onto the large table she'd borrowed from her grandfather (who was a retired plumber and coming by to sort out hooking up the washer and dryer for them as well as collect the table later that day) before coating it in paste while Frankie held it at the top end. And by the time her lovely old grandfather had been and gone, connecting anything that needed to be connected to the water mains the bedroom was finished and they'd moved on to painting the lounge, joined by Hayley after she'd finished work.
'Put it down' said Shannon as he saw Keri pick up a paint roller and begin to cover the white bit of wall she was stood next to in the cream coloured paint she had chosen.
'I'll only do the bits I don't have to stretch to reach though' she said, poking out her bottom lip. She didn't take well to orders at the best of times, and hated the fact she had to take it easy still when apart from a little soreness and itchy stitches on her back she felt perfectly fine.
'Nope, sorry! Gimmie, you can finish the skirting board' he said, taking the roller from her hand and hugging her. 'I know you hate it, watching everyone else do the heavy work, but you really have to be careful you don't tear your stitches baby' he added, giving her a kiss on the cheek before he carried on painting the part she'd started.
'I know but I'm just bored of sitting on my ass is all' she said, carefully sitting down again by his feet to carry on painting the skirting board.
'Well you gotta get used to it because when you start your chemo you'll be lucky if I let you out of the house at all what with the beating your immune systems gonna take from the drugs' he said, reaching down to re load the roller with paint.
'I just have to be careful sweetheart, not go to places where I'm going to get dirty, no letting the dogs lick my face and always washing my hands when I've fussed them and no going near sick people. Look, I know you're worried and you have every right to be, but let's just wait until it starts and see how my body copes with it. It might not affect me that much; they do say it differs from person to person with what you experience, and the doctor will take blood tests every time I go for treatment so we'll be well informed with how my immune system is handling it' she replied, standing back up and taking the roller from his hand and turning him to face her.
'You're really scared aren't you?' she said. He could put on all the brave faces he liked, but he couldn't hide the tone in his voice; his wife knew him too well not to be fooled.
'I'm fucking terrified' he admitted, his voice trembling a little as she pulled him close and kissed him.
'I'm going to be fine' she said, this time changing the role in their relationship and being the one to support him. But one thing remained the same for both of them, outside they were brave but inside, they were scared to death about what was to come.
Note - All information shown in itallics is not my own, but sourced from the internet.
And also yay you're all still with me hehehehe!!! I was starting to think someone had stole you all away lol! Glad to see you are still enjoying this girls, much love to all xxx