ChemoWHAT?

plugged up to chemo.

So, after being asked many a time, I've realised people don't know much about Chemotherapy and what it is. So, I'm reluctant to answer this question much more; it's like in second year, after subject choice, every person you come across asked you what subjects you were taking and for the 500th time that day you begin '..English, Physics..' in a droned out voice, that is exactly what this is like, so imma tell you.

Chemotherapy is the treatment used for cancer with an antineoplastic drug or a combination of these in a treatment regime. The way it works is it rapidly kills fast dividing cells which are what cancer cells are; fast dividing. The drug regime depends on what type of cancer you have and how serious it is, so I have a different regime than someone with Breast Cancer or Leukaemia. Chemo is not always given to cure a patient, a Palliative chemo regime is given with the intention to decrease the tumours and increase life expectancy.

chemo regime.

Chemotherapy originated in the early 20th century but was not originally intended for cancer treatment. During WW1 mustard gas was used as a chemical warfare and it was studied in WW2. During a German air raid on the Italian harbour, Bari, a group of people were accidentally exposed to mustard gas and were later found to have very low white blood cell counts. They then thought that as the agent damaged rapidly growing white blood cells, it could do the same to cancer cells. So in the 1940s, patients with 'advanced lymphomas' (cancers of certain white blood cells) were given the drug intravenously and the improvement was remarkable. Researchers then looked for other substances that may have the similar effects against cancer and that is how other drugs have been discovered and developed, mainly from plants.
The drugs I'm given are; cyclophosphamide, vinchristine, etoposide, etoposide phosphate, doxorubicin (also known as 'the red death' -yummy), prednisolone (a beloved steroid) and dacarbazine. And here's a bit about them;
-Cyclophosphomide is  a nitrogen mustard alkylating agent in the oxazophorines group of drugs. It was developed by Norbert Brock who synthesised and screened more than 1000 oxazaphosphorine compounds and converted the base nitrogen into a non-toxic 'transport form' which was a pro-drug subsequently actively transported into the cancer cells. This is given as an hour infusion which must be followed with a 5 hour infused hydration.
-Vinchristine is a vinca alkaloid from the Catharanthus roseus (Madagascar periwinkle) and was used for many years as a folk remedy. This is given via a syringe so only takes 2-3 minutes.
-Etoposide is made up of podophyllotoxin, a toxin found in the American Mayapple. This is given as an hour infusion.
-Doxorubicin is from a red pigment of soil in the Castel de Monte in Italy. An antibiotic was produced from the bacterium and was found to have good activity against murine tumours. Doxorubicin is extremely dangerous and can be fatal if too high a dose is given. Due to it's bright red colour and bad side effects it is known as the 'red devil' or 'the red death.' It's given an an hour infusion.
-Prednisolone is a steroid with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions. This is a tablet taken orally.
-Dacarbazine is an alkylating agent which destroy cancer cells by adding an alkyl group to it's DNA. It is bioactivated in liver by dementhlyation to "MTIC" and then to diazomethane which is also an alkylating agent. This is given as a half hour infusion.

...don't worry, I don't understand half those words either.

Most of these are given through a drip into my port, some are through a syringe, also into my port and prednisolone is taken orally. I've blabbed on about my port quite a lot and I've been asked what it is, and it's pretty hard to explain 'um..a plasticy, metal thing in my side where needles are put' doesn't really cut it. So these are pictures of the type of port i have (although I have a double port..so basically two) and hopefully you'll understand better.

This is a single port with a gripper put into it;
the port is under my skin so the gripper is basically a needle.

this is an x-ray where you can see
the port and the line coming out
of it into the central vein.

Chemotherapy can either be given as an inpatient or an outpatient. Luckily, I'm an outpatient and don't spend much time in hospital anymore. During my first two cycles called OAPA I was in hospital for roughly 5 days a month getting infusions and taking prednisolone for 15 days and then a 13 day off of drugs before the next cycle began. I'm currently on a regime called COPDAC where I'm in hospital for roughly four days a month, taking prednisolone for  15 days and then a drugless 13 days.


The common side effects of chemo are tough. Firstly there's the death of the much needed immune system which can lead to fatal infections- how nice. Then there's fatigue which is the side effect that's effected me most. I'm constantly shattered. This also leads to anemia which leads to blood transfusions. The reduction of platelets means you bleed and bruise easily and reduces the ability to clot the blood which is brillz, you just bleed and bleed and it never seems to stop. Gastrointestinal distress such as nausea and vomitting and of course there's the allopecia which is simply the worst of them all. This is only temporary and hair grows back, and in many cases previous straight hair grows back curly which is known as the 'chemo-perm.'

my current blood counts- best they have been since
pre-diagnosis. AYYO.

Chemo generally doesn't hurt- you can't actually feel it being dripped into you and so far (touch wood) it hasn't made me vomit, although I have felt not 100% and have been very tired. I'm guessing the whole raft of anti-sickness drugs I'm given help. The worst side effect with me is boredom, as I've told you. Especially whilst you're sitting on the ward for a good 5/6/7 hours watching some drug drip into you- not fun I tell you.

Battle of the Lashes

So the way chemotherapy works is that it kills all the cells in your body in order to kill the fast dividing cells (cancer cells.) Obviously, drugs don't have brains so they can't tell the difference between the good cells and the bad cells, so kills them all. This is how your hair comes out, the cells in the hair follicles are killed so the hair comes out and doesn't grow. And yes, ALL body hair comes out except the odd one here and there and with an exception of your eyebrows and eyelashes which thin dramatically but don't necessarily disappear completely. Thankfully, this isn't permanent and hair grows back post treatment.

