10 June - The oncologist and learning about Chemotherapy

Wednesday 10 June. We drive to the new hospital. Dr S is very straightforward and explains the survival rates from my type of cancer, which we are now defining as Stage IIa (T1, N1, M0). This means that the tumor measures 2 centimeters or less, has spread to the axillary lymph nodes on the same side of the body as the breast cancer but that they can be moved around (they aren't matted together by the cancer), and the cancer hasn't spread to another part of the body. In addition my cancer has proved to be estrogen receptive so I will be able to benefit from hormone therapy as well. We are still waiting to hear if it is HER2 positive. This is another factor, which can indicate the need for additional therapy in the form of a drug called Herceptin – more on this once we know.



Basically chemotherapy moves my chances of not dying from this cancer in the next ten years from 80% to 90%. With additional hormone therapy and radiotherapy the chances go even higher. It is a no-brainer. We go for chemotherapy despite the side effects. The discussion now revolves around what those side effects are, how debilitating they may be and therefore what the timing of the therapy should be…this is important to me as I have a number of things I want to do in the next few weeks and months. I know it sounds a bit strange but I want to live my life as normally as possible despite this sword of Damocles hanging over my head. My partner and I are due to play in a prestigious open golf event in July..and I really want to be able to do this. I am also refereeing an amateur championship and again, I want to be able to do this. So before we set the date for the chemotherapy to begin, we take a couple of days to get the calendar straight.

Basically the chemotherapy will be in six cycles, three weeks apart. The possible side effects are severe sickness, reduced immunity and subsequent risk of infections, mouth ulcers, hair loss, fatigue, and many others. But I decide to take a positive view that I will be reasonably OK and so agree to start the first cycle the next week. The date set is 17 June, which will allow me to do much of my planned activity. An additional bonus is that the chemotherapy will always occur on a Wednesday which fits beautifully with my working pattern of Monday and Tuesday in the office, Wednesday and Thursday off and Friday working from home. This means I can go back to work pretty much as normal. It all helps to put the beastly disease in perspective.



During the discussion with Dr S I ask about something I read about to prevent hair loss from chemotherapy – a cold cap system. Dr S says it is worth trying but that it doesn’t work for everyone and when it does it is not 100 % effective. I decide to give it a go but also to explore the alternative headwear route as well. Best to have all the bases covered.

Having made the decision to start the chemotherapy fairly quickly, I needed to get moving on some more research. Firstly I needed to understand exactly what the chemo was, how it was administered and the timing of side effects etc. The regime I would be having is called FEC –T in shorthand.
FEC–T is named after the initials of the chemotherapy drugs used, which are:
Fluorouracil, which is also called 5FU
Epirubicin
Cyclophosphamide
Docetaxel, which is commonly known as Taxotere®



FEC–T treatment is usually given as a day patient and you are given a number of other drugs to stop the major side effect of sickness and nausea
The side effects kick in at different times. If you are going to get sick, this usually happens within a few hours of having the chemo and can last for several days. Things like mouth ulcers, and a metallic taste in a couple of days, fatigue at any time, and increased risk of infection after between 7 and 14 days after the dose. I would just have to hope for the best.