Treatment starts

Once all of the tests had been carried out and the results of the important ones were in I knew exactly what I was up against and I felt like I was back in control somewhat which was a huge relief.  However it was then a waiting game for treatment to actually start on 25th September.  Whether we know someone who has faced this personally or not we all know chemotherapy isn’t pleasant.  I’ll be honest, I wasn’t looking forward to it but a big part of me couldn’t actually wait to start.  That may sound odd given that I was feeling perfectly fit and healthy, why would I be keen for someone to inject me with a toxic, poisonous substance that has a huge long list of nasty side effects.  Quite simply that poisonous, toxic substance is the only thing that is going to get rid of this horrid thing inside me so I have no choice.  It’s hard to get your head around the fact that the “medicine” will be the thing to make you ill, isn’t that what is supposed to make you better? 

Having been diagnosed with this disease I need to get ill to get better, a funny old thought but sadly it needs doing and I have no choice but to do it so there is no point in thinking that I can’t.  It’s reassuring to know that chemotherapy and how the medics deal with its awful side effects has come on in leaps and bounds over the years but the bottom line is that I just need to face up to it and get on with it.  So that is what I intend to do, face it, head on and quite frankly whilst I’m on I plan to dropkick the little shit right out of the window!  (Sorry Mam and Dad for the language but I think under the circumstances I’m allowed). 

In between the various tests I also had an appointment with the Oncology Consultant Doctor Branson.  I like Doctor Branson, he reminds me of a mad professor but I feel I can trust him completely.  He explained that whilst the initial plan had been surgery first he felt there was now a better way forward.  My cancer is HER2+.  Now here is the science bit taken straight from the Macmillan site.

HER2 (human epidermal growth factor) is a protein that can affect the growth of some cancer cells. It is found on the surface of normal breast cells.  Some breast cancer cells have a very high number of HER2 receptors. The extra HER2 receptors stimulate the cancer cells to divide and grow. This is called HER2 positive breast cancer.  HER2 positive breast cancers tend to grow more quickly than HER2 negative breast cancers.

With this knowledge Doctor Branson is able to treat the cancer I have with two targeted therapies – Herceptin and Perjeta.  These drugs attack the actual tumours themselves and also work to reduce the risk of the cancer returning.  You may have heard of Herceptin as it has been on offer for a few years and has been on the news recently.  However Perjeta is a new drug that only became available in September this year.  It has been proven to work really well alongside Herceptin but is only available through the Cancer Doctors Fund as it is very expensive.  In order for Doctor Branson to receive funding for me to have this drug it must be seen to be working.  If they carried out surgery now there would technically be nothing for the drug to work on as the cancer would in effect be gone.  As a result of this I was told I would need to have chemotherapy prior to surgery, this would hopefully shrink the tumours and would mean that after surgery I could continue to receive the Herceptin and Perjeta for a whole year, thus decreasing the chance of the cancer returning later on. 

Given my age and current state of health (cancer aside) they admitted they were throwing everything at me as they were confident I would be able to handle it, who am I to argue, Ill happily take everything they can offer me.  On top of these two targeted drugs I would also receive the chemotherapy itself, in my case a lovely little drug called Docetaxel which would basically blast my entire system to kill off the cancer they know I have as well as any stray cells that may be lurking elsewhere.  All pretty powerful and amazing stuff. 

The three drugs I am going to be given are all ones that can cause reactions in people when they are administered.  Trust me to pick those ones eh!  Because of this I was told I would have to be given each one on a separate day initially so that if I did react they would know which one was causing the problem.  So first up was Herceptin.  When I arrived in the Oncology Department a nurse warmed my veins (in a washing up bowl full of warm water – really high tech stuff) before inserting a cannula into the back of my hand.  Blood was taken for checking and my blood pressure and temperature were also checked too.  They then flushed saline through my system for half an hour before the main course arrived. 

Once I was ready for the Herceptin drug two nurses arrived with said drug, checked my name, date of birth and address before one hooked the drug onto my drip stand and set it away to flow into me.  The Herceptin takes 90 minutes to be administered and all you do is sit there waiting for it to be finished, it’s as simple as that.  During treatment I sat in a comfy arm chair type seat with Simon sitting in a chair next to me.  I was allowed to go to the loo, which took a few attempts to master given the fact that I must take my entire drip stand with me but I’m now an expert!  

The lovely Nurses bring you tea, coffee and biscuits and you can have as much water as you like from the water cooler which is really important when having this sort of treatment as it really helps to flush your system out and keep side effects to a minimum.  I drank loads hence the reason I quickly became an expert at going to the loo with my drip stand.  Luckily in Rake Lane lunch is provided for patients (soup, crackers n cheese and rhubarb crumble n custard) and again it’s a bit of an art eating whilst hooked up but I got there in the end. Simon even got given pudding which he was delighted about.   I behaved myself and didn’t react to the Herceptin which was great and the whole thing was over by about by about noon. 

However I needed to stay around for 4 more hours so they could continue to monitor me for delayed reactions.  Well as you can imagine this, for me, was the hard part.  Bored, bored bored!  Simon had brought his work with him and had set up a mobile office next to me using a hospital bed table so he was engrossed in the latest website he is working on!  I amused myself by chatting to a lovely lady sat in the chair next to me.  She was on her last session and advised me to try to carry on as normal.  She sat there with no wig on (not sure I’ll ever be brave enough to do that so I take my hat off to her for that, or should I say take my hair off) and casually told me she had continued throughout to take children with special needs sailing.  She said she had a few bad days each cycle but made a big effort to get on with things and I decided this was good advice and Id happily follow it. 

