So I thought I would do a post on how I am getting on with this round of chemo.
This chemo regime is known as AC and consists of Adriamycin and Cytoxan. This regime has been different in that I am only receiving 4 infusions every 2 weeks. I have currently received 2 out of the 4 infusions and will be having my 3rd on Monday. Adriamycin is an anthracycline drug which works by stopping or slowing the growth of cancerous cells. Cytoxan also works by stopping or slowing the growth of cancer cells and is also an immunosuppressant.
Adriamycin is a red coloured drug which is referred to by some people as the Red Devil. It's a very strong cytotoxic drug and it has the potential to cause heart damage although this is a very rare side effect. I was extremely anxious about starting AC. I felt that because my tumour seemed to completely disappear on TC that I was putting my body under unneccessary strain and potential harm. I mentioned this to my oncologist and she immediately shut me down and said that his part of the treatment regime was definitely neccessary unless I could give her a very good reason. Obviously I couldn't give her a good reason other than fear! So I went ahead. I had an Echocardiogram done before starting treatment which showed my heart to be in good condition so I was deemed fit to start AC!
Infusion Procedure
Pre-meds before AC are a bit different from TC and only consist of two IV infusions of an anti-nausea drug and a steroid. I was also started on another anti-nausea tablet called Emend. This tablet should be taken 1 hour before chemotherapy and then again for the following two days. Unfortunately on my first infusion the Emend was not given to me until after the Adriamycin had already been infused and I knew all about it later that day! Once I'd had the pre-meds, it was time for the Adriamycin. When they came towards me with this bag of bright red coloured liquid, it did not calm my nerves at all!
Adriamycin is a vesicant, which means that it is extremely damaging if it comes into contact with the skin and can cause very severe burns. This was another worry for me as I do not have a port or a Picc-line. During my first infusion I just sat there staring at the IV line terrified the crazy-looking red liquid was going to leak out and burn a hole in my arm, all while causing damage to my heart! The Adriamycin takes about 30 minutes to infuse and then they started me on the Cytoxan, which also took about 30 minutes. The time spent in hospital for this regime is only about 2 hours, which is about half the time in comparison to TC!
Side Effects
Nausea; The evening after my first infusion of AC, I was very unwell. I was vomitting and wasn't able to eat anything. For the following few days I took anti-nausea tablets regularly and although I felt somewhat nauseous, it wasn't too bad and I was able to manage bland food. This was not the case after my 2nd infusion and I think it was because my Emend tablet was given to me an hour before chemotherapy began, so I suffered much less with nausea.
Brain Fog; The worst side effect I have experienced so far happened after my 1st AC infusion. I was on steroids for 3 days after receiving chemo and then I stopped taking them, as instructed. Once I stopped taking them I had the most horrible foggy head for about 3-4 days. I felt like I was dreaming and I felt very disconnected from what was happening around me. Even simple tasks like just making lunch seemed more difficult than normal and I was extremely emotional and anxious. I spoke to my oncologist about this when I was in the hospital for my second infusion and she changed my post chemo steroids to a tapering off plan which completely eliminated this side effect, thank god!
Muscle/Bone Pain; When on AC, you have a high likelihood of becoming Neutropenic. This means one kind of White Blood Cell - Neutrophils, become very low, which opens you up to infection in a serious way. Due to this, when on AC, you are given an injection within 24-48 hours of Chemo which stimulates production of blood cells. This injection is called Neulasta. Due to the fact blood cells are produced in the Bone Marrow, this injection can cause alot of Bone Pain. I had read some serious horror stories online about Neulasta and the Bone Pain associated with it. I also had read that taking Claritin while on Neulasta reduced bone pain for some reason, so I decided to give it a try. I have been extremely lucky and have had very minimal pain after Neulasta! I don't know if this is due to taking Claritin but I am beyond happy that I haven't had to deal with that horrible side effect!
Fatigue; The fatigue I feel with AC has definitely been worse than TC but then again I expected this. I actually expected it to be worse than it has been. I have been able to do so much more than I thought I would!
Other; I have been having a bit of pain in my chest, a mild dull achey pain. I was told to come into the hospital to have some tests done yesterday to just make sure it wasn't heart related. I have also noticed that my resting pulse is higher than normal at about 90-100bpm. I also suffer from Hashimoto's Thyroiditis and am on medication for this. I had general, heart and some thyroid bloods done yesterday aswell as an ECG which all came back fine. They have put the chest pain down to a muscular issue and they are unsure of why my pulse is higher than normal and have said it could be due to steroids. I think the medication I am on for my thyroid problem is probably too high and has put my body into overdrive, I'm going to reduce down that medication and see how that goes!
In Other News...I got some great news since the last time I posted! I got my genetic results back finally! I was tested for 3 genes - BRCA1, BRCA2 and P53 and all three of these genes came back negative! I was actually in the supermarket when I got the call to say I had tested negative and I burst out crying! I'm sure other customers were highly amused at me. Getting this news really helped to give me some positive feeling towards my future. Not having these genes reduces my risk of recurrence hugely and also means that if I have children I wont be passing on this gene to them. I am also very aware of the fact that just because these 3 genes are negative, it does not mean that I don't have a genetic mutation that is unknown or hasn't been discovered yet but it definitely helps to know that these three known genes are negative! This news also gives me more information that I need to make a decision towards the type of surgery I'll be having. I will be meeting with my surgeon soon to make this decision, I currently don't have a clue what type of surgery I need.
On Monday, I go in for my second last Chemo. I am also having an MRI, Ultrasound and Mammogram done too in preparation for surgery. At the moment, it looks like the tumour has either completely disappeared or is very tiny. The scans will clarify this so fingers crossed its completely gone! I'm getting very excited to be coming towards the end of chemo. I know I still have quite a while to go until I finish treatment but the longest part of treatment is nearly over!
Congratulations on the genetic results. Great news. You are doing so well and being so brave. Keep fighting. We are all behind you.
ReplyDeleteJacintha