When I reflected on my first day of chemotherapy, I realised that this was going to be a boring read. Why? Because quite frankly, COVID has meant that any of the fun stuff about being sat on your rear for a significant amount of time has been stripped away! Being in separate units from people and having to keep your distance (especially as most of us on the ward are high risk individual’s courtesy of having compromised immune systems) plus the fact that you can’t bring anyone with you, means that the general camaraderie you may feel – the whole, we’re in this together, has somewhat disappeared entirely.
Anyways, the morning before Chemotherapy, my mate Ricardo (okay, so its Richard but we’ve always called him Ricardo when speaking about him) came over and had a cuppa with me and came along in the cab to drop me at the door at the prestigiously sounding Platinum Medical Suites in St Johns Wood – platinum baby – not silver, not gold – it’s just how I roll
I was set for a long day as I had been told I’d be there for 10 hours! 10 hours!!!! Everyone having chemo has different schedules, but I was prepared for the full day and came in with snacks, laptop, chargers, my own teabags (Yorkshire decaf for those who care and want to know) and a mug – pretty standard, for anyone that knows me. I think I’d spent a lot of time preparing for the day, making sure I took something warm (any excuse to buy another cashmere jumper or cardigan), had stuff to keep me occupied … clearly because like anything when you have no idea what to expect, you plan for every eventuality – I think I rocked up looking like I was going on a mini-break!
First up, I had to get on the scales – this, I was told, was not to torture you about how many pounds you’d managed to put on during lockdown, but it does determine how much of the various drugs you get. Then they check your blood pressure, make you do a urine sample to check your kidneys are working (kinda important as the kidneys are what flush the chemo out of your system) and then they take your bloods to make sure that you are well enough to have chemo.
Once you’ve passed those hurdles, you get to actually get started. I usually pass the time by checking out what’s on the menu for lunch and ordering as much hot water and skinny milk as poss – lest the delightful ladies get waylaid and I’m left ridiculously parched with no tea in sight – this is something that I experienced crossing the north pacific when “teagate” happened and we had to start using one teabag between two – just thinking about it now sends shivers down my spine. Anyway, I digress.
There are over 100 different chemotherapy drugs out there, each with their own ability to work better on certain types of cancers but broadly speaking they fall into a couple of different categories which I won’t bore you with.
For anyone who snoozed during Science at school because their teacher wasn’t very good at teaching and it was more fun to talk about her 5 o’clock shadow (how cruel kids are), the way chemotherapy works is relatively simple.
All cells in our bodies grow by splitting into two cells, or dividing. Others divide to repair damage in the body. Cancer rocks up when something causes cells to divide and grow out of control and as they keep growing, they form a mass of cells – or more commonly known as a tumour – some of which have decided to take up residence inside my good self like Celine Dion at her Vegas residency. In any event, chemotherapy attacks dividing cells, which means (theoretically) it is more likely to kill the cancer cells than the normal cells. There are some types of chemotherapy that damage the genetic material inside the cell that tells it how to copy or repair itself, whereas others block the chemicals that the cell needs to divide.
I’ve been asked why hair falls out when having some chemo and the fact is, hair and skin cells also divide often, so when chemo attacks those type of cells, they get hit as well, but in the majority of cases, these cells recover once you’ve finished treatment.
Okay – chemo 101 over. I settle into a big white leather chair which is a cross between a dentist chair and Dr No’s chair in Bond – and is probably as masochistic as them both! Before you even get to any drugs, they give you Intravenous (IV) sodium chloride (fluids as we all know that to be, to make sure you’re hydrated) and then they can get started.
I have three drugs. One is an immunotherapy drug, found to work well with the two chemotherapy drugs I’m going to be having.
The Immunotherapy drug is Avastin (The Brand name for Bevacizumab). So, the science bit – basically, it is a tumour-starving therapy and blocks a protein called vascular endothelial growth factor (VEGF). Normal cells make VEGF, but some cancer cells make too much VEGF. Blocking VEGF may prevent the growth of new blood vessels, including normal blood vessels and blood vessels that feed tumours. Unlike chemotherapy that attacks the cancer cells, the purpose of Avastin is to block the blood supply that feeds the tumour. This can stop the tumour from growing.
After they’ve pumped me full of Avastin, I then get a round of IVs to help combat the side-effects of the chemotherapy. Usually, this cocktail (and I call it a cocktail as for some reason in the oncology world, they like to refer to having these drugs as infusions??? Like its some cocktail or herbal tea) includes Piriton, anti-nausea stuff, steroids, more fluids etc.
The two chemotherapy drugs I’m having are 2.5 hours of Paclitaxel and then 3.5 hours of Carboplatin. You can read my A-Z for a bit of info on those.
Now, as I mentioned I rocked up to the session prepared for a mini break which included bringing along both my work and personal laptop, thinking in some small way I would use the 10 hours productively. How wrong I was. Between all the tests, prep and the like and the Piriton, I really did sweet FA. The Piriton made me fall asleep for a couple of hours, which was glorious as I hadn’t slept much anyway over the previous days.
The chemo itself is relatively incident free, but mind numbingly boring given the length of time I’m in for. You can walk around – but really only to the loo and back and you’re hooked up to the IV so it’s not like you can do much. I was the first person in and the last person out, joking with the nurses that they could give me the keys so I could lock up on the way out. I literally left the hospital at 7pm, having been in since 9am.
I get very cold during the treatment, so the extra layers are key and my vein starts to ache and become painful towards the end of the session, but its manageable and we’ll just swap veins each session to give them a break. I’ve always been told during blood donating and the many hospital gigs I’ve done that I have super good veins (note to self to put that on the CV), and given at present, I’m doing 6 rounds of chemo, figured I’d go for using the vein as opposed to a PICC line (A PICC line is a thin, soft, long catheter (tube) that is inserted into a vein in your arm, neck etc. The tip of the catheter is positioned in a large vein that carries blood into the heart and is then used for long-term IV antibiotics, nutrition or medications, and for blood draws). Clearly having a PICC line if you’re doing a lot of treatment and regularly can make sense as chemotherapy can damage your veins and as experienced can bloody hurt!
So, in a nutshell, the day was uneventful. The key, is seeing how my body is going to react to the drugs, so stay tuned for that update next week!
Eyebrows and skin looking on point!
I’m a twinnings English breakfast girl myself, however I may give The Yorkshire ago on your recommendation
One down as you said! You got this!