|plugged up to chemo.|
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.
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|
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.