Throughout the day patients came and went and I chatted with a number of them.  I also chatted with the Nurses on duty who I must say are amazing.  You would be forgiven for thinking that the Oncology ward is a depressing place where everyone talks in hushed voices because nobody wants to mention the C word.  In reality it’s a homely, reasonably cosy place and many of the patients are happy to chat and joke on with the nurses who are more than happy to provide patients and relatives with plenty of cheeky banter.  Considering the magnitude of what many of us in there are facing it is a nice place to be if you have to have this treatment and can actually be quite fun at times considering how hilariously cheeky the nurses are with some of the patients they know quite well.  By 4pm I had still had no reaction so I was allowed to go home YAY!! 

The following day I was back for drug number two, Perjeta.  The routine was exactly the same as yesterday only this time I had to wait a while because the drug hadn’t arrived in the hospital.  The hospital where I go for treatment does not make the chemotherapy and related drugs on site.  The drugs are mixed, sometimes the evening before and sometimes on the same day depending on its shelf life, up at Wansbeck Hospital and are driven down to Rake Lane twice a day.  Some, including the Perjeta drug only have a shelf life of a few hours so this is one that is made up on the day of treatment.  By the time it arrived I had been slowly being flushed with saline for an hour and a half so had had a few trips to the loo! 

The routine was exactly the same so plenty of sitting around waiting!  Lunch was served again, I was a bit disappointed to see it was the same menu as yesterday albeit the soup had orange bits in it!  Again I had no reaction but I had to wait around for a few hours to check for a delayed reaction.  Whilst Simon was busy in the “mobile Way Fresh office” I spent the afternoon pacing the floor, staring out of the window and huffing and puffing away again I was bored and not good at sitting around.  The Nurses had already figured I wasn’t good at this side of things and by 3pm I could see them whispering in the corner and I heard my name being mentioned.  At this point they asked if I wanted to go home……did I ever!  So we were two down one to go now!

The first two days had gone to plan, I’d taken the drugs well and felt quite fine.  I also saw the drugs Id had as “nice” drugs.  The side effects from them are minimal and seeing as how I would be having them for an entire year they wouldn’t make me too poorly (hopefully).  However day three was when I would be getting the chemotherapy which in my eyes is the big nasty one.  Whilst it would hopefully attack and destroy the tumours like the other two would it would also attack the rest of my system and this was the bit that scared me.  I don’t really do being ill so I had a few tears about this one.  Once this was in my system there was no going back.  When I was told which chemo I would be getting I was also told about the side effects – hair loss, nasty tasting mouth, bleeding and bruising (nose and gums), nausea and vomiting, server bone and muscle pain, infertility, early menopause, fluid retention, anaemia, diarrhoea, sore palms and soles of the feet, skin changes, loss of appetite and extreme fatigue. 
 
Then there is the risk of infection.  I had been sent home with a new thermometer and told that I need to get myself to the nearest A&E department should my temperature go above 37.5°.  If I fail to do this I was told that I would be going to hospital anyway within 12 hours but by then it would be under a flashing blue light to the nearest Intensive Care Unit.  I was then told that if the infection didn’t kill me the nurses would for not going in earlier.  All joking aside this is how serious it can get and is the reason I was told to stay off work.  Working in a reception class which is a haven for germs and bugs is not the place to be when you are receiving chemo.  When you receive chemo it destroys your white blood cells (along with many other things clearly) leaving you with nothing to fight a simple infection with.  So any kind of infection can often lead to a little stay courtesy of the NHS hooked up to strong IV drugs in an attempt to make you well again.  I really really really don’t want to have to go to hospital! 
 
But you can perhaps now understand the few tears I had regarding this little gem of a drug!  Many people have told me how brave I am being.  Whilst that is very nice I’m not sure it’s the right word, like I said before I have no choice but to do this so I gave myself a firm talking too, dried my tears and set off for day number three, reminding myself that the chemo would begin quickly killing off these horrid tumours which is a good thing.  The side effects would be inevitable but Id cope with those when they arose.  I was also worried about reacting to the drug as it was being administered.  The lovely Minnie who has been a rock through all of this was in my mind today and I know she won’t mind me saying that it was for all the wrong reasons!  You see Minnie was a bit of a naughty patient and reacted to this very drug, and me, having read her story knew exactly how she had reacted!  To be fair Minnie reacted on her second dose (so I’ll still be worrying about this during the second cycle) but it was still on my mind as a possible problem with round one! 
 
At the hospital the usual procedures took place and before long two nurses arrived with my very own bag of chemo.  This was it, there truly was no going back.  Big deep breaths were took at this point!  Because this drug is so powerful and can cause bad reactions pretty much instantly a nurse sits with you whilst it is first administered.  This is so they can start work on you right away should things kick off.  I gripped Simons hand tightly for the first few minutes and chatted with the nurse whilst Simon carried on typing away with one hand.  

In the end I was a good patient and didn’t react although there is still the chance that this could happen second time round.  I’m hoping the hard as nails Geordie card trumps the soft southerner card thoughJ.  There was no waiting around after the chemo so I was on my way home shortly after lunch which for your information consisted of……you guessed it, soup, crackers n cheese and rhubarb crumble n custard!!  Now it was simply a case of waiting to see which of the delightful side effects would hit me!  

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