The Chemo has Started

Hi, I'm Dan. My wife Bitsy is fighting Breast Cancer right now. She blogs about the process, but more about her fight. This blog isn't about her fight, it's not even about my fight. It's about trying to record what chemo was like. When she got recommended a course of treatment, I wanted to know what it would be like. Doctors (and I am not one) told her that everybody is different, and so we couldn't know. And everybody is different. But it would be nice to have some idea of what the range of experiences are like. So, I plan to be the side-effect-noticing Boswell to her Johnson, and just record what's going on. If you're reading this, I hope you're someone facing chemo (as either the patient or a supporter) and you want to have more of an idea of what's coming at you. This will be incomplete, cause I'm imperfect and forgetful. I hope it's helpful.

Today is Friday. It's about 3 in the afternoon.

She has Breast Cancer. Specifically, Invasive Ductal Carcinoma. Stage 1A, grade 2, ER+, PR+, HER2+. Margins were good, node-negative (sentinel lymph, not all of them). She's a 33 (34 as of Wednesday) year-old woman. BRCA1 was normal. BRCA2 had an oddness they'd only seen in 6 people before (ever!). Not sure what to make of that. Probably ought to get it tested in more depth.

Medical Oncologists recommended either ACTH or TCH. ACTH would have been 4 rounds, 2 weeks each, of Adriamycin and Carboplatin followed by 4 rounds, 2 weeks each, of Taxol and Herceptin (and then Herceptin to finish out the year). TCH is Taxotere (which is a brand name for Docetaxol, which is like Taxol but maybe a little more toxic?) and Carboplatin and Herceptin. 6 rounds, 3 weeks each. Bitsy picked the TCH because of Adriamycin's possible cardiac side effects (I think the numbers were 4-7% of patients have severe cardiac side effects, but that's also a lot of older/less healthy people picking the more drastic option).

Chemo started Wednesday morning at 9:45. Bitsy had put a port in, which makes it easier for them to put drugs in. BUT, it also made it easier to draw blood because they could use her vein in her elbow instead of wanting to save that for the injection site. If she had no port, they would have had to draw blood from the back of her hand, which sucks.

They do the drugs one at a time. Starting with the Taxotere, then the Carboplatin, then the Herceptin. I believe the Taxotere and the Carboplatin were each an hour. The Herceptin has a risk of an allergic reaction, so they set it to go in over 90 minutes. Then the next round they'd do 60 minutes, and the 3rd round 30 minutes. But Bitsy got a little flushed and so they slowed it down to 2 hours, and gave her some tylenol.

The infuser machiney thingy is battery powered, so you can walk around with it. This means that Bitsy could get up and go to the restroom at any time, instead of having to wait to do it between drugs or something.

Your first time (at this hospital), you get a private room. Later rounds you get a chair in the common area. This is nice for your sanity as a patient (lots of room for your family), but is probably done more for the benefit of everyone else, who don't have to deal with people having allergic reactions or freaking out (which happen the first treatment).

Bitsy took a nap while getting the chemo, maybe 30 or 45 minutes.

We left at about 5, and came home. Bitsy was feeling very good until about 8:50, when she suddenly started feeling nauseous, so she went to bed and slept through the night.

The chemo agents aren't poisons that kill cells, but that prevent them from dividing. I guess we expected that Bitsy would get visibly sick over the course of the day, but she didn't. Which I wish I'd realized more.