Ding Ding: Chemo Round 2 – but enough of that fight terminology!
25/10/2021
We’ve all spent a Sunday with our head in a bucket, or over the loo at some point or other. The sweaty palms, heart palpitations and full-body spewing – it’s all in a weekend’s work.
Few of us, however, choose to go through that voluntarily… having barely touched a drop of alcohol in the weeks leading up to my second chemo, it was time to be infused with poison again.
Poison, cut and burn
I recently read somewhere that the first line of treatment for primary breast cancer (first tumour) is ‘poison, cut and burn’. Of course, ‘poison’ refers to the cocktail of chemotherapy drugs that kill cancer cells. Whereas, ‘cut’ refers to surgery and ‘burn’ to radiation.
But chemo doesn’t just kill cancer cells. Oh no!
Any article on the subject will tell you that chemotherapy can also affect the DNA of fast-growing healthy cells in the blood, heart, skin, nails and stomach.
In fact, my oncology nurse told me that the toxicity of some chemotherapy drugs (if not monitored carefully) can kill a patient faster than cancer itself which perhaps, wasn’t the best news to hear on chemo day.
It also didn’t help that I had just read an article in Cancer Research UK which said, the earliest class of chemotherapy drugs actually derived from ‘mustard gas’ - a chemical warfare agent used in both the First and Second World Wars.
Still, I haven’t got much choice in the matter. So, nitrogen mustard (aka Cyclophosphamide) with an Epirubicin chaser it is.
From mustard gas to modern medicine
As with all chemotherapy drugs though, intention is important. After all, we’re not talking about fighting a common cold here. Chemotherapy literally means using chemicals to fight a disease and despite its sinister history, Cyclophosphamide has been used for decades to do just that.
According to Cancer Research UK, it all started with a brilliant scientist called Alexander Haddow, who in 1948, researched exactly which parts of the nitrogen mustard molecule were needed to kill cancer cells.
His research stemmed from a WWII mustard gas incident, in which the autopsies of soldiers exposed to the gas were found to have a significant reduction in white blood cells. Since white blood cells grow quickly, this prompted attention to nitrogen mustard as an agent for killing rapidly dividing cancer cells.
You can read more about Haddow and his ground-breaking research here: https://news.cancerresearchuk.org/2014/08/27/mustard-gas-from-the-great-war-to-frontline-chemotherapy/
But essentially, his work paved the way for future scientists to develop a ‘less toxic’ yet ‘more potent’ cancer killing pro-drug like Cyclophosphamide, which is precisely what I’m having today.
Show us your metal
Mum came with me, which was lovely… because even at the grand old age of 50, there are still times when I need my mum most and this was one of them. To be honest though, I do feel a bit sheepish about admitting that.
It’s difficult to explain, but following my diagnosis I often heard phrases like;
“you’re made of strong stuff” and “if anyone can get through this, you can.”
Don’t get me wrong, the sentiment was always heard and very much appreciated. Yet the meaning of those words put me on a pedestal and made me feel like a fraud.
In actual fact, I sometimes worried that the military might hear about this ‘strong’ woman and kick my door down only to find me blubbering in bed and say;
“yep, there she is… We need you on the front lines now - you’re the strong one.”
On top of that, people kept telling me to “fight the BIG C” and “kick cancer’s arse.” I knew they only meant well, yet this type of positivity actually pushed me away.
It was as if I had to prove my metal in a game of prestige against cancer. But in reality, all I wanted to do was talk.
In fact, it really meant a lot when people didn’t completely run me over with shero rhetoric and simply listened to how I felt. Because let’s face it, I’m just a frightened human being with breast cancer and these military metaphors seriously piss me off.
Not that I’m innocent of using fight terminology myself.
When I was diagnosed with cancer, war metaphors appealed because they made grey areas clear and the ‘enemy’ distinct. But now that I find myself in the thick of treatment, it feels like only those who ‘fight’ hard against the disease deserve to live.
I guess what I’m trying to say is that it’s good to accept an individual’s use of war metaphors for themselves. But telling a patient what their attitude to cancer should be, doesn’t help.
So instead of karate kicking cancer into a corner or beating it to a bloody pulp, I’m doing everything I can to make my treatment a little more tolerable and having a PowerPort fitted, is one example.
‘A port in every storm’
Even when carefully administered through a catheter, chemotherapy can burn the veins and cause serious tissue damage. The inside of my left arm already felt tight and uncomfortable from treatment. So after my second chemo, I had a PowerPort fitted.
A PowerPort is basically a central line that can withstand high injection pressures and comes in two parts:
1. an access point which is implanted beneath the skin
2. a central line that tunnels through the jugular vein and towards the heart
Although it might sound invasive (and yes, the port does leave a couple of scars), the procedure was done and dusted within 30 minutes under local anaesthetic, and apart from a bit of tugging around my neck, I hardly felt a thing.
The only problem was, I had the port fitted 5 days before my third chemo. So just when I had almost recovered from the exhaustion, nausea and constipation of the second round, most of my good week was spent recuperating from the procedure.
I shouldn’t really complain though, as having the port means no more stabbing (I’m a total needle phobic), no more bruising (a consequence of the stabbing) and no more burning my veins (I’ve got plenty of fire in my belly anyway).
So that’s two down, four more to go… Bring on chemo 3 and the halfway mark!