TC Chemotherapy

My first regime of Chemotherapy included 12 weekly infusions of Taxol and Carboplatin (TC). Chemotherapy is a treatment which involves the use of a combination of medications which attacks rapidly growing cells such as cancer cells but also any healthy cells which have a tendency to grow rapidly. Taxol is a drug which prevents cancer cells from dividing and multiplying. Carboplatin is a drug which damages the DNA inside cancer cells thus preventing them from multiplying.

Considerations before starting Chemo

Before starting Chemo there are a few things that I needed to do and I needed to consider doing. Firstly, I was told to have a dental check up, as it is not recommended to have dental work done during treatment. I attended the dentist to ensure my oral health was good and was also prescribed a strong toothpaste to use during Chemo called Duraphat. I have heard of many people having dental issues after Chemo has finished and therefore wanted to ensure I used the best products on my teeth while having treatment.


I was offered the choice of 'cold-capping' during Chemo to try and save some of my hair from falling out which I decided against. Cold-capping works by basically wearing a cap during treatment which prevents the chemotherapy drug from reaching the scalp and therefore prevents some of the hair from falling out. The thing about cold-capping that made me sceptical was that you can lose up to 60% of you hair even using the cap. My hair was very fine before starting any treatment and if I lost 60% of it, it would have looked pretty horrendous. I also didn't like the idea of using a cold-cap because the thought of preventing the Chemotherapy drug from reaching any area of my body scared me. Although no cancerous cells were found in my lymph nodes, there is still a chance that cells can travel through your body in the blood stream. With that knowledge, I wanted to make sure every single part of my body from my head to my toes was treated just in case!
The last reason I decided against cold-capping was because it extends treatment by a few hours. The cap must be worn before and after the treatment for a period of time to prevent the drugs from reaching the scalp. When having weekly treatments, this just seemed like a hindrance to save possibly 40% of my very thin hair!

Another consideration I needed to make was whether or not I wanted to have a Port or Picc-line inserted for use during chemotherapy. These are devices which are inserted into either your chest or arm and left there for the duration of Chemotherapy and sometimes for a time after. Having one of these devices means that every time you need bloods taken or are having an infusion that you wont need to have a line inserted. I decided against this as I felt that having a device such as this could higher the likelihood of me getting an infection. I also didn't like the idea of having something

permanently there, just in case I pulled at it or hurt myself somehow! Making this decision meant that every time I had an infusion I had to have an IV line inserted and every time I needed blood taken I had to have a needle inserted, which was an easy enough procedure in the beginning of treatment, but as time went on and my veins felt more assaulted by needles and chemo drugs it became more difficult and often took multiple attempts to get a suitable vein!


Chemotherapy Infusions

Before having chemo each week I had to have bloods taken which monitored; liver and kidney function, inflammatory markers, magnesium levels and full blood counts including; red and white blood cell levels. I tried to have my bloods taken the day before each infusion to try speed up my infusion the following day. There is an option to have bloods taken on the day of Chemo but it delays your treatment for up to 2 hours and I'm too impatient for that! I was lucky that for each of my 12 infusions of TC my blood levels were within normal range and I could therefore receive each infusion. If bloods are not within the normal range the infusion is not given and you have to wait until your bloods come back to a normal level which can delay your overall treatment time.

The Chemotherapy infusion suite itself is quite nice as far as hospitals go. They are equipped with those comfy chairs you see in films etc! The nurses go through a checklist before each infusion to check on the side effects you have been having since your last treatment, this will also determine whether or not your infusion will go ahead. The nurses tried to make me as comfortable as possible during treatments with pillows and blankets.

I had to have an IV line inserted each time I had Chemo. I was told initially that when having blood taken or having a line inserted I should only have it done on the side of the unaffected breast. After I had had a few infusions, I was told by a nurse that I could use both arms as I had not had surgery, so she proceeded to use the affected side. I found that during the 12 weeks, some nurses were happy to use the affected side and some were not. The nurses who weren't felt that there was a possibility I could develop Lymphedema after surgery if I kept using the affected side. I found this very confusing and clarified with my Oncologist, who said it was fine to use both sides! Initially it was very easy for the nurses to insert the IV but as time went on it could take up to three times before they managed to get a line in! Before each infusion I was given four different pre-medications to try and help with side effects. These included a steroid, anti nausea, anti histamine and a medication to line your stomach to help with nausea. The anti-histamine was a high dose of Piriton which tended to make me very sleepy.

Once the pre-meds were finished, it was time to start the chemo drugs. I always had Taxol infused first. Initially it took about two hours for the Taxol to infuse. Taxol is not given through a pump as it can be very irritating to the vein. As time went on, they were able to speed the Taxol infusion up and it would take about an hour. I found the Taxol to be quite painful when going into the vein and found using a heat pack on my arm relieved the pain a lot. Once the Taxol infusion was finished, they would start the Carboplatin. Carboplatin was given through a pump and generally took about an hour to infuse. The most amazing part of TC chemo is that after only 1 infusion I could feel a decrease in the size of my tumour. After about 6-7 infusions, the tumour could no longer be felt at all by hand. I can't say the tumour is completely gone until I have scans done but if it is still there it has decreased from a big 8cm lump sticking out of my skin, to something that can't even be felt at all! Yayyyyy!

During Chemo I generally tried to sleep. That generally didn't pan out as I am the lightest sleeper of all time! Failing that I would listen to music or read. There are TVs present in the infusion suite but I didn't bother with that. Since I am having treatment in the hospital I work in, I tend to have a lot of visitors. You are allowed one visitor at a time, on the day of my first infusion, there was a period of time that I had about 7 people standing around me! I was getting some serious dirty looks!

Once the drugs had infused, the nurse would remove the IV line and let me go home. My dad would come and drive me home after each infusion as I definitely wasn't 100% with it and I wouldn't have trusted myself driving!

I am going to do a full post on side effects, steroids and hair loss with TC. I don't want to make each post into a novel! But I have to say I have been extremely lucky with TC and have been very well mostly. My next course of treatment starts tomorrow, which is AC chemo. I have to say I am quite nervous about this as its a harsher course of drugs. The A of AC is a red drug called Adriamycin and it is known as the 'Red Devil' which is a little bit disconcerting! But the positive side of this is I have only 2 months and 4 infusions left until I can say I survived Chemo!