Sunday, 22nd January 2006

Why Chemotherapy?

This is a question I asked myself shortly after returning home from hospital and only recently uncovered the complete answer.

A copy of the pathologist's report I received after the surgery revealed that my cancer was Grade 3, more aggressive than the Grade 2 suggested by the biopsy and, what initially looked like three distinct masses in my left breast was in fact one large mass that had started to spread. The MRI scan report notes there was evidence the cancer had spread to two of the 32 lymph nodes under my arm as these looked enlarged. Lymph nodes are part of the body's lymphatic system http://www.cancerhelp.org.uk/help/?page=117#drain and are located at several points around the body. The lymph nodes usually become swollen when fighting infection: in my case this was clear evidence the cancer had found a route to the rest of my body. A route interrupted by my surgeon who advised me before the surgery he would remove all 32 lymph nodes.

I, like most people, had no idea I had as many as 32 lymph nodes underneath each arm however now understand why my left arm will be vulnerable to infection, in all probability, for the rest of my life. So in answer to the question “Why chemotherapy?” it has become clear through my own reading around the subject that the treatment is given to patients who have a cancer that has started to spread. In my case the spread appears to have been confined to the lymph nodes as the CT scan, bone scan and MRI scan did not pick up anything elsewhere. However this does not mean the presence of cancerous cells elsewhere in my body can be ruled out; that is why the chemotherapy is required. Cancer cells are fast dividing cells and chemotherapy drugs has been carefully developed to interfere with the duplication process of these rogue cells.

Side-effects of Chemotherapy

Well, hair loss is well-documented. However I can expect a number of other side-effects:

Infertility

A large proportion of women become infertile and I have been told my periods are likely to cease and not return effectively bringing forward the menopause.

Tiredness

Some people report tiredness for two or three days after the injections others for a week with energy levels gradually returning to normal before you get the next injection and then it begins all over again.

Susceptibility to infection

The chemotherapy medicine cannot tell the difference (yet!) between fast dividing cancer cells and fast dividing healthy cells such as those that exist in bone marrow and the digestive tract. As the bone marrow forms an important part of the immune system I am likely to be vulnerable to infection. Not a good time I imagine for me to catch anything and the oncologist suggested I avoid contact with young children (whoops) and people who may be sick with something.

Nausea

A feeling of nausea is caused by the unusual levels of acidity in the stomach. This is triggered by the drugs. However, the oncologist assures me that if I take the anti-sickness tablets “religiously” this will be significantly reduced.

There are are a number of other possible side-effects such as weight gain, hot flushes etc, all useful to know in advance. It's not enough that I will be bald : I am also likely to be fat, red faced and regularly have moments when I want to throw up. Great company really for anyone planning a visit. But surely it won't be as bad as all that ? On the plus side: no hairy legs to worry about in the Summer - and think of all the money I will be saving that I used to spend on Shampoo.

I was contacted by the hospital and was told the treatment is likely to start week commencing 30th January 2006. I can't say I'm looking forward to any of it, and yet in a bizarre way, I can't wait to get going with it all. Maybe a part of me is afraid that some cancerous cells remain. I cheer myself up with the knowledge that, for all the unpleasant side-effects, chemotherapy has one central benefit: it will inflict maximum damage to any cancerous cells, stop them from harming me and provide me with the chance to continue my life.