Chemotherapy commences

After all the preparation work, my chemotherapy started on Wednesday 12 October at the Royal Marsden Hospital in Sutton.

When people occasionally ask me about the chemo treatment, it’s clear that the exact process is not always fully understood. For example, some people think I have to stay in hospital or that is, in some way, an uncomfortable or painful process.

Hopefully this post will clarify the treatment, or rather my specific treatment. Your (or your friends and relatives) chemotherapy mileage may vary with the drugs administered, the duration and frequency and the possible (and actual) side effects.

Firstly, we had to review the list of possible side-effects and sign the consent form. This had already been covered in an earlier meeting but the most common side-effects seemed to be:

  • Neuropathy – sensitivity to cold in extremities (fingers and maybe toes, mouth and lips). Wrap up well with gloves and scarf.
  • Tiredness. Err, sleep.
  • Mouth ulcers – This one is on my handy chemotherapy credit card checklist so tell your consultant.
  • Shortness of breath.
  • Nausea and vomiting. You are given injections and pills to counteract these symptoms.
  • Fever.
  • Shivering.
  • Increased susceptibility to colds and infections. Avoid sick people and hospitals.

Anyway, enough of that scaremongering – let’s sign the flipping form and get started.

Chemotherapy always starts with a blood test to check your white blood cell count. If this is below a threshold, the chemotherapy must be suspended to let the body and your immune system recover. Obviously, the first blood test is to establish a baseline. Handy terminology to impress the nurses – ‘Any news on the results of my bloods yet ?

The weigh in – I have lost a stone since being diagnosed. Other positive side effects are my alcohol consumption has been significantly reduced and I have stopped snoring. Hurrah !

I was embarking on six chemotherapy treatments with a period of two weeks between each treatment. Handy terminology to confuse friends and relatives – ‘6 fortnightly cycles’.

My chemotherapy drugs were oxaliplatin and fluorouracil. Handy medical shorthand for fluorouracil to impress oncologists – ‘5FU’ which has the added advantage of sounding slightly rude so care is needed with volume and intonation here.

Before the chemotherapy is started, there is the inevitable saline flush which checks the portacath line is working correctly. Then there is a hormone injection and anti-sickness drugs. These are all just quick and easy 10 second injections via the portacath – the medical term is ‘push’.

The oxaliplatin is also injected via the wonderful portacath device over a period of 2 hours. The drug is suspended in a bag  from what looks like a metal coat stand. This drug is light sensitive so is shielded in a bag and is combined with a flushing agent (I think).

The infusion process is absolutely painless. You basically sit in a small room with other patients – you can read the paper, chat to the wife, eat, drink and if you disconnect the mains plug and manipulate the coat stand on wheels, walk about making new friends.

After the two hours is up, the machine beeps loudly and the nurse hooks up a final 10 minute ‘glucose flush’.

The 5FU (see I told you it sounded rude) is then administered over a longer time period (48 hours) so this is provided in a handy takeaway clear bottle (like a half-size baby’s milk bottle complete with pink trim). The bottle comes in a camera sized case and fits into your shirt or trouser pocket. Again, this is a minor inconvenience but doesn’t preclude you day to day activities and is preferable to two days in hospital for all concerned.

After two days, when the 5FU has been fully dispensed, a nurse comes to your home to disconnect the pump and that’s it for two weeks until the next cycle.