I've already done a blog about my hair, which I miss deeply so I'll tell you about the battle I'm having with my lashes and brows. They started thinning during my second cycle of chemo. Not to be cocky, but I had the most beautiful, thick, long lashes, and they were my favourite, most prized feature. My brother used to get christmas cards addressed to 'Maybeline' when he was in junior school. So of course, it's devastating to see them go, my heart sinks a little more each time I find a lash on my cheek. I've stopped wearing mascara because of the fear of pulling them out whilst removing it. I've been trying various make-up tricks to cause an optical illusion that I have normal lashes and brows, some of which have worked and some of which have failed epically. But it's all about trial and error. When they started to thin, the hospital promised to set me up a 'Look Good Feel Better' session, which is a visit from someone from Maggies who show you how to do your make up to make you look normal. When I say normal, I mean it. I seem to have developed the cancer 'look' and by that I mean, the steroids have caused my face to bloat to the extreme giving me hamster cheeks and a very round face, I've developed bags under my eyes which don't look normal anyway due to my lack of lashes, my eyebrows are almost invisible and the change in hair follicles on my forehead have caused me to develop spot-like things that aren't actually spots. So ladies and gentlemen, that is the cancer 'look.'

So here you can see the difference a bit of eyeliner and clear mascara can do, and I've filled in my eyebrows with a Benefit brown eyeshadow as I'm yet to be taught properly. But still, for the tiny bit of effort and 30 seconds it takes to put that on, it's beyond worth it to look half-normal.

I managed to venture into the hallowed halls of school last week after a surprise visit to surgery. I swear, my ports hate me. I have had literally no luck with them since the beginning, I developed Pseudomonas in my first one which could have caused my death (luckily it didn't) and I get my second one, it settles down, scar is healing, swelling has gone, and BAM it decides to flip over.

But anyway, that was dealt with and I went to school. Entirely for the social benefit rather than academic. Not that we're doing much, I seem to spend too many lessons sitting 'getting on with other work' which I have none of due to the fact I've not been in school so have done no work since March. I got a lovely homely welcome back from the tech department which put me on a high for the rest of the day. Speaking of which I have a picture for Sophie. Sophie has been fascinated by my wig and has been nagging me to take it off and show her the inside of it, which of course I refused to do as we were in a classroom full of 20 girls who would find it very awkward, and I look like a pigeon with no hair on. So I promised her I'd upload a picture of the inside of my wig so she wouldn't take it off me and run away, leaving me bald and upset. Oh..and Mowat and Isla are okay too.

Cycle four of chemo starts on Tuesday, half way to success and still smiling. Except on the odd day where I'm all 'why ME' and hatin' on life. This is generally when i take a good look in the mirror after flicking through photos of pre-cancer life and be hating on my hamster cheeks and severe lack of hair, which, by the way, is kept in a River Island bag in my hair utensils basket (you may think it's disgusting, but I spent fifteen years growing it and it's sentimental.). MISS YOU BUD.

Sugar, We're Going Down

So diet has been a biig question mark since I was diagnosed. Being told what to and not to eat to make everything better. Being told no carry outs, then having the hospital order me a pizza. It's all been very confusing and contradictory. I've spoken to a few people this week about diet and, from experience, whats worked for them. Cutting down in some food groups, increasing intake of others, much of it is common sense, like healthy eating, moderation, water but the biggest piece of advice is on sugar. Sugar feeds cancer and can cause some cancers. So I've been told to cut sugar. LOLWUT!? Sugar is in everything. Literally, everything. Even these 'sugar-free' products have natural sugar in them. So I don't think cutting sugar out is humanely possible, but cutting down is definitely on the agenda. (good luck to me) I've also been told not too much dairy, dairy is bad. Also a maximum of five portions of meat per week and fish for the rest. Which is awkward because I gag at the smell/sight/taste of any seafood. So my diet shall be interesting over the next few months. But oh well, it's not going to kill me, right? Going all out healthy eating, we'll just see how long this lasts. Especially seeing as I just received an invite for a chinese on Saturday and have been craving a Nandos for about three weeks.

So I'm currently sitting on the ward waiting for the surgeons to come round and take me up to surgery. I was due at 8am this morning, second on the CPod list to get my port flipped as it's been misbehaving again and decided it doesn't want any more chemo so it'll turn around and then can't be accessed. My port hates me. It's now 1pm and we're still here, along with the other girls waiting to be taken. Seems to be the story of my life these days; waiting around. I came in yesterday for a simple blood test at 11.30 yesterday and didn't get home until 5. But it's always worse when you're being fasted. I was hoping to go back to school as well yesterday, but that obviously didn't happen. It's weird, I'm SO keen for school; haven't been since March 8th. Not as if we'll be doing any work..but still. Keen to get back into a routine and see my guurls. All my girls and I were reunited on Saturday for the first time in forever. Literally thee best thing. Saw all my favie people on Saturday, I was in my element. Had suuch a good time and just realised how lucky I am to have such amazing friends.

It was interesting though, speaking to some of them who I haven't seen since D-Day (diagnosis day) Some of them are so interested, literally wanting to know everything; what happens to me, how chemo works, what I do, does it hurt, are you ill etc. Which is exactly how I'd be, because I'm nosey. And others are kinda like..ew no don't wanna know, which is also fair enough. But with one person I spoke to, I realised how arrogant some people can be. I was on the verge of knocking them out. Some people are so caught up in their own lives, so self-centred and in a bubble with not a care in the world for anyone or anything else but their own well being and how they appear. It made me very angry to say the least.

 But nothing can get me down I'm now finished all the drugs for cycle three; we're half way ladies and gents. The light at the end of the tunnel is only getting brighter.